What are the general risks of body contouring surgery?
All operations carry risks. You must be fully aware of all risks that could occur and happy to proceed knowing what complications are possible and expected. Body contouring surgery carries a high risk of developing a complication. Up to 50% of patients will develop one. However, these may be minor complications that are easily managed without further surgery.
Bleeding/Haematoma
This can occur at the time of the operation or afterwards. If afterwards, it may present as blood in your drains, if present, or swelling to the operated area called a haematoma. It may require a return to the operating theatre.
Seroma
The body produces fluid in the area operated on. If that fluid collects and swells, it is called a seroma. This often reabsorbs by itself, but may take a long time to do so. Sometimes, it may require drainage with a needle or even a return to theatre.
Infection
Early signs of infection include increasing pain that often throbs, spreading redness and you may even develop a thick yellow smelly discharge. If seen early, infection may be easily treated with antibiotics. If this it is left, however, it may lead to potential long term problems and may even be life-threatening. If in any doubt, you must immediately seek medical help at Accident and Emergency.
Prolonged/persistent swelling
This is very common after surgery. The swelling after body contouring surgery may take many months to fully settle and in some cases, may be persistent, such as in lymphedema.
Skin excess/dog ears
When skin has been moved and tightened, there may be small excesses formed at the ends, these are also called dog ears. These often settle with time, but occasionally require a small procedure, often under local anaesthetic in theatre, to correct the excess.
Tissue/skin death
All forms of body contouring surgery may lead to reduced blood flow to some areas of skin. An example may be the nipple area after a mastopexy. If the blood supply to an area of skin or tissue is interrupted, the skin will die. This leads to a scab forming, which can often be managed with dressings and allowed to heal by itself. Sometimes, it requires a further operation to remove the dead tissue.
Altered/loss of sensation
It is normal to expect some loss of feeling in the skin around the area operated on. This may also extend to adjacent areas if nerves run nearby. Examples here are numbness in the lateral thigh caused by damage to the lateral cutaneous nerve of thigh during an abdominoplasty, and numbness in the medial leg if the saphenous nerve is damaged during an inner thigh lift. This is often temporary, but may be permanent.
Scars
As the wounds heal, they will form scars, which will initially be red, raised, lumpy areas. These tend to soften, flatten and become paler with time and may take many months to settle.
Asymmetry
Asymmetry is very common. Any surgery on two sides of the body may lead to asymmetry. In most cases this is because of pre-existing asymmetry, but can occur following surgery too.
DVT/PE
Blood clots in the legs (deep vein thrombosis or DVT ) can migrate to the lungs (pulmonary embolism or PE) and can occur after any prolonged surgery. Early mobilisation, maintaining good hydration and blood thinning medication are ways to prevent this problem.
Dissatisfaction with results
Despite the best efforts of your surgeon and the post-operative care you receive, it may still be that you are unhappy with your final results. Perfection is not possible with this surgery but an improvement is expected. Understanding what can and cannot be achieved is important. Your surgeon will help generate realistic expectations with you.
What are the specific risks of body
What are the specific risks of an apronectomy/abdominoplasty/belt lipectomy?
Nerve injury
It is common to develop numbness around your wound after the surgery, this may be temporary or permanent. The surgery also carries a risk of damaging nerves that give feeling to the skin on the upper outer parts of both thighs. These nerves do not control any movement, only feeling. Again, this may be temporary or permanent.
Distortion of surrounding tissues
As part of the closure of the wounds, the surrounding tissues can be pulled together leading to distortion. In women, this may lead to the mons pubis (tissue where pubic hair grows) being pulled up and distorting the external genitalia.
Total or partial loss of belly button
In an abdominoplasty or belly lipectomy, the surgery may also involve cutting around the belly button and repositioning it as the abdominal skin is tightened. This can sometimes interfere with the blood supply to the belly button and lead to some or all of it being lost and replaced by a scar.
What are the specific risks of a brachioplasty/inner thigh lift?
Prolonged swelling/lymphoedema
It is common to have prolonged swelling in the area following the surgery. However, in some cases, the draining fluid channels (lymphatics) may be damaged and this may result in long-term swelling that could require compression garments.
Nerve injury
The surgery carries a risk of damaging nerves that give feeling to the skin on the upper arms and forearms in a brachioplasty, or the inner and outer aspects of both thighs with an inner thigh lift. These nerves do not control any movement, only feeling. Again, this may be temporary or permanent.
Distortion of surrounding tissues
In women undergoing an inner thigh lift, lifting of the thigh tissues can cause pulling and distortion of vulva. This may lead to an appearance of the vulva being spread.
What are the specific risks of a mastopexy?
Total or partial nipple or skin loss
As part of this surgery, the blood supply to the nipple, areola or skin could be damaged. This may lead to part or all of the nipple, areola or patches of skin not surviving. This will cause a scab to form, leading to an eventual a scar over the area.
Altered nipple sensation
The surgery may also lead to increased, altered or decreased sensation of the nipple and areola, with a risk of total numbness to the area.
Inability to breastfeed
Following this surgery, there is a small risk of being unable to breastfeed or not producing enough milk.
Delayed healing/wound dehiscence
It is relatively common that small areas of the wounds, such as the point where the breast meets the chest underneath, may take longer to heal and may lead to a slightly widened scar in this area.
Asymmetry
This is almost always the case. It is impossible to make both breasts absolutely identical and asymmetries that exist before the surgery tend to persist afterwards.