Plastic surgery can be life changing – but not always in the ways that one would expect. Plastic surgery is designed to surgically change the body in order to normalise or improve appearance and by doing so, reduce self-consciousness and anxiety. When plastic surgery goes wrong, however, it can have devastating consequences.
Because of the perceived benefits of plastic surgery, each year more and more Australians are seeking out low-cost clinics both in Australia and overseas in order to make their surgery more affordable.
While the results can sometimes be satisfactory, all surgery carries risks and you should therefore take extra care when considering surgery either overseas or at certain cut-price clinics in Australia.
Australian Health Authorities go to great lengths to improve safety by accrediting doctors and hospitals. Hospitals and clinics overseas do not have to abide by Australian safety standards, sanitation may be poor and follow-up non-existent.
So, what are the risks?
Risks Prior To Surgery
It is said that good surgical results are determined during consultation. This is true because it is during the consultation that the diagnosis is made and the surgical procedure planned. Communication during your consultation is most important, so you should be careful to select a surgeon with whom you feel comfortable and to whom you can express your concerns.
While the surgeon is evaluating you, you have the opportunity to evaluate your surgeon! What are his qualifications? Does he have experience in the specific procedure he intends to perform? Does he have staff to support you during the post-operative period and who will be responsible for your post-operative care? Has he given you time to consider your options, which should always include not going ahead with surgery?
We have seen many patients who have returned to Australia following surgery overseas who have developed complications which have required treatment in Australia at additional cost to the patient.
Your surgeon’s choice of hospital is also important. Legislation has recently been passed in Australia to prevent surgery being performed in facilities which are not accredited by the ACHS (Australian Council on Healthcare Standards). It may sound “safer” and easier to have your surgery done under local anaesthetic in a small operating room at the surgeon’s clinic. However, this is not the case. Large doses of local anaesthetic are highly toxic and, when combined with sedation, can result in major medical emergencies. The surgical environment is much more controlled in accredited hospitals, which have the staff and equipment to deal with any emergency. Sterilisation procedures are also important in order to avoid post-operative infection. Having your surgery in an unaccredited facility will increase your risk of infection.
Most surgeons will work with a few anaesthetists with whom they have close working relationships. A good anaesthetic is critical to the outcome of your surgery. After putting you to sleep, the anaesthetist is very busy controlling your blood pressure and ensuring the operating conditions are optimal for your surgeon. Especially when undergoing surgery overseas, there is a risk that the anaesthetist will be under-qualified and there may be a communication barrier. The outcome can be deadly and include problems associated with airway obstruction, drug overdose, allergic reaction, waking during surgery and cardiac arrest.
The Post-Surgery Period
What happens after your surgery is critical to the final outcome. In the immediate post-operative period, steps should be taken to ensure that pain and nausea are well controlled. There should also be a scar management program in place to ensure all your surgical wounds heal with the best possible scar. This may involve taping the scars, massaging the scars and the use of high intensity LED lights for a period of up to 12 weeks following your surgery.
Should a complication develop, such as the beginnings of a wound infection or the collection of fluid at the operative site, early detection and treatment will ensure the final result will not be affected. More serious complications such as deep vein thrombosis, although rare, can occur especially in certain susceptible individuals. Again, if recognised and treated early, it is possible to avoid a complication developing into a life-threatening event.
Our Recommendations to Reduce the Risk of Surgery
Acting on the recommendation of your general practitioner or a friend is a good start. Always ring around to a few clinics. The way your inquiry is managed will be a good indication as to the quality of the surgical practice.
Find out as much as you can beforehand but remember that your consultation is the starting point of your relationship with your surgeon. Make sure you are able to communicate freely and that the surgeon understands not just the surgery you desire but the real reasons behind your wish to have surgery. Be modest in your expectations and remember that surgery may not change your life in the ways that you hope.
It may sound obvious, but make sure your surgeon is a real surgeon! He or she should be a fellow of a reputable surgical organisation. In Australia, surgeons are fellows of The Royal Australasian College of Surgeons (FRACS). In Britain, surgeons are Fellows of The Royal College of Surgeons (FRCS) or of The Royal College of Surgeons in Edinburgh. (FRCS(Ed)). In the US, surgeons are fellows of The American College of Surgeons (FACS) and are ‘Board Certified’.
Furthermore, ensure your surgeon has experience in your specific procedure. Don’t be afraid to ask!
Always remember that your surgery is elective and therefore, your first option is not to have surgery at all. In fact, there may be a non-surgical, non-invasive way to solve your problem. If you do require an operation, then, if there are a number of potential procedures available, always select the procedure that involves the least risk.
FRCS, FRCS(Ed), FRACS
Plastic and Reconstructive Surgeon