Risks of Surgery

Every surgical procedure carries risk. Being clear about what can go wrong is an essential part of informed consent, and understanding these possibilities helps you weigh whether an operation is the right decision for you.

The information below is general in nature. It describes complications that are recognised in plastic and reconstructive surgery, but it is not a complete list, and it is not a substitute for a consultation. Dr Shepherd will discuss the risks that apply specifically to your procedure, your health history and your circumstances, and these will be set out in the consent documents you review before surgery.

The following are examples of complications that can occur following cosmetic or reconstructive surgery. They include, but are not limited to:

Haematoma (collection of blood)

Blood can pool underneath the skin, most commonly within the first day after surgery. Depending on the size, a return to theatre may be needed to drain it.

Seroma (collection of fluid)

Clear fluid can gather in the surgical space during the weeks following an operation. Smaller collections often resolve without intervention, while larger ones may need to be drained with a needle or a drain tube. Wearing your compression garment as directed reduces the likelihood.

Infection

Sterile technique lowers the risk of infection but does not remove it. Wound infections are managed with antibiotics and wound care. Contact the practice promptly if you notice redness, warmth, discharge, fever, or pain that is worsening rather than settling.

Slow healing or wound separation

Wounds may take longer to close than expected, or the edges may partially separate. This is more likely if you smoke or vape, carry excess weight, have diabetes, or have impaired circulation. Extended dressing regimes or a further procedure may be required.

Changed sensation and numbness

Reduced feeling near the incisions is expected in the early recovery period and usually improves gradually. Some alteration in sensation can persist for one to two years, and in a small number of cases it does not fully return.

Scarring

Scars are an unavoidable outcome of surgery. They typically pass through a red, firm phase over several months before gradually softening and fading across the following year or more. Some people are prone to thickened (hypertrophic) or keloid scars, which may require silicone products, steroid injections, laser treatment or surgical revision. Incisions are planned to sit as inconspicuously as the procedure allows.

Loss of skin or fat tissue (necrosis)

If the blood supply to an area of skin or fat is compromised, that tissue can die. This slows healing and sometimes requires additional surgery. Nicotine use substantially increases this risk.

Asymmetry and contour irregularities

Small differences between the left and right side are normal, both before and after surgery. Firmness, dimpling, or rippling can develop after body contouring procedures. A minor revision is occasionally considered once the tissues have fully settled.

Prolonged swelling and changes in skin colour

Bruising and pigmentation changes may take weeks or months to resolve. Intermittent swelling can continue for some time after that.

Further surgery

A secondary procedure is sometimes recommended to refine the result, improve scar appearance, or address asymmetry once healing is complete.

Risks tied to specific procedures

Some complications are particular to the operation being performed. Examples include capsular contracture or implant rupture following breast augmentation, surface irregularities following liposuction, excess skin folds at the ends of an incision line, and changes to the position or sensitivity of the nipple and areola after breast surgery. The risks relevant to your operation will be detailed in your consent documentation.

Factors that increase your risk

Smoking and vaping, uncontrolled blood pressure, a high body mass index, and certain medications and supplements (including aspirin, anti-inflammatories and high-dose vitamin E) all raise the likelihood of complications. Dr Shepherd will advise you on how to prepare and which medications may need to be paused.

Regardless of the procedure, all surgery carries a set of shared risks. These include, but are not limited to:

Bruising, swelling and skin discolouration. Common in the early weeks. Compression and adherence to your post-operative instructions help. Sudden marked swelling, fever, or escalating pain requires urgent assessment.

Bleeding and haematoma. Continued bleeding may need urgent drainage and raises the risk of subsequent infection. Managing blood pressure and pausing specified medications and supplements reduces the risk.

Wound breakdown. Can result from infection, tension across the closure, poor blood supply, pressure on the area, or underlying medical conditions. Prolonged dressings or further surgery, including skin grafting, may be needed.

Allergy and sensitivity reactions. Some patients react to antiseptic solutions, tapes, dressings, sutures or topical preparations. These are usually mild and settle once the cause is identified.

Suture complications. Stitches can occasionally work their way to the surface or produce a small inflammatory lump. These are generally straightforward to manage in clinic.

Thickened, keloid or widened scars. More likely in some skin types and where healing has been delayed. Treatment options include silicone therapy, taping, steroid injection, laser or surgical revision.

Deep vein thrombosis and pulmonary embolism. A clot forming in the leg can travel to the lungs, which is a potentially life-threatening event. Preventive measures include getting up and moving early, compression stockings, and blood-thinning medication where the risk profile warrants it.

Complications related to nicotine. Smoking and vaping meaningfully increase the risks of infection, wound breakdown, tissue necrosis, clotting and respiratory problems. Ceasing at least four weeks before surgery and for four to six weeks afterwards is strongly advised.

Persistent pain. Uncommon, but scar tissue can occasionally involve or irritate a nerve, producing ongoing discomfort that can be difficult to resolve completely.

Anaesthesia is generally safe for healthy patients, and your anaesthetist will plan your care around
your health status and the operation being performed. As with any medical intervention, potential
risks exist, including but not limited to:

Side effects after anaesthesia. A sore throat from the breathing tube, nausea and vomiting, drowsiness, shivering, headache, or discomfort at the drip site. These usually settle quickly with treatment.

Dental and oral injury. Teeth can be damaged during airway management, and minor injuries to the lips or tongue are more common. Your anaesthetist will check for loose or fragile teeth before your procedure.

Eye irritation or corneal abrasion. The surface of the eye can rarely be scratched while you are unconscious. This typically heals without lasting consequence, and the eyes are taped and protected to reduce the chance.

Nerve injury and positioning issues. Uncommon. Pressure or body position during a longer operation can irritate a nerve and cause temporary numbness or weakness. Lasting problems are rare, and careful padding and positioning reduce the risk.

Confusion or delirium after surgery. Usually short-lived, and more frequently seen in older patients or those in poorer health. It generally appears within the first few days and resolves as the contributing causes are addressed.

Drug reactions and allergy, including anaphylaxis. Severe reactions are rare but need immediate treatment. Your anaesthetist will review your medical and allergy history beforehand.

Awareness during general anaesthesia. Very rare. Anaesthetic teams use several safeguards to prevent unintended recall.

Respiratory complications. Aspiration, bronchospasm, or partial collapse of a lung can occur infrequently. Fasting instructions and airway protection reduce these risks.

Rare but serious events. These include cardiac rhythm disturbances, heart attack, stroke and severe infection. Your individual risk depends on your general health and the type and length of your operation.

• Stop all nicotine use, including vaping, for at least four weeks before surgery and four to six
  weeks afterwards.
• Follow the medication instructions you are given, including pausing aspirin, anti-
  inflammatories or supplements where advised.
• Address your general health beforehand: blood pressure control, weight management,
  correcting anaemia, and good nutrition all support healing.
• Move as instructed after surgery and wear your compression garments as directed.
• Attend every follow-up appointment, and contact the practice early if something concerns you.

The complications described on this page are examples only, and the list is not exhaustive. Individual risk varies considerably depending on medical history, lifestyle factors and the specific procedure being undertaken. Your own risks will be discussed in detail at consultation and documented in your consent paperwork.

This page provides general information and does not replace a consultation with your surgeon and anaesthetist. If you have questions at any stage, before or after your procedure, please contact our team.

For further information about surgical risk, please contact Dr Henry Shepherd’s practice.