What are the potential risks of Body Lift Surgery?

Every surgical procedure has its potential risks even with the best surgeon. The decision to have body contouring done is extremely personal, and one should decide if this procedure is worth the possible risks. Before having any cosmetic procedure done, you should have a full understanding of the procedure itself. It is important for you to realize that combining lower and upper body contouring procedures can increase the risks related to wound healing, the need for revisional surgery, and deep venous thrombosis (DVT). Below, you will learn more about potential complications and how to prevent them. Click here to view our plastic surgery gallery. 

Potential risks of body contouring surgery can include:

Surgical Anesthesia: On your surgery day, your anesthesiologist will speak with you about the risks of local and general anesthesia.

Scarring: Every surgery leaves scars at the site of incisions. Although if the sutured area doesn’t heal properly or takes too long to heal, the scars may be thicker than expected. If the patient heals relatively quickly, thinner scarring is expected. Scars can take years to fade, but they are long-lasting. Despite Dr. Agha’s best efforts, scar appearance and healing are not fully predictable. The scars may be uneven, wide, and/or asymmetrical. Scar appearance may vary within the same region, exhibit unevenness, or can bunch. Scars may also appear asymmetrical, and of a different color than the surrounding skin. Having excessive, hypertrophic, and keloid scarring are uncommon, but can occur. Additional treatments or surgery, may be necessary to treat abnormal scarring.

Bleeding or Hematoma: Bleeding may result if the sutured areas do not heal correctly or if there is improper coagulation after the procedures. If a patient notices any unusual bleeding after a surgical procedure, they should contact Dr. Agha immediately. Do not take any aspirin or anti-inflammatory medications for two weeks prior to your surgery as this will increase the risk of bleeding. Non-prescription “herbs” and dietary supplements can also increase the risk of surgical bleeding. If bleeding does occur, hematoma (blood collection) may develop under the skin and expand as a tender bulge. This may require an emergency treatment to remove the blood collection. Also, blood transfusions may be needed to replace the lost blood volume.

Infection: An infection with a fever and large areas of red skin (cellulitis) is unusual after this type of surgery. If a serious infection does occur, treatment, including intravenous antibiotics or additional surgery to remove dead tissue, might be necessary. Minor wound infections accompanied by exposed and “spitting” sutures can occur and are usually easily dealt with by limited debridement, antibiotics, and dressing care. There is a greater risk of infection in smokers, malnourished patients, people with diabetes, and with multiple surgical procedures.

Fluid Accumulation (Seroma): Drains are placed at the surgical site at the end of the operation to collect seepage of fluid. After being removed in about five to seven days, body fluids (serum) occasionally accumulate underneath the skin. This may require aspirations. If that fails to cure the seroma, then the patient will need to be seen either in the office or the operating room for insertion of new drainage tubes and removal of seroma cavities. This is very rarely needed.

Improper Wound Healing: Individuals with a slower than average healing rate or smokers may not heal as well. They may notice that the sutured areas reopen easily, or that they are more prone to infection. Patients should avoid smoking three weeks prior to and after the procedure so that their body’s natural healing process is not hindered. Patients with nutritional deficiencies may be at risk for poor wound healing.

Wound Dehiscence: Generally, your skin closure is in multiple layers. Separation of the superficial, deep, and/or both layers may occur any time during your first post-operative month. The recognized causes of dehiscence include, suture breakage, knots untying, suture tearing, too much movement or bending, and skin necrosis (death). Breakage of sutures in the superficial layer of skin may be sutured closed or allowed to heal secondarily at the judgment of Dr. Agha.

Deep dehiscence may require a return trip to the operating room for closure under anesthesia. These healing problems may need frequent dressing changes, additional office visits, and further surgery to remove the non-healed tissue. Open wounds may take weeks to heal or a secondary closure may be appropriate. Wounds allowed to heal on their own usually benefit from secondary scar revision. Smokers have a higher risk of skin loss and wound healing complications. Do not smoke for three weeks before and after your surgery to prevent these risks.

Suture Granuloma: Body contouring techniques use multiple deep sutures. Sometimes, one or more sutures may be noticed by the patient following surgery. These usually resolve since most of the stitches used by Dr. Agha will be absorbed by your body. However, sutures can spontaneously extrude through the skin, be visible, or cause irritation that requires removal.

Skin Necrosis (Death): The skin at the site of surgery or incision site may become necrotic or “die.” When this happens, skin may change color and fall off. Necrotic skin may become infected with bacteria or microorganisms. This may require further surgical treatment. 

Numbness in Skin: This is a normal consequence at the site of surgery in everyone to a different extent. You may experience “paresthesia,” which is an altered sensation. This may either be increased sensitivity or pain in the area, or loss of any feeling or numbness in the area. In most patients, numbness goes away within the first four to sixth months after surgery. By massaging the surgical area, this helps increase circulation and facilitates the return of normal skin sensation. As nerve endings regenerate, you may experience pins and needles, burning or itching. Skin numbness is long-lasting in very rare cases.

Contour Depressions: Contour irregularities and depressions can occur after body contouring procedures. Sometimes, asymmetrical fullness, bulges, and depressions may occur.

Asymmetry: Most patients are asymmetrical with their right and left face, breast, and body. Therefore, asymmetrical body appearance, contour, and scar placement may occur after body contouring surgery. This may require additional surgery.

Skin Discoloration or Swelling: Skin discoloration and swelling can occur following body contouring surgery. In rare cases, swelling and skin discoloration may persist for long periods of time. Permanent skin discoloration is extremely rare.

Persistent Pain: A patient having long-term persistent pain may occur, from nerves becoming trapped in scar tissue after surgery.

Nerve Damage: The patient may have some nerve damage if improper healing occurs. The possibility of nerve damage should be discussed with the doctor before the procedure. Nerve damage can result in over-sensitivity or it can result in a lack of sensitivity at the surgical site.

Damage to Other Structures: There is the potential to injure fat, muscles, nerves, blood vessels, bowels, and lungs during any surgical procedure. Injury to the deeper structures may be temporary or long-lasting.

Fatty Necrosis: Rarely, fatty tissue under the skin can undergo skin necrosis (death) after surgery. This usually shows at the incision sites as a small lump of firm tissue that can be excised at a later date.

Allergic Reactions: In rare cases, allergies to tape, gloves, suture material, injected agents, or topical preparations have been reported. More serious systemic reactions can include, response to drugs used during surgery and prescription medicines. Allergic reactions may require additional treatment.

Residual Deformity: Despite best efforts to obtain tight contours, a small degree of residual deformity may develop months after the surgery.

Revisional Surgery: The practice of surgery is not an exact science. If complications occur or some aesthetic expectations remain unmet, additional procedures or other treatments may be needed. Other complications and risks can occur, but are more uncommon.

Suboptimal Aesthetic Result: You may be disappointed with the results of the surgery. Having residual laxity and looseness or over-treatment with excessive tightness of the skin can occur with the flattening of regional contours, and the widening or thickening of scars. While considerable judgment is used to achieve the optimum shape, for a variety of reasons, the ultimate results may be suboptimal. At times, it may be desirable to perform additional procedures to improve your results.

Deep Vein Thrombosis (DVT) and Pulmonary Complications: Deep vein thrombosis is a rare but worrisome complication of cosmetic surgery. It represents the formation of a blood clot in the deep veins of the legs during anesthesia and surgery. A sequential compression device will be used for up to five days after surgery to reduce the risks during and after the surgery, however, a few patients may still develop DVTs. Its frequency is reduced by early post-operative mobility so that blood does not have time to become stagnant in a person's calf muscles. A fat embolism during liposuction is an extremely rare condition where loosened fat enters the blood through injured blood vessels during liposuction. Fat fragments can then become trapped in the blood vessels, gather in the lungs, or travel to the brain.

Pulmonary complications may occur after the migration of blood clots or fat clots into the lungs (pulmonary emboli) or partial collapse of the lungs after general anesthesia. The signs of pulmonary emboli may be difficulty breathing or shortness of breath. If you have signs or symptoms of pulmonary emboli, it is important for you to seek emergency medical care at once. If this complication occurs, you may require hospitalization and additional treatment. Pulmonary emboli can be life-threatening or fatal in some cases. Also, inactivity and certain medical conditions (see above) may increase your risk of blood clot formation. Many factors may increase the risk of deep venous thrombosis and pulmonary complications.

These factors include:

• An individual older than 60
• Active or passive smoking
• Surgery within last three months
• Oral contraceptive use and estrogen therapy
• Family history of clotting disorders, such as Factor V Leiden mutation
• Cardiac failure
• Recent trauma
• Leg immobilization or paralysis
• Cancer
• White blood cell disorders, such as leukemia and polycythemia vera
• Kidney disorders
• Lupus
• Pregnancy and the postpartum period (after childbirth)
• Paroxysmal nocturnal hemoglobinuria (episodic loss of hemoglobin)
• Anticancer drug use, including tamoxifen
• Inflammatory bowel disease (IBS)

Cardiac Issues: Cardiac complications are a risk with any major stress, surgery, and anesthesia even in those who have no heart symptoms. It is important to have a full medical evaluation and clearance by your primary care physician before major surgery.

Long-term Effects: Subsequent alterations in body contour may occur as the result of aging, weight loss or gain, pregnancy, or other circumstances unrelated to the above procedures.

Procedure Complications:

Abdominoplasty

• Loss of Umbilicus: Malposition, unacceptable appearance, scarring, and partial or complete loss of the umbilicus (navel) can occur after an abdominoplasty procedure.
• Pubic Distortion: It is possible to have distortion of the pubic area on one side more than the other. This may require revision surgery.

Thigh Lift (Thighplasty)

• Pubic Distortion: It is possible for women to develop distortion of the pubic area or labia after a medial thigh lift or spiral thighplasty. This may require revision surgery.
• Swelling or Lymphedema: This may occur in the lower extremities after a thighplasty or thigh lift procedure from disruption of the lymphatic vessels that drain lymph from the legs. Although rare, this complication can last for up to 12 months or longer. Compression stockings are usually helpful.
• Sensation of Thigh Tightness: This rare sensation is often short-lived.

Liposuction

• Visceral Perforations (Puncture Wounds in Organs): There have been reports of visceral perforations during liposuction, which damage internal organs with the liposuction cannula. When organs are damaged, surgery may be required to repair them. Visceral perforations can be fatal.

Buttock Lipoaugmentation

• Fat Absorption and Sclerosis: About 20-30% of the fat injected into the buttocks does not survive and becomes absorbed. If this happens unevenly, there could be areas were you feel or see asymmetry. Gentle massage over the buttock area helps even out and smooth these areas during the recovery phase.
• Skin Irregularities or Dimples: Contour irregularities and dimples in the skin may occur after liposuction. Also, the areas of injected fat can occasionally develop contour irregularities, including bumps and dimples depending on skin elasticity. Usually, post-operative massage can be helpful in smoothing these areas. Asymmetrical fullness, bulges, and depressions may occur after surgery.
• Asymmetry in Buttock Size: No two halves of the body are identical. Therefore, after buttock augmentation, these asymmetries may persist and appear as differences between the size of the two sides. Scoliosis or other spine disorders can magnify body asymmetry.
• Buttock Infection: Infection may occur after any surgery and may occur after buttock lipoaugmentation. The rate of infection increases with the amount of injected fat, but the overall rate still remains very low due to routine use of antibiotics during and after your surgery.