The quest for perfection, for achieving the “ideal physical shape” and for a younger appearance, is turning more and more people to cosmetic plastic surgery. We are among the countries with the largest number of procedures of this type in the world – the most common are liposuction, abdominoplasty, facial and breast surgery (enlargement or reduction). Data from the Brazilian Society of Plastic Surgery indicates that more than 1.5 million procedures are performed each year.
But how much is it worth? In addition to affecting self-esteem, these procedures may also pose health risks. In many situations, lack of care and exaggeration are triggers of serious complications.
I believe that everyone has heard about, for example, a death or serious problem from liposuction. Histories of cardiac arrest and side effects of anesthetics. And why do they occur?
We cannot exclude the risks
First, we must remember: plastic surgery, like any other surgery, comes with risks and possible side effects. As much as it is a matter of aesthetics in the vast majority of cases, they will somehow – or in many ways – mess with the functioning of the organism, regardless of the specialty in which the intervention is performed.
Progress has been made, this is a fact, making procedures more and more safer, yet we are talking about surgery and thus the need for special care and attention.
In the case of liposuction, some of the risks are fat embolism (closure of small blood vessels by fat droplets), seroma (too much fluid retained near the scar, causing inflammation) and bruising – consequences that can also manifest in other procedures that are currently offered. †
The list of common complications also includes: respiratory problems, implant rejection, sensory and skin disorders, tissue necrosis, asymmetry, bleeding, pain and allergic reactions, in addition to infections – the chance of infection is small, usually less than 1%, but it does exist and cannot be ignored.
In the postoperative period of major surgery, such as a tummy tuck or mammoplasty, there is still a risk of thrombosis, ie clot formation, usually in the veins of the legs, and the risk of pulmonary embolism.
That’s because if the clot migrates to the lungs and creates a blockage in blood circulation, it can cause a decompensation of the heart’s function, with a decrease in blood volume to the body and even the risk of death.
Here we can list some factors that increase the likelihood of this type of complications: obesity, history of thrombosis and varicose veins of the lower extremities, severe or uncontrolled chronic conditions (such as high blood pressure or diabetes), smoking, age over 40 years, long-term use from oral contraceptives, drug use, certain medications, many associated surgeries and even the time to perform them – very long surgeries tend to exponentially increase the risks.
But can a patient with heart problems undergo plastic surgery or not?
The answer is complex and carries a great deal of responsibility, which should not be summed up in a simple yes or no. In general, the heart is an organ with a low risk of damage from plastic surgery, provided it is properly evaluated preoperatively. As we have seen, there are a number of things to consider.
The cardiovascular systems of those undergoing general anesthesia and surgical procedures are subject to multiple stresses and complications. The heart, as our vital pump, is required in such a scenario. Therefore, it must be in good health to deal with a probable overload, even if it is small.
Therefore, before any kind of intervention, it is essential that both doctors and patients have a clear understanding of all the conditions present that could be the cause of the onset of a cardiovascular complication, such as an arrhythmia (abnormal, irregular, very fast or slow) . †
Cardiological problems added to the metabolic and circulatory stress that any surgery causes can be life-threatening. Blood loss, release of substances into the circulatory system, hypothermia, myocardial ischemia, and effects of drugs or medications administered as a result of the procedure are possible.
Untreated or unstable heart conditions, for example under the effects of anesthesia, can cause an arrhythmia and even cause a heart attack – most anesthetics are agents that suppress breathing and the heart, meaning they affect the normal heart rate.
This is even in healthy individuals. In patients with a pre-existing heart problem, these potential anesthetic effects become much more of a concern, as patients may not tolerate large fluctuations in rate and pressure.
Another situation: A person with high blood pressure can have a tummy tuck — or any other procedure, as long as their pressure is under control. Hypertension is a chronic disease caused by high blood pressure in the arteries, forcing the heart to make a greater effort than normal to circulate blood through the arteries. For example, plastic surgery on someone with uncontrolled pressure can be extremely dangerous.
Before every operation…
You should be aware of the extra precautions that need to be taken. And the patient is not always aware of that at the time of the plastic surgery decision. Some don’t discover problems until the surgeon requests a cardiology exam before the desired procedure.
Today, these interventions offer a high degree of safety. Yet again, we are talking about surgery and as such it demands attention in pre-, intra- and post-operative care. That is, patients should be evaluated according to the same rigorous standards adopted for other surgical procedures.
So the more complete the check-up, the more certainty. Here, the heart conditions are known to reduce complications during surgery such as hypertension, heart failure, arrhythmia or the presence of diabetes, dyslipidemia (high cholesterol), obesity, etc.
Unlike other emergency surgeries, plastic surgery can usually be anticipated, planned, and even revised — and it’s worth a parenthesis here: Plastic surgery isn’t always for vanity, as it’s also used for major physical corrections. In such cases, there is often urgency.
Finally, it is necessary to keep in mind that in the postoperative period, the body recovers, while the immune system is compromised. A minor reaction can turn into a major infection. Therefore, care should be maintained until full recovery.
Therefore, the importance of the professional and the place of surgery is clear. Consideration and criteria are needed when choosing the clinic and the doctor who will perform the procedure.