Introduction
The American society for Aesthetic Plastic Surgery (ASAPS) reports that in 2003, approximately 7.3 million women underwent cosmetic procedures while an estimated 1.1million man had cosmetic procedures. Liposuction was the common procedure for both women and men with breast augmentation coming in second for women.
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The increase in people having cosmetic surgery points to a reduced concern for the dangers associated with plastic surgery. It has also been noted that there is an increase in the number of women younger than 18 years who are having cosmetic surgery. While the actual numbers indicate that those teenagers below 18 undergoing cosmetic surgery form a small percentage of the total, the worrying trend is the 48% increase noted in their numbers from 2002 to 2003.
Cosmetic surgery for a teenager is not only dangerous because of medical risks involved there is also the additional aspect that the way the young patient’s body is changing will be affected. Sometimes a small increase in weight results in changes in the size of the breast. Due to the fact that the patient is still growing, altering her body parts may lead to dissatisfaction later in life when the patient is fully mature.
Complications of cosmetic surgery range from minor problems such as scarring to more serious complications like fatalities. Many cosmetic surgeons attempt to hide incision lines by putting them in places where they are hardly noticeable. For example for a breast augmentation, this could be along the crease of the breast while for facial surgery; the incision line is hidden in the hairline. Permanent scarring is a common result of most surgeries. There is a probability of bleeding and infection with every surgery but these are complications that can be managed without posing a serious health risk (Washington, 2006, Pg 2)
Nerve damage is one of the more serious risks associated with plastic surgery. This may manifest with loss of feeling in the operated areas and difficulty in muscle movement. Generally the risk of a cosmetic surgery procedure differs depending on the specific procedure. For example breast augmentation will have such risks as nerve damage at the site of operation, tissue necrosis, infection, scar tissue formation and asymmetry. Premature aging, features that look abnormal and visible tissue damage are some of the risks associated with facial plastic surgery (Washington, 2006 Pg 2).
It is necessary to have tests done and undergo a physical examination done before going through with a cosmetic surgery because then certain conditions that would put an individual at risk can be discovered. Clients with diabetes, cardiovascular conditions and allergic conditions are at a greater risk of developing complications that other people would normally not get.
Many times patients report that the results of the surgery are usually different from what they had anticipated. A story in the Telegraph illustrates this; a mother of four went to a hospital for a liposuction but the whole operation got botched and she sustained puncture wounds to her colon and bowel, which led to blood poisoning and multi organ failure causing her to have cardiac arrest for four minutes (Bunyan, 2006, Pp 1).
Another illustration of how cosmetic surgery can go wrong is provided by ITV’s documentary, ‘Facelift from Hell’ which follows a group of ladies who underwent eye, facial and stomach surgery in Poland. The documentary provides insight into the degree of agony the women underwent, one of the women even claimed that following the surgery she had not been able to open her mouth properly for a period of 18 months. (Bunyan, 2006).
An FDA study indicates that for women who have had silicone implants for a period of about 6-10 years, approximately 50% will have a broken implant and 21%of them will experience migration of implant to another body part. There are possibilities of raptures and leakages together with complications like fibromyalgia and thyroid disease (Canadian Women’s Health Network, 2003).
Silicone implants have gradually been replaced with saline filled ones. A study by the Mayo Clinic resulted in evidence that 25% of women who had breast implants required more surgery within a span of five years (Tweed, 2003). Adverse reactions are not only associated with silicone implants but with saline implants too.
The complications with breast implants include surgical complications systemic and psychological complications. The local complications are those likely to be experienced by all patients who go for surgery. These include complications related to being anaesthetized, infection, delayed healing of wounds and increased possibility of other surgeries. Some of the local complications include formation of contractures in the capsule which occurs on average in within the first two years of surgery for those women who have implants (Tweed, 2003). Contracture formation is very uncomfortable and excessively painful.
The implant usually deteriorates with time. A US government study indicates that in 344 women with implants 2/3rd of them had ruptured implants upon MRI examination (Tweed, 2003 pp1). Deflation and rupture results in the filling of the implant being spread throughout the body. Chest discomfort and pain, discharge from the nipple and interference with the mammography are other possible local complications (Tweed, 2003 Pp1)
Systemic complications usually occur several years following implantation. Though the link between systemic complications and breast implantations is unclear, research from epidemiology indicates that implants are a vulnerability factor. Often, the complications appear as a group of symptoms associated with conditions like autoimmune diseases, fibrositis disorders and connective tissue conditions. Involvement of lymph nodes and granuloma formation are other conditions reported by women who have implants (Tweed, 2003, Pp1).
Many surgeons report that most patients are happy and satisfied with breast augmentation. This may be so for a while especially the immediate post-operative period. Many of the reports of satisfaction are given by the cosmetic surgeons themselves raising questions about the credibility of the reports. This is because it is highly unlikely that a patient will admit to the cosmetic surgeon (face-to-face) that they are dissatisfied. Most surgeons will also not admit to other surgeons that their patients are dissatisfied.
There are studies that indicate that women who have not undergone breast augmentation have lower levels of breast anxiety, dissatisfaction with their upper torso and depression compared to those who undergo implantation. Those who undergo implantation and ‘explantation’ have high levels of anxiety both before and after ‘explantation’ (Tweed, 2003, Pp2). Consequently, the most viable conclusion is that contrary to popular belief breast augmentation has negative psychological effects.
Liposuction the most common cosmetic surgical procedure also has dangers associated with it. The most common complications are scars, and irregularities of contours following liposuction. These irregularities increase the need for surgery due to the loose skin that is commonly left hanging especially for older patients and those who already have stretch marks. The more significant and distressing complications of liposuction include swelling, infection, damage of organs, pulmonary embolism and fluid imbalance among others.
Edema (swelling) may occur for several months after liposuction. This has the effect of numbing nerves and the patient may have a tingling effect. Organ damage is a more severe complication which may occur due to the fact that the surgeon probes using a cannula inserted in a small incision. The intestines may be punctured because visibility is not adequate. For a patient with a hernia (intestine protruding out of the abdominal wall) the risk of internal organ damage is increased.
Liposuction may lead to dislodging of small pieces of fat which may travel to the lungs. Once here, they cause pulmonary emboli. This situation compromises breathing and is an emergency situation that if not attended to immediately could pose a fatal health risk. Most patients have the highest vulnerability to pulmonary embolism, in the first 3 days post-operation. Fluid imbalance is a complication that arises from the use of tumescent liposuction a procedure whereby fluids are injected in large amounts and the fat tissue also has fluid removed from it. The potential for fluid imbalance is high and when the imbalance is not treated pulmonary edema results. Heart and kidney dysfunction may also result.
Though the actual deaths associated with liposuction are on average 3 for every 100, 000, the effects of liposuction cannot and should not be ignored as these complications do not have physical effects but also have psychological implications and monetary implications which work together to influence the health of the patient negatively and sometimes contribute to death.
Facelifts also have their own complications and in some cases have been known to cause deaths primarily because of the need to anaesthetize the patient. With cosmetic surgeries usually, one is never enough and continually going under the knife increases the threshold for the anesthesia to be effective. Afsun Smith reports that a media mogul in the UK Micheline Charest died after undergoing a facelift (Smith, 2007, Pg1)
The major problem associated with the dangers of plastic surgery is that most surgeons do not tell their patients of the risks associated with the surgeries. The patients therefore are not in a position to make informed decisions. The fact that most of the surgeries are done in private clinics also contributes to the complications and fatalities associated with plastic surgery. When a patient gets an emergency complication, rushing them from the private clinic to the emergency room in another hospital lowers the survival chances of the patients with a complication.
To cut costs of operation plastic surgeons sometimes work without anesthetists. This is a situation that puts the client at risk. In Florida the Health Department withdrew the license of one doctor whose failure to work with an anesthetist led to a patient’s death. The doctor did not respond in time when the patient had difficulty in breathing leading to cardiac arrest and finally the death of the patient (Smith, 2007, Pg 1).
The seriousness of the danger associated with plastic surgery is compounded by the fact that some Americans are willing to undergo cosmetic surgery where the cost is cheap without consideration for the risks involved. Victoria Corderi of the Dateline NBC reports on the dangers of having plastic surgery in countries where it is cheap like the Dominican Republic. She gives an account of different women who came back with infections so severe they would have caused their deaths. Some women even died as a result of the liposuctions while others came back with infections whose causative organisms are unknown causing the New York Health Department to put out an alert (Corderi, 2005, pp1-3).
Conclusion
Despite the fact that technology has decreased the risks associated with cosmetic surgery more awareness needs to be created to ensure patients can make informed decisions or even better overcome the desire to go under the knife when they realize how dangerous the cosmetic procedure can become. In addition, close supervision of cosmetic surgery clinics for quality care is necessary if the dangers are to be decreased.
Works Cited
Bunyan Nigal, 2006 Liposuction almost killed me says Hendry’s Wife, Telegraph.co.uk. Web.
Corderi Victoria, 2005 Plastic Surgery Tourism? Dangers of going under the knife on the cheap, Dateline NBC,. Web.
Dangers of Cosmetic Surgery. Web.
Liposuction risks, dangers and unwanted effects. Web.
Smith Afsum, 2004, Media Mogul dies aafter facelift: Problem in London and Florida pp 1-3. Web.
Tweed Aleina, 2003 Health Complications from Breast Implant Surgery: A Canadian Study with Implications for the U.S British Columbia Centre of Excellence for Women’s Health.
Washington S, 2006 Risks and Dangers of Plastic Surgery, Understanding the Factors of Cosmetic Surgery pp1-3. Web.