All cosmetic surgery is invasive and carries risks. The risks of surgery varies with the type of surgery and also with the background health of the patient. It is important that patients consider these risks when deciding to undergo any type of surgical procedure – especially cosmetic surgery, which is by definition completely elective and not being performed to improve someone’s health.

Generally speaking, the bigger the surgical procedure, the bigger the risk of serious complications

The decision to undergo surgery – especially cosmetic surgery – is a serious one. Patients must carefully weigh the options and consider the training, experience and expertise of their chosen surgeon before deciding to undergo cosmetic surgery.

As a result of rules introduced by AHPRA in July 2023, all patients presenting for cosmetic surgery must

• Have a referral for their GP to see their chosen plastic surgeon
• Undergo a screening assessment (series of questions) to make sure they are not suffering from Body Dysmorphic Disorder
• Have two consultations prior to any cosmetic surgery
• Consider non-surgical options

Here are some risks associated with all cosmetic surgery procedures. Obviously specific procedures have specific risks, but here are the general ones

• Scarring

All surgery involves making scars. Scars tend to fade over time and become less noticeable. However different people scar differently. All scars are permanent to some degree. Some scars can be red, some scars can be raised. Others can stretch or be indented. Sometimes there are lumps at the end of the wound called “dog ears”. Some patients can develop tick lumpy scars called “keloids”, which themselves require treatment. Although sutures are used to put the skin back together, sometimes there can be wound healing problems that require dressings. Sometimes revision surgery is required to correct scars.

• Infection

Infections can occur after any surgery. Some infections are minor and settle with tablet antibiotics. Some infections can be more serious and even require admission to a hospital or even further surgery. Infections can occur at the site of surgery, or elsewhere like the lungs or bladder.

• Pain

Pain can occur after any surgical procedure. Although pain killers are usually given during surgery, when these wear off patients often require extra pain killers. Most commonly these are tablets. Some pain killers are very strong and mean that a patient can’t drive or drink alcohol while they are taking that pain medication. Different people experience pain differently. Some patient require ongoing pain killers even after all their wounds have healed

• Undesirable Cosmetic Outcome

A/Prof Damian Marucci is a well trained, experienced and caring plastic surgeon. He strives to give every patient the best outcome he can. Sometimes, even when a surgeon and the team have done everything “right”, the patient can be left with a cosmetic outcome they are not happy with. Sometimes this is because of unanticipated scarring or swelling or infection. Sometimes it is because the patient’s expectation of the outcome were not the same as the surgeon’s ability to achieve that outcome. Rarely, errors of management occur. Poor or undesirable outcomes are upsetting the patient – and the surgeon. A/Prof Marucci takes the time to understand a patient’s goals before the surgery and does everything possible to correct the situation when those goals aren’t met. This may involve further surgery – which may itself entail further scars, risks and expense.

• Nerve Damage

Nerves are found everywhere in the body. Some nerves carry impulses to muscles to make them move (‘motor nerves”). Other nerves carry information about sensation back to the brain (“sensory nerves”). Still other nerves carry non-conscious regulatory impulses to and from organs in all parts the body (“autonomic nerves”). Any surgery runs the risk of damaging nerves. Nerve damage may result in pain, burning, loss of sensation and, very rarely, loss of movement. The risk of nerve damage varies with different surgical procedures.

• Bruising and Swelling

All surgical procedures are followed by some bruising and swelling to some degree. Bruising can be unsightly and goes through colour changes with time (red to purple/black to green to yellow). Swelling can sometimes takes weeks or even months to completely go away.

• Bleeding

Bleeding can occur after any surgery. Sometimes the bleeding stops on its own and there is just some swelling and bruiding to wait out. Other times bleeding doesn’t stop and patients need to return to the operating theatre, involving further surgery, recovery time and costs. Very rarely in cosmetic surgery, significant bleeding can occur and patient can require a blood transfusion.

• Seroma

With some types of surgery, drains are placed into the woundin order to remove any fluid that may be underneath the skin.Occasionally, even once these drains have appeared to stop draining, some patients will nevertheless develop a fluid collection, called a “seroma”.The risk of having a seroma is that it can become infected. Seromas may need to be drained, either with the use of ultrasound or else under general anaesthesia in an operating theatre.

• Anaesthetic Complications

Any anaesthetic put strain on the heart and lungs. The anaesthetist will closely monitor a patient who is undergoing surgery in order to make sure that there are no issues with their breathing,blood pressure or their pulse. The anaesthetist may need to give a patient fluid of medicines during surgery. There are risks of a heart or lung damage with any surgical procedure. Problems with anaesthesia may involve

• Death

The risk of death from cosmetic surgery is extremely small. Having your surgery performed in an accredited facility, with a properly trained anaesthetist, surgeon and nursing staff will minimise the chances of poor outcomes.