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Risks and Complications of Facial Implant Surgery
Risks and possible complications include:
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Facial implant surgery - including mentoplasty or genioplasty, cheek implants or a jaw implant can have potential risks. Sometimes the implant might shift, infection, capsular contracture or the implant has an unnatural shape requiring additional surgery. Having your surgery performed by a board certified plastic surgeon helps minimize some of these potential complications from happening. Making sure the patient has the pre and post operative instructions and be able to comply with them will help as well.
Fortunately most "bad reactions" to anesthesia are not life-threatening. However, all forms of anesthesia including the different forms of local, can carry a risk of an allergic reaction. Anesthesia exposes the body to controlled levels of toxic chemicals in order to make sure there is no pain felt during a surgical procedure. The main goal of anesthesia is to either stop pain temporarily or to induce a semi-conscious or unconscious state. Even though anesthesia carries a risk, the benefits outweigh any potential disadvantage. The most important factor is making sure that whoever administers the anesthesia are board certified in anesthesiology. By doing this, you reduce the risks of any complication that might arise during surgery. All body functions and chemistry are monitored during your surgery to ensure a safe procedure. The most common reaction or danger of having anesthesia is an allergic reaction to one of the medications used. This is addressed immediately by the attending anesthesiologist by monitoring your vital signs. If an allergic reaction occurs, your anesthesiologist is equipped to handle this immediately. Severe allergic reactions during anesthesia are fortunately rare. It is very important to tell your anesthesiologist every medication you take on a regular basis, so that he can prevent any potential problem during surgery. Read more about anesthesia's risks and complications
Blood clots are a risk that is associated with any type of surgery. Any surgery that involves the use of general anesthesia for longer than 30 minutes carries a high elevated risk of causing internal blood clots. Blood clotting is nature’s way of controlling bleeding after an injury or an incision is made, however; blood clots can become dangerous. When a clot forms inside a blood vessel, it can interfere with your circulation or become lodged in an artery inside the heart, causing a heart attack. Clots can also travel to the brain and can become the cause of having a stroke, as well as the lung in which it would end up being a pulmonary embolism.
The timeline for developing blood clots after surgery can vary, however the greatest risk is the first few days following surgery.
For patients that are known to keloid or have hypertrophic scarring, it is best to ask your plastic surgeon what incisions will be is going to be right for you with placing facial implants. Most surgeons believe that the best way to prevent keloids is meticulous, expert technique. Not too much tension on the closure with clever suturing. The mini-lift is known for producing keloid scars. Reasoning is because there is too much tension placed on the incisions and they tend to stretch out causing excessive scarring. Patients who are darker skin have more melatonin in their tissue, and tend to get hypertrophic or keloid scarring much easier. Read our section on hypertrophic and keloid scarring
Excess tightening and hardening of scar tissue around an artificial implant ("capsular contracture"), causing unnatural shape.
The human face is normally not symmetrical to being with. There can be distinct differences between one side of the face versus the other. During your consultation with your surgeon, he or she will tell you what the chances of this occurring with facial implants.
The blood has collected under the skin and may have to be removed. Other factors that are associated with an increased risk of hematoma include high systolic blood pressure, aspirin or anti-inflammatory medications were not stopped before surgery, and smoking.
Each time surgery is performed on any part of the body the risk of bleeding is there. Hypertension (high blood pressure) that is not under good medical control may cause bleeding during or after cosmetic surgery. Bleeding risks can start from the day of surgery to several days after the procedure. It is important during the recovery period that the patient does not get their blood pressure elevated or their heart rate increased - as this can add to the risk of possible bleeding. If bleeding does occur and it is not stopped sometimes a wound will have to be surgically opened - and the blood vessels contributing to the bleeding will have to be cauterized.
Skin necrosis results from the loss of skin from a poor blood supply. It is more common in larger operations and smokers. The skin changes coloration from a light red to a darker color over the course of a few days. This skin might blister and peel, and also turn black over a period of a week. Patients who are still smoking and also ex-smokers who newly quit will be at a higher risk for this severe complication. In smaller skin necrosis cases, areas of the incision will scab over and take a very long time to heal. This complication is very rare in non-smokers.
Fat necrosis occurs when fat cells lose blood flow. Fat cells are living cells and if there is no blood flow, they may die and cause "fat necrosis". The liquefied fat cells can harden overtime underneath the skin, causing firmness or contour irregularities. Surgical intervention might be needed to help alleviate some of the symptoms caused by fat necrosis.
Seromas are fluid collections that can arise after surgery along the incision line. Drains are used to help combat this complication. Because of the location of the lymphatic system - seromas and swelling is very common with this type of surgery. Wearing the compression garment helps to prevent a seroma.
Extrusion, a condition in which the implant can be seen through the skin, is a rare risk. If this occurs, the implant must be surgically removed. In some cases, the implant may shift or collect fluid, also requiring a second surgery.
There are nerves which supply sensation to the cheek and chin which can be damaged with placement of implants. This can result in temporary or possibly permanent numbness of the areas around the implant. For chin implants, any nerve damage in that area can result in lip numbness and sometimes difficulty with drooling. Most nerve problems come from the bruising of the mental nerve during surgery. Normal feeling is normally restored within three to six months.
There are two nerve roots that come out of the lower jaw and provide feeling to the lower lip. Placement of a chin implant is below these nerves. However, sometimes these nerves can get bruised or stretched and will take time to recovery. This can take up to a couple of months to recover from this. Very rarely is the numbness permanent. Nerve regeneration takes a long time, as nerve fibers grow and repair themselves at a very slow rate. Taking Vitamin B Complex helps nerve regeneration.
Deeper structures such as blood vessels, muscles, and particularly nerves may be damaged during a procedure placing facial implants. Different techniques can sometimes have higher risks than others. Injury to these deeper structures can be temporary or permanent.
As with any cosmetic surgery procedure, an infection can occur. Patients will be given antibiotics during the surgery through an IV, as well as oral antibiotics to be taken for at least a week to ten days following the procedure. This is done as a preventative measure to make sure an infection doesn't occur. Facial implants tend to be more porous and sticky making them potentially more prone to infections. If an infection should occur post operatively and does not dissipate then the possibility of the implants having to be removed might be likely. If this should happen, the surgeon will wait until the infection completely is cleared up and then replace the implants at a later time.
A facial implant could move slightly out of alignment and a second operation might be necessary to reposition it in its proper place.
Bruising and swelling normally occurs following a rhytidectomy or face lift procedure. The skin near the incision site can appear either light or darker than the surrounding tissue. In rare circumstances, swelling and skin discoloration or bruising can be permanent or lasts for long periods of time following the face lift procedure.
Pain associated with having facial implants is generally for the most part moderate to minimal, however some patients have a harder time than others simply because everyone's own pain threshold is so different. Your surgeon will be prescribing narcotic pain medication for several days after surgery, to make sure you are comfortable during the initial recovery.
The possibility of a substandard result from facial implants can occur. The following can occur during a rhytidectomy (face lift):
Sometimes it is necessary to perform additional cosmetic surgery to improve your results.
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