Body Lift Risks and Potential Complications
All surgeries come with risks and potential complications, no matter what the procedure is. The decision to undergo surgery is different for everyone and the desired procedure should be considered carefully, weighing the goals and outcome with the risks and potential complications. Understanding the risks and potential complications will help make an informative decision about going forward with body lift surgery. The combination of lower and upper body contouring procedures can increase risks associated with wound healing and deep vein thrombosis. It also increases the risk for additional or secondary surgery. Below is a list of possible risks associated with body lift surgery.
Anesthesia: The risks of local and general anesthesia will be discussed by the anesthesiologist on the day of surgery.
Unfavorable Scarring: Any time the body is cut, a scar forms. After surgery, the site of the incisions will leave scars. If the area does not heal properly or healing takes longer than normal, the scars can become thicker. When incisions heal quickly, typically the scars are thinner. Scarring is permanent but they do fade over many years. However, because everyone is different, how a scar heals and what it ultimately looks like is unpredictable. Scars can be uneven, extra wide and/or asymmetrical, and the appearance of them can even vary within the same region. They may bunch and seem unattractive and become a different color than the skin surrounding it. Excessive scarring, extra thick scarring, referred to as hypertrophic scarring, and scarring that extends beyond the original wound, referred to as keloid scarring, are not common but can happen. Additional treatments or secondary surgery may be needed to correct abnormal scarring.
Bleeding/Hematoma: If the incisions do not heal properly, bleeding can result. If the blood does not coagulate or clot correctly, excessive bleeding may occur after the surgery. See your doctor immediately if there is any unusual bleeding. If bleeding does occur, there is a risk for developing a hematoma, or an abnormal collection of blood, under the skin, which can expand the skin and create a bulge that is tender to the touch. This could involve emergency treatment to take care of the blood collection and a blood transfusion may be required to replace any lost blood. To help reduce the risk of bleeding, do not take aspirin, blood thinners or anti-inflammatory medications for the 2 weeks prior to surgery. Also avoid herbal and dietary supplements, as these can increase the risk of bleeding. Speak with your doctor if you are unsure about discontinuing any of your medications.
Infection: A rare but potential risk of body lift surgery is an infection with fever, coupled with expansive areas of red skin, known as cellulitis. Treatment that includes intravenous antibiotics or additional surgery may be required for a serious infection in order to remove any dead tissue. Minor infections that are accompanied by spitting sutures (the result of the body rejecting the suture and pushing it out of the body) and exposed sutures may happen but are typically treated with antibiotics, limited debridement (the removal of the unhealthy tissue) and dressing care. There is an increased risk of infection for smokers, diabetics, malnourished individuals and those who have had multiple surgeries.
Seroma: A rare but potential risk is the accumulation of fluid under the skin, known as a seroma. Once surgery is complete, drainage tubes are sometimes placed at the surgical site to catch any leaking fluid. Drains are normally removed after 5 to 7 days but body fluids, referred to as serum, can accumulate under the skin. Treatment includes aspirating, or removing the fluid through a needle, but if this does not correct the problem, a visit to the doctor's office or hospital may be needed to remove the seroma and insert new drainage tubes.
Poor Wound Healing: Poor wound healing can occur in individuals who smoke or heal slower than the average healing rate. Individuals with nutritional deficiencies also have an increased risk of not healing properly. Sutured areas may reopen too easily or the wounds may be more prone to infection. Avoid smoking 3 weeks before and after surgery to promote the natural healing process and reduce the risk of poor wound healing.
Wound Dehiscence: Wound dehiscence is when the sutures burst open or split. The closure of the wound is in multiple layers of skin. Separation of any of these layers, whether superficial or deep, can happen in the first month following surgery. Wound dehiscence can be caused by broken or torn sutures, knots untying, too much moving around or bending, or skin necrosis, which is the death of skin tissue.
If the sutures break at the superficial layer of skin, the sutures can be closed or allowed to heal naturally. Sutures that break at the deeper layer of skin may require additional surgery that would necessitate anesthesia to close the sutures. Changing the dressing frequently, making extra office visits and additional surgery could be required to remove the tissue that has not healed. Wounds that can heal on their own benefit from secondary scar revision. Open wounds may need to be closed again as healing on their own could take weeks. Individuals who smoke have an increased risk of complications from wound healing and a higher risk of skin loss. It is advised to refrain from smoking for 3 weeks before and after body lift surgery.
Suture Granuloma: The techniques used for body contouring create multiple deep sutures. One or more of these sutures might be noticeable after surgery. If absorbable sutures were used, this problem usually resolves on its own. However, some sutures may need to be removed if they extrude through the skin, become visible or cause irritation.
Skin Necrosis: Necrosis of the skin, or death of the skin tissue, may occur at the surgical or incision site, causing the skin to change color and fall off. Necrotic skin can become infected with bacteria or microorganisms, a problem which might call for additional surgery.
Paresthesia: Paresthesia, or altered sensation, is something that may happen after surgery. Paresthesia may be increased sensitivity, exhibiting as pain, or numbness, which is a loss of feeling. Numbness is a normal surgical consequence that happens at the site of incisions but the extent to which it happens is different for everyone. Numbness subsides 4 to 6 months after surgery in the majority of individuals. Rarely, the numbness is permanent. Massage the surgical area to help reduce numbness and increase circulation to encourage normal skin sensation. As the nerve endings in the skin regenerate, burning, itching or the feeling of pins and needles may occur.
Contour Irregularities: Irregularities and depressions in contouring can occur after body contouring procedures. Once in a while, bulges or asymmetrical fullness may also be present.
Asymmetry: People tend to be asymmetrical; that is, their right side does not match their left side. Therefore, after body contouring surgery, an asymmetrical appearance is entirely possible. Asymmetry of contour and scar placement can also occur. Significant asymmetry could require additional surgery.
Skin Discoloration/Swelling: Skin discoloration and/or swelling may happen as a result of body contouring surgery. Rarely, swelling and/or skin discoloration may last for long periods of time and skin discoloration may become permanent.
Persistent Pain: Pain that becomes persistent and lasts for a long period of time can happen but seldom does. This is a result of nerves becoming trapped in scar tissue.
Nerve Damage: Nerve damage is possible should there be improper healing. This possibility should be discussed with your doctor prior to undergoing body lift or body contouring surgery. Nerve damage can show as over-sensitivity or a lack of sensitivity at the surgical site.
Internal Damage: Surgery carries risk of internal damage, such as injury to fat, muscles, nerves, blood vessels, lungs or bowels. This type of injury to the internal bodily structure may be temporary or permanent.
Fatty Necrosis: From time to time, the fatty tissue under the skin can become necrotic following surgery. Fatty necrosis looks like a small, firm lump of tissue, typically developing around the incision site, which can be excised at a future date.
Allergic Reactions: Speak with your doctor prior to surgery about any allergies you may have. Localized allergies to gloves, tape, suture material, topical preparations or injected agents have been reported in rare cases. A more serious systemic reaction as a response to drugs used for surgery or prescription medications following surgery can happen. Additional treatment may be necessary should an allergic reaction develop.
Residual Deformity: Residual deformity is possible, though tight contours are the goal with body contouring surgery. Small amounts of deformity may be present or develop months following the surgery.
Revision Surgery: Occasionally, additional procedures are necessary for a variety of reasons; some small, some involved. Complications may arise. Results for a desired appearance are not met. These reasons may call for secondary surgery or other treatments to rectify the situation.
Suboptimal Aesthetic Result: There is always a chance you will be disappointed with the results. Despite all the preparation and procedures discussed beforehand, the ultimate results of surgery may not be what you hoped, for whatever reason. There may be residual looseness or excessive tightness of skin, flattening of regional contours, or widening or thickening of scars. If wanted or needed, secondary procedures may be performed to help improve the desired outcome.
Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is a rare but serious complication of plastic surgery. It occurs in the deep veins of the legs when a blood clot forms during anesthesia and surgery. A small percentage of individuals may develop DVT, though a sequential compression device is used for up to 5 days after surgery. This compression device helps reduce the risk, as does early post-operative mobility. Moving around shortly after surgery is beneficial to keep the blood circulating so it does not have time to become stagnant in the leg muscles. A rare condition from liposuction is a fat embolism, described as loose fat that enters the bloodstream through injured blood vessels. Fragments of fat become trapped in the blood vessels and collect in the lungs or travel to the brain. As a result of the migration of fat or blood clots, pulmonary complications can occur. When the complications happen in the lungs, it is termed pulmonary emboli. Symptoms of pulmonary emboli include shortness of breath or difficulty breathing, and should be brought to the attention of a doctor immediately. Hospitalization and additional treatment could be needed. Pulmonary emboli is a serious condition that can be life-threatening and sometimes fatal. Inactivity and other medical conditions can increase the risk of developing blood clots.
Other risk factors include:
- Over the age of 60
- First and second hand smoke
- Surgery within the previous 3 months
- Oral contraceptives or estrogen therapy
- Family history of clotting disorders, such as Factor V Leiden mutation
- Heart failure
- Recent trauma
- Leg immobilization or paralysis
- White blood cell disorders, such as leukemia or polycythemia vera
- Kidney disorders
- Pregnancy and postpartum (period after childbirth)
- Paroxysmal nocturnal hemoglobinuria (episodic loss of hemoglobin)
- Anticancer drug use, including tamoxifen
- Inflammatory bowel disease
Cardiac Complications: With any major stress on the body, such as that with surgery or anesthesia, cardiac complications are a risk even if the individual does not have any prior heart conditions. Speak with your doctor before surgery to make sure you are medically cleared to have surgery.
Long Term Effects: There is the possibility of bodily alterations not related to the body lift procedures as a result of aging, pregnancy, weight gain or loss, or other circumstances.
Navel Loss: Scarring or an unacceptable appearance is possible in the navel area following abdominoplasty surgery. Malposition, or a partial or complete loss of the navel can occur after the procedure.
Pubic Distortion: A potential complication is distortion of the pubic area. It may happen on either side, though this problem is usually temporary. Secondary surgery could be needed.
Pubic Distortion: Pubic distortion may occur after a spiral thighplasty, or medial thigh lift, as well as distortion of the labia but this is rare for women. Secondary surgery may be necessary.
Lymphedema: Lymphedema, or a persistent swelling, can occur after a thighplasty or thigh lift in the lower extremities. This is a result of the lymphatic vessels not draining the lymph from the legs properly. Though this is rare, the swelling can last up to 12 months or even longer. Compression stockings are typically used to help with this complication.
Thigh Tightness: The feeling of tightness in the thighs is rare but should it occur, is usually temporary.
Visceral Perforations: Visceral perforations are puncture wounds in the organs. During liposuction, damage to the internal organs can happen from the use of the liposuction cannula. Should organs become damaged, additional surgery may be warranted to repair them. However, this complication can also be fatal.
Fat Absorption: About 20 to 30 percent of the fat that is injected into the buttocks does not stay and is absorbed by the body. In cases where this creates an unevenness, some areas will appear or feel asymmetrical. To help combat this, gently massaging the buttocks area during recovery will help smooth and even out the areas of asymmetry.
Sclerosis: A potential complication of buttocks lipoaugmentation is sclerosis, or an abnormal hardening of the tissue.
Skin Irregularities: Irregularities or depressions in the skin may occur following liposuction. In the areas where the fat is injected, contour irregularities, such as bumps and dimples can develop, depending on the skin's elasticity. Bulges, depressions or asymmetrical fullness may also develop. Massaging the buttocks area during recovery can help smooth out the irregular areas.
Asymmetry: The body is not symmetrical; one side does not match the other. Logically then, asymmetries are entirely possible following buttocks augmentation. The unevenness can be seen as a difference in contour and size for each side of the buttocks. Spine disorders, such as scoliosis can enhance the body's asymmetry.
Infection: Infection is always a risk with surgery and buttocks lipoaugmentation is no exception. The risk of infection increases with amount of fat being injected into the buttocks. However, the risk of infection is low as a result of antibiotics being used during and after surgery.
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