How to Reduce Complications After Plastic Surgery

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Most complications after surgery are not random events. They cluster around recognisable risk factors, several of which the patient can influence directly and several of which are determined by the surgeon and facility. This guide sets out the complications that affect outcomes — what they are, what raises and lowers the risk of each, and the specific actions that reduce them.

The realistic standard is not zero complications. Every surgeon has complications. The differentiator is rate, recognition, and management. The same standard applies to patients: full of risk is not possible, but the risk profile of an elective cosmetic is substantially modifiable by what happens around the operation.

The complications worth understanding

The main categories are:

Patient-side factors that materially reduce risk

The single highest-impact intervention available to most patients. Nicotine constricts blood vessels, reducing tissue oxygenation by 30 to 40%. The downstream effects are substantially higher rates of wound dehiscence, skin necrosis, infection, and impaired scar quality.

Centre for Surgery requires complete cessation of smoking, vaping, and nicotine replacement products for at least six weeks before surgery and six weeks after. This is not negotiable, and we will test where indicated. Patients who continue to smoke during the cessation window are deferred until they have demonstrated genuine abstinence. See and .

Elevated BMI is an independent risk factor for infection, venous thromboembolism, wound healing complications, and anaesthetic complications. The largest aesthetic surgery dataset (127,961 patients, Gupta et al., 2016, Aesthetic Surgery Journal) found that overweight (BMI 25-29.9) and obesity (BMI ≥ 30) are both independent risk factors after controlling for other variables. For most body the appropriate ceiling is BMI 30, with limited flexibility for selected cases. See .

Several common medications and supplements increase risk and should be paused on medical advice before surgery: aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginkgo, ginseng, garlic supplements, St John’s wort. Prescription anticoagulants (warfarin, apixaban, rivaroxaban, clopidogrel) require structured bridging managed by the prescribing doctor.

Withholding information about medications or at consultation is not in your interest. The needs the full picture to plan safely, and most issues are manageable with appropriate planning when disclosed.

Diabetes, hypertension, hypothyroidism, and other conditions should be well controlled before elective surgery. Tell your GP that surgery is upcoming, ask whether any medications need adjusting, and ensure relevant blood tests are recent. Uncontrolled diabetes in particular materially increases infection and wound healing risk.

Protein intake supports wound healing. Patients on highly restrictive diets, those who have lost significant weight in the preceding months, and those with eating disorders are at higher risk of poor healing. The target is around 1.2 to 1.6g of protein per kg of bodyweight per day in the pre- and period. See .

Alcohol increases bleeding risk, interferes with anaesthetic metabolism, dehydrates tissues, and impairs healing. for two weeks before and two weeks after surgery is the appropriate baseline; longer for major body procedures. See .

A dedicated adult to accompany you home and stay for 24 hours is a clinical requirement. Time off work, childcare arrangements, and a properly prepared home environment all materially affect how well you recover. Patients who try to power through with inadequate support have more complications and worse satisfaction. See .

Surgeon and facility factors that reduce risk

Surgeon on the GMC Specialist Register for Plastic Surgery, holding FRCS (Plast) or equivalent, with full membership of BAAPS or BAPRAS. High annual case volume for the specific procedure you are considering. These are not vanity credentials — they correlate directly with complication rates. See .

Care Quality Commission registration, with a current inspection rating of Good or Outstanding, indicates that the facility has met operational and safety standards. CQC-regulated facilities have full theatre standards for sterilisation, infection control, equipment, staffing, and emergency response. Treatment rooms above shops, hotel suites used by visiting surgeons, and non-regulated premises do not.

For any procedure beyond minor work under local anaesthetic, a consultant anaesthetist should be present throughout, with full monitoring including ECG, pulse oximetry, blood pressure, and capnography. The surgeon should not be managing anaesthesia themselves while operating. See .

Operating time over 6 hours is associated with materially higher rates — VTE risk doubles, infection risk rises, and anaesthetic complications accumulate. The clinical decision to combine procedures should be made on risk grounds, not on marketing or discount-stacking grounds. Patients booked for multiple major procedures simultaneously should ask why, and what the alternative staged approach would look like.

Specific procedure-related risk reduction

After abdominoplasty: compression binder worn 24 hours a day for 6 weeks; gentle mobilisation from day 1 (with mid-flexed posture); careful drain management; adequate protein intake; smoking cessation absolutely.

After breast augmentation: surgical bra continuously for 6 weeks; sleeping on the back propped at 30 degrees; no chest exercise for 6 weeks; monitor for early signs of capsular contracture (firmness, distortion) at follow-up. See .

After BBL: no sitting directly on the buttocks for 2 weeks; BBL that transfers weight to the thighs for several weeks beyond that; no flights for at least 2 weeks; monitor for fat embolism symptoms.

After facelift: sleeping propped at 30 degrees for 2 weeks; head bandage as instructed; no smoking under any circumstances; minimal facial expression for the first week; ice packs for the first 48 hours.

After rhinoplasty: head elevated for sleep; no on the nose for 6 weeks; nasal saline as instructed; no nose blowing for 2 weeks; sun protection on the nasal skin.

After liposuction: compression garment continuously for 6 weeks; gentle walking from day 2; manual drainage massage from week 2 if recommended; hydration; weight stability.

Sun protection — the long-tail factor

UV exposure on immature scars produces that does not fade. For 12 months after any procedure with visible scars, direct sun on the scar should be avoided, with SPF 50 sunscreen used reliably. This applies autumn and winter too — UV exposure is reduced but not absent.

The longer-term picture also matters. UV exposure is the modifiable contributor to facial skin ageing, and the of facial rejuvenation procedures is directly affected by sun habits in the years following surgery. See .

Attending follow-ups

Centre for Surgery’s standard follow-up schedule is day 1, week 1, week 3, week 6, three months, six months, and twelve months for most procedures. These appointments are not optional. Their is to catch complications early — when they are easy to manage — rather than late, when they are not.

Patients who skip follow-ups disproportionately present months later with problems that could have been addressed at the routine appointment. Conversely, patients with concerns between scheduled appointments should not wait — our 24/7 nurse-led aftercare line covers the first six weeks, and patient coordinators can arrange a clinical review at any point thereafter.

Warning signs that warrant immediate contact

Calling early is always preferable to waiting. The 24/7 aftercare line is for exactly this purpose.

Booking a consultation

To book a consultation, call or use the . We are based at . The specific risks of your planned procedure, and the strategies for minimising them, will be discussed in detail at consultation.

Centre for Surgery · CQC-regulated · GMC specialist-registered surgeons · · · ·

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Centre for Surgery is a CQC-regulated private hospital on London’s Baker Street, delivering plastic and cosmetic surgery through GMC-registered specialist surgeons. Our expertise spans facial procedures including and , , for men, and body contouring procedures such as and . Patient safety, surgical excellence and natural-looking results sit at the heart of everything we do.

Centre for Surgery is a private hospital on London’s iconic , offering plastic and cosmetic surgery led by GMC-registered consultant surgeons.