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.
Hematoma or excessive
bleeding occurring with a body lift is rare, however; they can happen.
If a hematoma occurs, it needs medical attention immediately and may need to be
surgically drained. Excessive bleeding or a hematoma increases when the
patient tends to get physically active after the surgical procedure, or if
medication is taken that can contribute to thinning the blood pre and post
operative. The use of post operative drains help reduce the chance of a
hematoma from forming.
Blood clots
are a risk that is associated with body lift
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.
At the initial consultation you will be asked to give your medical history
along with any and all medication you are taking on a regular basis. It is
this information that the surgeon will be able to ascertain whether or not you
are at an increased risk of forming blood clots following surgery.
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.
Phlebitis (inflammation of the
vein) may result from an intravenous (into the vein) or intramuscular (into the
muscle) injection. Phlebitis can result in painful swelling of the hand, arm, or
leg
that may be prolonged. Treatment may require medication or even hospitalization.
Phlebitis can occur in the leg and thigh veins. This is extremely rare.
Unfortunately sometimes
infection happen no matter how careful a surgeon is with keeping their surgical
room clean and sterile. Most infections
following body lift
procedure is from the patient with failing to care for their incisions properly.
As stated so many times before, it is very important to follow your surgeon’s
instructions of when and where to change the bandages. More than likely you will
have drains which will help with the bleeding and leakage right after surgery.
It is the drain incisions sometimes that are culprit with introducing bacteria
to this area, so being proactive with any changes to the surgical area is
paramount.
Signs to call your surgeon immediately:
Fever – temperature of 101 degrees
or higher
Chills
Sweating
Excessive pain or redness
from the incision site
General malaise
Drainage from the
incision has a greenish tint
Bad odor coming from the
incision site
Draining too steadily
All the above symptoms
are signs of an early
infection,
and if caught early enough, then sometimes all the patient might need is an
increase in antibiotics. Infections can cause a delay in wound healing as well
as prolong the recovery time for body lift
surgery. Because of the risks that are associated with an infection
with this surgery, you need to be in the best of health at the time or the
procedure to give you the very best odds.
Post operative blood loss is normally a rare complication with a body lift
procedure; however, if you do get this you should seek medical help immediately. Blood transfusions may be necessary in severe cases.
Your plastic surgeon will
instruct you before the surgery to stop taking any anti-coagulants before your
surgery, and an include aspirin and aspirin containing medications, Vitamin E,
anti-inflammatories or
Warfarin etc.
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. Large scale skin necrosis in
body lift
surgery occurs normally lower on the abdomen area and can include the pubic area
as well. 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.
All patients are going to be different with their healing times from any
surgical procedure. There are some risks that are considered much higher in
a body lift
surgery who tend to heal at a slower rate. Age and physical condition of the
patient is always going to dictate how someone is going to heal. Of course those
patients who exercise are physically fit, and are younger will always bounce
back a little bit easier than those patients that were not.
Normal healing time with a body
lift
is approximately between four to six weeks. Patients that are experiencing pain
and severe discomfort beyond that time are considered to be slow healers. Skin
necrosis or tissue death is one complication that can occur with patients who do
heal slowly. If this does happen, then a skin graft is sometimes needed, which
is not a simple procedure. The scarring can also tend to be more pronounced on
patients who were slow healing, developing into
hypertrophic scars
or
keloids.
Presence of an
infection of course
will delay healing time as well, as it depletes the body’s immune resources from
closing the wound. So the quicker you have an infection under control, the
better off the patient will be.
In rare cases, local allergies to
tape, suture material, or topical preparations have been reported. Systemic
reactions which are more serious may occur to drugs used during tummy tuck
surgery and prescription medicines.
Most surgical techniques use deep
sutures, which might spontaneously poke through the skin, become visible, or
produce irritation that might require removal. Spitting a stitch can lead
to infection if not taken care of. Make sure you call your surgeon if this
happens, so they can remove it with sterile instruments.
Sometimes the incisions will pull apart - especially with
a body lift procedure, because the skin and tissue are pulled very tight.
If this should occur, normally this will not require additional surgery. It is treated with moist dressings.
However, if this occurs, recovery time is much longer.
Skin laxity might occur after
a body lift if the patient is not at their ideal weight
before the procedure. Age does decrease the skin's natural elasticity over time and also the strain of
excess body fat can also contribute to your abdominal skin stretching out. Having an active lifestyle can help your body lift benefits to last longer.
Another factor to consider is
pregnancy. If a patient ends up having more children after their body lift, more than likely a revision will be needed. Pregnancy stretches out
the skin of the abdomen and also the abdominal muscles will lose their firmness.
Pregnancy or gaining weight can
all begin to contribute to the separation of the midline of the abdominal area. The laxity of these muscles can reduce muscle strength and can cause abdominal
sagging. This condition is known as "rectus diastasis". Most of the
time, if rectus diastasis is caught early, exercise can help alleviate this
problem. However, if the damage is severe, this can only be corrected with
surgery.
Malposition of the navel is a risk
that rarely occurs. The new navel could be placed too high or too low or
not in the middle of the torso. Surgery may be required to move the
umbilicus to a more favorable position.
Loss of the umbilicus can happen
if the blood supply is compromised or is inadequate after the implantation. If this should occur, further surgery will be recommended.
The mons-pubis appearing enlarged
after a body lift surgery can be due to several factors. Swelling at
the mons pubis area may take longer than the rest of the abdomen to resolve, as
this is the most dependent or lowest point of the surgical area. The
swelling of the Mons Pubis can also be from when the surgeon tightens the muscle
layers above this area. This ends up pulling the fatty tissue of the mons
together - causing them to "bulge".
Swelling or bruising in the pubic mound may appear even though no surgery had
been performed in this area. This swelling is medically referred to as edema,
which is an excess accumulation of fluid. With much swelling post-operatively in
the abdominal area, the swelling will generally tend to gravitate downward.
Bruising will also move in this direction. With time, this will also subside.
If
this enlargement or distortion of this area is not resolved after 3 to 4 months,
then persistent excess fat should be considered. Reduction of the mons pubis can be achieved through liposuction. If there is excess skin at
the mons pubis then reduction by direct excision is could be recommended.
As with most patients, there might
be some differences between the right and left side of their body before any
surgery is performed. Having surgery might not be able to correct this
difference. Having a body lift might not yield
perfect symmetry in the body after the procedure.
There are many factors that are
taken into consideration regarding asymmetry:
Contour and shape irregularities
and depressions may occur after a tummy tuck, body lift, or thigh lift. Residual
skin irregularities at the ends of the incision or "dog ears" are always
possible as is skin pleating when there is excessive redundant skin. "Dog ears"
need to be reduced by excision or liposuction or a combination of the two
techniques. Depending on the size of the dog ears, treatment can be performed as
a minor procedure under local anesthesia.
It is perfectly normal for the
skin of the abdomen, navel, genitalia, buttocks and thighs to become inflamed
and swollen. Bruising is also very common, and you could have residual
swelling for up to several weeks or months post op. Minimizing swelling
and bruising is important - wearing a compression garment after your
body lift will help tremendously. Most plastic surgeons want you to
wear the compression garment 24 hours a day for several weeks.
Massaging the areas a few times a
day will help reduce some of the swelling. The skin can become overly dry
and itchy after surgery. Massaging with lotion or a skin moisturizer will
help, but it is essential that you keep this lotion out of the area of the
surgical incision.
There may be some numbness in the
lower area of the abdomen area and thighs after a body lift procedure. In
the majority of patients, this numbness will disappear and sensation will
gradually return to near normal. The process of regaining the feeling back
may take many months, or even years to complete.
After a body lift there will be
some degree of pain and discomfort which can be controlled by narcotic pain
medication. Because of the pain associated with this procedure, it is not
uncommon for the surgeon to recommend bed rest for the first few days after
surgery. Keeping the patient's legs slightly bent at the hips will help
reduce the amount of strain placed on the abdominal muscles.
Most surgeons will provide the
patient with a compression binder, which will help support the newly tightened
areas. Walking will be instructed to help reduce the chance of blood clots
forming.
Some plastic surgeons might
recommend the pain pump immediately following surgery, which will help
tremendously with the patient managing the pain.
All surgery leaves scars, some more visible than
others. Although good wound healing after a surgical procedure is
expected, abnormal scars may occur within the skin and the deeper tissues.
Scars can become hypertrophic or possibly keloid, which can be unattractive. Scar appearance may also vary within the same scar, such as "bunching" due to
the amount of excess skin. Scars may be asymmetrical (appear different
between the right and the left side of the body). Also, there is the
possibility of visible marks in the skin from sutures. In some cases a
scar revision may be necessary.
With the body lift procedure, patients are
made aware that they are trading one problem of loose and lax skin for the
possibility of visible scarring.
The number one reason for
slow healing is from patients who smoke or are exposed to second hand cigarette
smoke. Because smoking decreases the size of the blood vessels in your skin,
less oxygen will get to the surgical area to help promote healing. Larger blood
vessels are needed for circulation to carry oxygen to your skin cells. Oxygen
speeds up the recovery process, and cigarette smoking depletes these oxygen
levels making it more difficult for patients to have a rapid recovery.
Change the breakdown of
certain drugs in your bloodstream
When you have surgery,
the anesthesia
that is used puts your body under stress. It has a tendency to lower your
resistance to infection, and if
you are unconscious, you’re breathing and heart needs to be monitored to prevent
problems. If you smoke the body is less able to cope with the stress.
The
nicotine that is found in cigarettes increases your heart rate and or course
will increase your blood pressure every time you smoke. The heart will therefore
work harder because it needs more oxygen. The carbon monoxide in cigarette smoke
competes literally for the oxygen in your blood. Nicotine reduces the supply of
oxygen to the tissue by up to 15%. Smokers have up to ten times more carbon
monoxide in their blood than non-smokers. This makes it harder for oxygen to be
carried in your blood stream from your heart to your surgical area; and oxygen
is needed in order for the wounds to heal.
It is so important to always make sure you are on the same page with
communication with your surgeon during the pre operative and post operative
periods. Early intervention on any post op complication is always the
best. Experiencing complications with a body lift
are rare, as most patients normally sail through this procedure with no problems
at all. But because this is major surgery, it is best you know of all the
possible things that could possibly go wrong so if you find something happening
to you, you will know how to act on it. Good patient – doctor relationships and
communication makes for a positive outcome with an easy recovery process.