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Plastic-surgery risks

Thinking about undergoing plastic surgery? Here's what you need to know
By Lisa Murphy

Plastic-surgery risks © Royalty-Free/Masterfile

Like many women—beguiled by television shows such as Extreme Makeover and The Swan—you may have fantasized about what an eyelid or breast lift could do for you. But the recent deaths of Canadian animation-company co-founder Micheline Charest and U.S. novelist Olivia Goldsmith while undergoing plastic surgery have put a damper on such musings. Now, you may be wondering, "Is plastic surgery safe?"

Any surgery involves risk, and cosmetic surgery comes with specific concerns. In a recent study of 400,000 U.S. cosmetic operations published in the journal Plastic and Reconstructive Surgery, death occurred in one of every 51,459 cases. (Karyn Wagner of the Canadian Society of Plastic Surgeons says that Canadian statistics on plastic-surgery usage, complications and satisfaction don't exist.) To find out more about the fine print and recovery times for the most common cosmetic procedures, see Flawless .

Doing your homework beforehand and maintaining good health can reduce the likelihood of plastic-surgery complications, says Dr. Kimit Rai, a Vancouver-based plastic surgeon. "It's buyer beware. You really need to screen your physician to make sure they're doing the right job for you," he adds. Here's what you need to know, including 10 questions to ask your cosmetic surgeon.

What complications can occur during plastic surgery?
Excessive blood loss, bad reactions to anesthesia and blood or fat clots that obstruct a blood vessel—potentially resulting in a deadly stroke or embolism—are the biggest concerns. These are rare, however.

Are some people more at risk of plastic surgery complications?
Yes. Smoking, being overweight, taking certain medications such as oral contraceptives, HRT or blood thinners, and having anesthetic allergies or a family history of blood clots, heart disease or lung disease can all increase your risk and perhaps lengthen your healing time as well.

Are some procedures more risky than others?
High-volume liposuctions may lead to excessive blood loss or a potentially dangerous body-fluid shift. And any procedures that involve multiple hours under general anesthesia can be problematic, says Rai. The reason? Lying prone for hours decreases circulation, increasing the likelihood of a blood clot.

What can you do to enhance the success of cosmetic surgery?
Maintaining a healthy weight and lifestyle and fully disclosing any drug use, allergy potential and your family health history to your cosmetic surgeon beforehand increase the likelihood of a good surgery and swift recovery, says Rai. Most important, make sure your surgeon is fully accredited and experienced in the procedure you've requested. Reading the 10 questions to ask your doctor, below, is a great first step.

What are cosmetic surgeons doing to reduce the risks?
Many Canadian surgeons won't extract more than five litres of fluid during liposuction. Responsible surgeons also use compression stockings and blood thinners to boost circulation and vary the types of anesthesia used to reduce risks during all kinds of cosmetic surgeries. If Rai is doing an eyelid lift and liposuction on the same patient, for example, he might do the eyelid lift with local anesthesia and use general anesthesia for the liposuction only. Most importantly, responsible practitioners obtain hospital privileges—meaning that they must comply with hospital regulations and can take you to the hospital without assigning your care to someone else—on the off chance that something goes wrong. A hospital setting is ideal but a private clinic with hospital privileges is the next best thing.

What can you do after an unsuccessful cosmetic surgery?
Responsible surgeons will follow up to ensure that you're healing well and are satisfied. If your doctor doesn't address your concerns, you can file a complaint with the medical regulatory authority in your province. Still, it's important to keep your expectations realistic. As Banff, Alberta plastic surgeon Dr. Elizabeth Hall-Findlay told Chatelaine earlier this year, "People know that renovating a kitchen isn't going to save their marriages, and neither will renovating their bodies."

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