Cosmetic surgery can enhance the shape, proportion, or appearance of the face and body. For some people, it can also increase comfort with a physical feature that has caused distress for years. However, every operation involves some degree of uncertainty. Understanding the risks of cosmetic surgery is an important part of deciding whether a procedure is right for you.
A major complication does not occur in most patients, yet a perfect outcome and completely risk-free surgery can never be promised. Anesthesia, bleeding, infection, healing difficulties, unexpected reactions, and the body's response to an operation can all cause problems. Certain complications are short-lived and can be treated without major intervention. More serious problems may call for medication, hospital treatment, revision surgery, or ongoing medical follow-up.
Patients in Canada should receive clear information about the expected benefits, material risks, alternatives, recovery requirements, and possible consequences of not having treatment. During a careful consultation, patients should be able to consider the facts without being rushed. Cosmetic surgery is usually elective, so you should feel comfortable delaying or declining it when the risks outweigh the likely benefits.
What Are the Risks of Cosmetic Surgery?
Any undesirable medical, functional, or cosmetic result connected with an operation may be considered a cosmetic surgery risk. Risk levels vary according to the procedure, surgical method, treatment area, operation length, anesthesia type, and the patient's general health.
Minor side effects are expected after many procedures. Swelling, bruising, soreness, numbness, tightness, fatigue, and mild drainage may be normal during early healing. Expected healing effects and surgical complications are different. A complication extends beyond normal recovery and may need medical care.
Possible complications of plastic surgery include:
- Bleeding or the development of a blood collection known as a hematoma
- Infection at the incision or within deeper tissue
- A collection of fluid called a seroma
- Blood clots in the legs or lungs
- Delayed wound healing or wound separation
- Noticeable, raised, widened, or uneven scars
- Nerve injury, numbness, or altered sensation
- Loss of skin, fat, or other tissue because of reduced circulation
- Unexpected reactions to anesthetic drugs, medicines, adhesives, or surgical products
- Aesthetic concerns such as asymmetry, poor contours, or an unwanted result
- Problems with normal function, including breathing, motion, or sensation
- Additional medical treatment or a revision operation
Serious complications are uncommon, but they are still important to discuss. Rare risks may include severe infection, major blood loss, organ injury, heart problems, stroke, pulmonary embolism, permanent disability, or death.
Expected Short-Term Effects of Cosmetic Surgery
Some discomfort and physical change are part of normal healing. Patients should understand what is expected so they can tell the difference between routine recovery and a warning sign.
Soreness After Cosmetic Surgery
Pain levels vary by procedure and patient. Patients may notice aching, tightness, burning, or tenderness around the treated area. As recovery progresses, pain should generally become less intense and easier to control. Patients should quickly report severe or spreading pain, especially when it is accompanied by fever, redness, shortness of breath, or unusual swelling.
Postoperative Swelling and Bruising
Swelling is caused by inflammation and fluid moving into the treated tissues. The early result can remain difficult to assess until swelling subsides over the following weeks or months. Bruises form when tiny blood vessels are damaged and blood collects beneath the skin. Visible bruising and swelling may follow facial surgery, liposuction, breast procedures, or body contouring.
The outcome of surgery should not be assessed before healing has progressed. During recovery, lingering swelling can make contours, symmetry, and skin texture appear different.
Altered Sensation and Numbness
During an operation, small nerves responsible for sensation may be stretched, repositioned, or divided. Temporary numbness, tingling, sensitivity, or reduced feeling is common after some operations. Feeling frequently returns as the nerves heal, although full recovery is not certain. There is a possibility that altered feeling will not fully resolve.
Temporary Limits on Activity
Assistance may be needed for travel, food preparation, child care, pet care, housework, and daily personal needs. Driving, exercise, heavy lifting, swimming, and returning to work may be restricted. Failing to follow activity restrictions may raise the risk of bleeding, swelling, wound breakdown, and other problems.
Potential Surgical Complications
Bleeding or Blood Collection
A small amount of bleeding may occur around an incision. More significant bleeding can form a hematoma, which is a collection of blood beneath the skin or inside the surgical area. A hematoma may cause increasing pain, firmness, swelling, discolouration, or a sudden difference between two sides of the body.
Depending on its size and symptoms, a hematoma may be watched or medically drained. Some hematomas require another operation to control the bleeding and remove collected blood.
Infection After Cosmetic Surgery
An infection can develop in the skin, incision, tissue, or around an implant. An infection may cause increasing warmth, redness, swelling, pain, discharge resembling pus, fever, chills, or a bad smell.
Antibiotics, specialized wound care, drainage, or further surgery may be needed to treat an infection. If a breast implant or another implanted device becomes infected, removal may be necessary. Infection risk and treatment difficulty may increase with smoking, poorly controlled diabetes, inadequate nutrition, or reduced circulation.
Postoperative Seroma
A seroma is a pocket of clear fluid that collects under the skin. Seromas occur more often after operations that leave a broad space under the tissue, including tummy tuck surgery, body lifts, breast procedures, and extensive liposuction.
Small seromas may resolve as the body absorbs the fluid. Larger ones may need to be drained, sometimes more than once. If fluid is not treated, it may strain the incision, delay healing, or lead to infection.
Deep Vein Thrombosis and Pulmonary Embolism
A blood clot that forms in a deep vein, commonly within the leg, is called deep vein thrombosis, or DVT. If part of the clot travels to the lungs, it can cause a pulmonary embolism. This complication can be life-threatening and must be treated urgently.
Factors that may raise blood clot risk include lengthy surgery, reduced mobility, a history of clots, particular medications, nicotine exposure, obesity, certain illnesses, and multiple procedures performed together. Prevention may include early walking, compression devices, support garments, hydration, or blood-thinning medication when appropriate.
Problems With Incision Healing
An incision may heal slowly or begin to separate. Healing may be impaired by poor circulation, infection, pressure on the incision, nicotine, some medicines, or underlying health conditions.
Wound problems may require dressings, antibiotics, removal of damaged tissue, or additional surgery. Secondary intention healing allows an open wound to fill and close naturally from the bottom upward. This process can take longer and may leave a more visible scar.
Tissue Necrosis
Necrosis occurs when inadequate circulation causes living tissue, such as skin or fat, to become damaged and die. This complication can occur after procedures that lift, tighten, or reposition large sections of tissue. Nicotine exposure is an important avoidable risk because it constricts blood vessels and limits oxygen reaching the tissues.
The extent of tissue damage determines which treatment is required. Possible treatment includes wound management, removal of dead tissue, a skin graft, reconstructive surgery, or revision at a later date.
Anesthesia Risks in Cosmetic Surgery
Cosmetic procedures may be performed with local anesthesia, sedation, general anesthesia, or a combination of these methods. Choosing an anesthesia method requires consideration of the operation, medical background, expected surgical time, and facility.
Potential complications connected with anesthesia include:
- Feeling sick or vomiting after anesthesia
- Dizziness, confusion, or prolonged drowsiness
- Throat discomfort or headache
- An allergic response or adverse drug reaction
- Changes in blood pressure or heart rhythm
- Problems with breathing
- Aspiration of stomach contents into the lungs
- Damage to teeth, lips, or the airway
- Major complications involving the heart, lungs, or nervous system
Patients must provide complete information about prescriptions, non-prescription drugs, vitamins, supplements, cannabis, alcohol, nicotine, allergies, earlier anesthesia problems, and medical conditions before surgery. The safety of the operation can be reduced when important health information is omitted.
Changes in Scarring, Colour, and Skin Texture
Any procedure that cuts the skin creates a scar. A surgeon may try to conceal incisions in folds, hair-bearing areas, or covered locations, but complete scar elimination is not possible.
Early scars can be firm, raised, reddish, or more deeply coloured before they mature. Scars may require a year or more to flatten, soften, and become less noticeable. How a scar eventually looks is affected by heredity, skin type, wound tension, infection, ultraviolet exposure, aftercare, incision placement, and the operation performed.
Hypertrophic Scars and Keloids
Hypertrophic scarring causes raised tissue that does not extend beyond the wound edges. Keloid tissue spreads past the edges of the initial incision. People with a personal or family history of abnormal scarring should tell their surgeon before surgery.
Raised or visible scars may be treated with silicone, compression, copyright injections, laser procedures, or surgical revision. Treatment may improve a scar, but it cannot guarantee that abnormal scar tissue will not return.
Changes in Skin Colour and Texture
The treated skin may develop colour changes, redness, noticeable blood vessels, dimpling, firmness, or textural differences. Some of these changes resolve over time, while others can last permanently. The risk can differ by skin tone and by the type of procedure performed.
Aesthetic Risks and Unsatisfactory Results
A technically successful operation does not always produce the appearance a patient expected. Individual anatomy, skin flexibility, age, past procedures, scarring, and natural asymmetry all affect healing.
Appearance-related problems may include:
- Persistent asymmetry
- Irregular or uneven body contours
- Too little or too much correction
- An artificial-looking or over-tightened outcome
- A changing contour as postoperative swelling decreases
- Implant position problems
- Scarring that is prominent or difficult to conceal
- Gradual recurrence of skin or tissue laxity
- Disappointment with an outcome that falls within an acceptable surgical range
Photos, digital simulations, and before-and-after galleries can support discussion, but they cannot guarantee an identical outcome. Anatomy and healing responses vary from one person to another.
Corrective and Revision Surgery
Revision surgery may be considered when a complication occurs or when the result can be improved. Revision surgery carries risks of its own. A second operation may be technically harder because previous surgery can leave scar tissue, stiffness, and diminished blood flow.
It is important to ask how the practice handles revisions and which expenses are covered. The first surgical fee may not cover a revision surgeon, facility charges, anesthesia, new implants, prescriptions, travel, or lost work time.
Procedure-Specific Cosmetic Surgery Risks
General risks are present across cosmetic surgery, while individual procedures introduce additional concerns.
Risks of Facelift and Neck Lift Surgery
Facelift and neck lift complications may include hematoma, facial nerve injury, hairline changes, hair loss near incisions, skin loss, contour irregularities, earlobe distortion, numbness, facial weakness, and visible scarring. Nicotine use can greatly increase the risk of skin-healing problems.
Possible Rhinoplasty Complications
Rhinoplasty may cause ongoing swelling, nosebleeds, infection, asymmetry, changes in smell, visible contour irregularities, septal perforation, nasal collapse, or difficulty breathing through the nose. A rhinoplasty result may not fully settle for 12 months or more. A revision nose operation is often more challenging because the first surgery changes the cartilage and creates internal scarring.
Eyelid Surgery Risks
Blepharoplasty risks include dry or irritated eyes, temporary blurred vision, difficulty closing the eyelids, eyelid malposition, asymmetry, scarring, bleeding behind the eye, and changes in vision. Immediate medical evaluation is needed for intense eye pain or a sudden visual disturbance.
Possible Breast Procedure Complications
Breast augmentation, breast lift, and breast reduction may affect nipple sensation, breast symmetry, scar appearance, and the ability to breastfeed. Additional complications can include bleeding beneath the tissue, infection, fat tissue death, slow wound healing, and changes to the nipple or areola location.
Breast implants bring added long-term considerations. Capsular contracture, rupture, deflation, rippling, displacement, rotation, pain, ongoing imaging, and future surgery may occur with breast implants. Patients should not assume that breast implants will remain in place permanently without further care. Health Canada also provides safety information about uncommon conditions linked with certain breast implants, including breast implant-associated anaplastic large cell lymphoma.
Liposuction Risks
Liposuction may lead to dents, surface irregularities, skin looseness, fluid problems, numbness, fluid collection, infection, organ injury, fat embolism, or lidocaine toxicity when local anesthesia is involved. The physical strain and recovery requirements may rise when large fat volumes are removed or multiple areas are treated.
Risks of Abdominoplasty and Body Lift Surgery
Large sections of skin and underlying tissue are moved during abdominoplasty and body lift surgery. Possible complications include fluid buildup, DVT, infection, tissue loss, incision opening, reduced sensation, visible scars, and changes in navel shape or placement. Activity and lifting restrictions can remain in place for a number of weeks.
Fat Grafting Risks
Fat transfer uses liposuction to collect fat, which is then injected into another part of the face or body. Some of the transferred fat will be absorbed, which can affect volume and symmetry. Other risks include fat necrosis, cysts, calcification, infection, oil cysts, and accidental injection into a blood vessel. The location where fat is injected, such as the face, breasts, or buttocks, affects the type and seriousness of potential complications.
Factors That Increase the Risk of Complications
A patient's health status and daily habits may make complications more likely. Before proceeding, some patients require tests, adjustments to treatment, weight changes, nicotine cessation, or approval from another medical professional.
Factors associated with higher surgical risk include:
- Exposure to nicotine through smoking, vaping, gum, patches, or other products
- Diabetes with unstable or elevated blood sugar
- Disease affecting the heart, lungs, kidneys, liver, or circulation
- Past DVT, pulmonary embolism, or a diagnosed bleeding disorder
- Obesity, unstable weight, or recent major weight loss or gain
- Obstructive sleep apnea
- Immune system disorders
- Inadequate nutrition or serious anemia
- Scar tissue or circulation changes from prior operations or radiation
- Drugs, vitamins, or supplements that interfere with clotting or tissue repair
- Expectations that cannot be achieved or unaddressed psychological concerns affecting consent
The presence of one or more risk factors does not automatically prevent cosmetic surgery. The surgeon needs to evaluate the level of risk and decide whether health or lifestyle changes are necessary before treatment.
Emotional and Mental Health Considerations
Cosmetic surgery can affect emotional health as well as physical health. Swelling, bruising, fatigue, and temporary lifestyle restrictions may leave some patients feeling worried, frustrated, or low. This temporary low mood is sometimes called postoperative blues.
When a patient's expectations exceed the realistic limits of surgery, deeper or longer-lasting disappointment may follow. A cosmetic procedure can modify the body, but it does not guarantee emotional confidence, relationship improvement, career advancement, or solutions to unrelated personal concerns.
A careful cosmetic surgery consultation should examine why the patient wants the procedure. Warning signs may include pressure from another person, repeated procedures without satisfaction, extreme focus on a minor feature, or the belief that one operation will completely transform a person's life.
Intense and persistent concern about perceived physical defects may be a sign of body dysmorphic disorder, a recognized mental health condition. Changing the physical feature does not necessarily treat the underlying mental health condition. In suitable cases, the surgeon may delay treatment and advise the patient to seek mental health assessment or counselling first.
How to Reduce the Risks of Cosmetic Surgery
Risk cannot be removed completely, but careful planning can make cosmetic surgery safer.
- Work with a properly trained physician whose practice includes the cosmetic operation you are considering.
- Verify the physician's registration and standing through the medical regulatory authority in your province or territory.
- Find out which facility will be used and whether it has suitable emergency plans, safety standards, and infection prevention measures.
- Disclose your entire health history, including previous surgery, allergies, medications, supplements, alcohol, cannabis, and nicotine use.
- Complete required testing and obey instructions about fasting, medicines, supplements, smoking, vaping, and other nicotine products.
- Arrange a responsible adult to drive you home and assist during early recovery when required.
- Do not schedule travel, work duties, exercise, or major events until you understand how long recovery may take.
- Follow-up care should not be skipped, and abnormal changes should be reported without delay.
- Your recovery should not be compared with social media images, promotional content, or another person's timeline.
- Wait until healing is mature before deciding whether revision surgery is needed.
How to Select a Cosmetic Surgeon in Canada
Each Canadian province and territory is responsible for regulating doctors within its jurisdiction. Patients can search the public register of the applicable college of physicians and surgeons to confirm a doctor's licence, registered specialty, and available practice information.
Another useful question is whether the doctor holds plastic surgery certification from the Royal College of Physicians and Surgeons of Canada. Certification is one useful qualification to review, but patients should also consider experience with the specific procedure, complication management, communication, surgical setting, and follow-up care.
Useful questions for a cosmetic surgery consultation include:
- What training and certification do you have?
- How frequently is this specific procedure performed in your practice?
- Based on my health, goals, and anatomy, is this procedure suitable for me?
- Which problems do your patients experience most often after this operation?
- What rare but serious risks should I understand?
- Who is responsible for anesthesia care during the operation?
- How can I obtain care if a problem develops at night or on a weekend?
- Where would I receive emergency care if needed?
- Which follow-up visits and services are included in the fee?
- What costs could arise if I need treatment or revision surgery?
Informed Consent for Cosmetic Surgery
Informed consent is more than signing a form. It should be a continuing conversation that allows the patient to decide freely after receiving adequate information.
The consent process should cover the nature of the procedure, expected benefits, important risks, reasonable alternatives, recovery, limitations, and what could happen without treatment. Risks that are especially relevant to the patient's health, job, lifestyle, or personal priorities should also be discussed.
Patients should have enough time to review consent information without being pressured. When medical language or a possible complication is confusing, the patient should request a clearer explanation. Patients may benefit from writing down information, attending with someone they trust, and reading the documents again at home.
When to Seek Help After Cosmetic Surgery
The surgeon's office should explain which symptoms require attention and copyright the appropriate provider. Contact the clinic promptly when symptoms are unexpected, worsening, or different from the recovery plan.
Urgent warning signs may include:
- Pain in the chest, difficulty breathing, coughing up blood, or loss of consciousness
- Sudden swelling, pain, redness, or warmth in one leg
- Uncontrolled bleeding or a sudden increase in swelling
- Intense pain that does not improve after taking the recommended medicine
- High fever, chills, spreading redness, or pus-like drainage
- Confusion, extreme weakness, or difficulty staying awake
- Skin that becomes very pale, dark, blistered, or cold to the touch
- An emergency eye symptom such as severe pain, sudden visual change, or vision loss
- Repeated vomiting or an inability to keep fluids down
- Any problem your surgeon specifically described as requiring emergency care
When a symptom could represent a life-threatening emergency, call 911 or go to an emergency department. Do not wait for an office to reopen when there is severe breathing trouble, chest pain, loss of consciousness, major bleeding, or another urgent concern.
Financial Risks and Health Coverage in Canada
When a procedure is intended only to improve appearance, public health insurance in Canada will usually not cover it. The patient is normally responsible for surgeon fees, anesthetic services, facility charges, implants, compression garments, medication, tests, and associated costs.
Complication-related costs should be discussed before surgery. Coverage may depend on the medical service required, the location where treatment is provided, and the patient's provincial or territorial plan. Travel, accommodation, nursing assistance, missed work, child care, and revision surgery can create additional expenses.
Anyone travelling outside Canada for cosmetic surgery should arrange appropriate postoperative care before coming home. A lower initial price may not include management of infection, wound problems, blood clots, implant complications, or revision surgery.
Balancing the Benefits and Risks of Cosmetic Surgery
Patients should consider surgery only when their goals are achievable, their health is suitable, and they understand the risks and recovery. An appropriate candidate understands that cosmetic surgery may create improvement without producing perfection.
Take time to compare the expected benefit with the medical, emotional, practical, and financial risks. Consider whether you can follow the recovery plan, accept visible scars, manage time away from work, and cope with the possibility of an imperfect result.
A responsible surgeon may decline surgery if the patient's risk level is unacceptable, the likely improvement is minimal, or the desired result is unrealistic. A decision not to operate is sometimes the safest and most responsible form of patient care.
How to Make an Informed Cosmetic Surgery Decision
Being aware of possible complications is not the same as believing they are certain to happen. Instead, risk awareness allows patients to decide using reliable facts rather than marketing, online trends, or cost as the only factor.
Before surgery, research the operation, assess your health risks, verify medical credentials, ask thorough questions, and prepare for the complete healing period. When the benefits, limits, alternatives, and possible complications are understood, patients are better prepared explore the topic to decide whether cosmetic surgery fits their needs.