Low Incidence of Hematoma and Infection Reported for Aesthetic Surgery
Two of the most common complications after any surgical procedure are hematoma and infection. Two articles (1, 2) from the Aesthetic Surgery Journal looked at the incidence of both hematoma and infection in a very large series of greater than 129,000 patients. What is unique about these reports is that the come from the practices of only board certified plastic surgeons; therefore, the variable of surgeon training is reduced considerably. The weakness is that the data is derived from reports that would have missed “minor” infections and hematomas. For example, a minor hematoma that did not require any intervention would not have been reported. One could, however, look at the data from the following perspective: it provides the incidence of clinically significant complications which are those that require intervention and/or reoperation.
The first thing to take away from these studies is that the overall incidence of both of these complications is much lower than has previously been reported. Secondly, when evaluating the data from the point of view of predisposing factors one finds there is some overlap but there are significant differences as well. For example, hematomas are much more likely to occur in men and in breast procedures, while infections are much more likely to occur in woman and in body procedures. Diabetes is not a risk factor for hematomas, but it is for infection. The highest incidence of both of these complications occurred in procedures performed in the hospital, while the lowest incidence was in procedures performed in office based surgery centers such as mine. Other predisposing factors looked at were age (not related ), BMI (not related), smoking (infection), and multiple procedures performed simultaneously (both).
The takeaway should be that overall the incidence of these complications is very low, but, nevertheless, a true evaluation and understanding of your individual risks can only be determined after a full evaluation of your history, a relevant physical examination and a detailed consultation.
1- Incidence and Risk Factors for Major Hematomas in Aesthetic Surgery: An Analysis of 129,007 Patients. Kaoutzanis, C, et. al. Aesthetic Surgery Journal. April, 2017.
2- Incidence and Risk Factors for Major Surcial Site Infections in Aesthetic Surgery: An Analysis of 129,007 Patients. Kaoutzanis, C, et. al. Aesthetic Surgery Journal. 37: 89, Sept. 2016.