What can be done to correct a bad outcome following a plastic surgery procedure? First and foremost, all physicians have taken the old Hippocratic oath when they became doctors, and one of the primary elements of that oath is that first, we will do the patient no harm. Every step must be taken to AVOID complications and to insure patient safety. This begins with the very first patient visit, when an extensive health history form is filled out and reviewed. Sometimes patients with minor issues, for example, someone wishing Botox or removal of a small skin lesion, question why they have to take ten minutes to fill out a thorough health questionnaire. The reason for this is that a patient may not connect the significance of a prior illness, allergy, or family condition which may affect the outcome of a future treatment.
We have to know if a patient is on diet pills (most contain a form of speed and this could react with anesthetic medications given to a patient), vitamins or herbs (some increase the chance of bleeding and other complications), smoking history (smokers have a higher incidence of skin loss following a tummy tuck, breast reduction or face lift) or recreational drug use (many interfere with medications, could destabilize the heart or other organs, after administration of an otherwise appropriate medication). Once we are sure that no significant health issues exist, we as physicians must evaluate each patients concerns and decide if a treatment is appropriate and safe, and to go over the various options with each patient. Before surgery is contemplated, more laboratory tests are ordered to make sure the patient is a fit candidate for the procedure. And finally, every precaution must be taken during the operation itself to insure patient safety and sound surgical judgments.
Given this approach, complications should be few and far between, but every surgeon will see a complication from time to time. The surgeon must be prepared to deal with complications if they occur. For example, patients who have a bleeding problem after surgery may have to return to surgery to stop the bleeder and to evacuate accumulated blood; if done promptly and properly, the patient should heal well without any side effects. But ignoring such a problem, or delaying proper diagnosis or treatment could result in skin loss, infections or other major complications. Any surgeon who operates for many years will see his share of complications, but the trick is to recognize them early and to treat them appropriately.
The patient whose photographs I show below had a breast reduction north of the Grapevine and came to see me a year after a breast reduction. She experienced some swelling and pain initially after surgery, but the problem was not recognized or treated by her surgeon, then she developed an infection and tissue necrosis in the vicinity of her nipples, and came to see me a year later, after her surgeon told her it was as good as it would get! I took her back to surgery, excised the scar tissue, reshaped her breast mounds and make her new nipple areolar complexes with techniques we use for breast cancer patients. Had this problem been treated more aggressively when it first occurred, the patient may have been spared the misery of walking around deformed for a year!