Plastic surgery encompasses a wide variety of procedures for the face and body. From nose jobs to breast implants, we perform a broad scope of body changes. While the vast majority of these procedures do very well and patients have an uncomplicated after surgery course, some patients will experience complications. The occurrence of complications in plastic surgery, of the minor variety, are not rare. Major complications in plastic surgery, fortunately, are very rare.
Interestingly, there is a vast difference in the occurrence rate and types of complications between plastic surgery of the face and that of the body. While patients understandably place a greater emphasis on procedures done to their face, the actual rate of significant complications from facial plastic surgery is quite low. There are several reasons for this that include; the tremendous blood supply to facial tissues which is quite resistant to infection and allows most wounds to heal quite quickly (including the clearing of bruising and swelling), cosmetic surgery of the face is really ‘superficial’ surgery and does not enter any major body cavities or cause major pain and surgery on the face does not disrupt the body’s physiologic functions (like temperature control and fluid shifts) like body plastic surgery does. For these reasons, facial plastic surgery procedures do not pose the same systemic risks as body plastic surgery such as deep vein thromboses, pulmonary embolisms, and infection. Most complications in the face, short of bleeding and hematomas, are mainly about appearance, symmetry, and scarring. Not that these are not significant, but they rarely are life-threatening or invoke major medical problems.
Body plastic surgery, conversely, carries with it bigger risks in my opinion. First, body plastic surgery is ‘bigger’ and involves more surface area of the body than the face. Whether it be liposuction or a tummy tuck, large body areas are being opened or manipulated. As a result, the issues of blood loss, adverse temperature changes, and fluid shifts are real potential issues and expose the patient to greater medical risks such as fluid collections (seromas) and blood clots. Second, the blood supply below the neck to any one body part is not as great as any part of the face. Therefore, infection rates for body plastic surgery are definitely greater than that of the face. While patients are more tolerant to small differences or asymmetries on the body as opposed to the face, the chances of more significant differences is also likely because the surgery site is much bigger and the changes being made are bigger. No where are these issues more evident than in bariatric plastic surgery, the extreme end of body plastic surgery, where big skin cutouts, long incisions, and extended operating times test the ability of any patient to heal in an uncomplicated manner.
Potential complications are part of any form of plastic surgery and fortunately most are relatively minor and are often just a bump (aggravating as that is) along the way of recovery. However, body plastic surgery is associated with longer recoveries (for many of the procedures) and higher rates of complications such as wound dehiscences, seromas, and asymmetry between body parts. This is in contrast to plastic surgery of the face where the surgical sites by comparison are smaller and healing is much quicker and less complicated.
Dr. Barry Eppley
Indianapolis, Indiana