Patient Safety During Cosmetic Surgery and Its Guidelines

Introduction

Cosmetic surgery has grown in popularity recently, with millions of treatments performed each year. Patients' safety must be prioritized throughout the procedure as patients attempt to improve their appearance and boost their self-confidence. The cosmetic surgery sector is guided by "first, not harm." This Hippocratic Oath-based principle highlights the necessity of protecting patients and delivering compassionate care.

Plastic surgeons who have completed considerable training and education are committed to respecting these values and making cosmetic surgery as safe as feasible. Several aspects must be considered while evaluating the safety of cosmetic surgery techniques. These include the study's quality, the surgeon's skill, and the technology used. People can acquire insights into the hazards connected with certain procedures and propose solutions to manage these risks by evaluating these factors.

What Are the Complications and Mortality Rates of Common Cosmetic Surgery?

Breast augmentation, liposuction, rhinoplasty, blepharoplasty, and abdominoplasty comprise the most commonly performed cosmetic surgery procedures in the United States, according to the American Society of Plastic Surgeons. While each surgery has its own unique risks, comparing complication rates is critical to understanding their relative safety. As studies become more accurate and extensive, the mortality rates related to cosmetic surgery have changed over time. It is critical to examine the quality of the study, particularly its design, data collection methods, and participant demographics when assessing mortality rates.

What Are the Safety Concerns of Common Cosmetic Surgery?

• Outpatient Surgery: Outpatient surgery in operating rooms or post-anesthesia care units is confirmed to be safe. The operative mortality rate related to outpatient anesthesia and surgery is estimated to be 0.25 to 0.50 per 100,000 outpatient operations. Cosmetic procedures are conducted with a high level of safety in hospitals, ambulatory surgery centers, and office-based surgical suites.

• Buttock Augmentation: The Brazilian Butt Lift (BBL), commonly known as buttock augmentation using fat grafting, has grown in popularity recently. To improve the form and size of the buttocks, fat is transferred from one area of the body to the buttocks. However, this procedure has created safety concerns. In 2018, the MultiSociety Gluteal Fat Grafting Task Force made recommendations after evaluating numerous deaths linked to gluteal fat injection. Plastic surgeons are encouraged to use appropriate patient selection, to avoid intramuscular injections and incisions near the "danger zone" region of the buttocks, to use a blue and larger cannula to prevent bending and accidental intramuscular injection, to inject parallel to the buttocks in a retrograde fashion with patients in the jackknife position, and to have a strong understanding of gluteal anatomy.

• Liposuction: Concerns regarding patient safety emerged when liposuction was first introduced in the United States in the 1980s due to higher fatality rates. Massive blood loss, lengthy surgical times, thrombosis, pulmonary edema, and abdominal or viscus perforation are frequently related to these rates. The American Society of Plastic Surgeons formed a task force to investigate the problem in response to these concerns. Advances in methodology and adequate training of board-certified plastic surgeons have resulted in a considerable decrease in the mortality rate linked with liposuction over time. Liposuction is one of the safest cosmetic procedures because of the super-wet method and enhanced fluid control.

• Facial Surgery: Rhinoplasty, blepharoplasty, and rhytidectomy are three frequent facial aesthetic operations with a 1.8 percent complication rate. The most common is hematoma, followed by infection. Combining procedures raises the possibility of venous thromboembolism.

• Breast Surgery: An analysis of 3000 aesthetic breast augmentations revealed an overall complication rate of 4.6 percent, with hematoma, infection, and fluid overload being the most prevalent. Obesity, tobacco use, and diabetes all increase the chance of problems.

What Are the Guidelines for Ensuring Patient Safety in Cosmetic Surgery?

Several guidelines should be followed to maintain a high degree of patient safety in cosmetic surgery:

• Conduct extensive basic scientific and anatomical research to check the safety and reproducibility of new procedures and technologies.

• Develop training modules, such as hands-on cadaver dissection laboratories, interactive operations, and didactic sessions intended for residents and experienced plastic surgeons.

• Training in new methods and technology is required in recognized plastic surgery residency programs or post-graduate educational courses.

• Prioritize patient safety over profits and make excellent judgments when making decisions.

• Only operate on healthy individuals who do not smoke, as smoking raises the chance of problems.

• Perform complex combination procedures that last more than six hours to avoid problems.

• Provide patients with open and honest communication, alerting them of the inherent potential risks of each procedure.

• Strive to provide the greatest and safest care possible, helping patients obtain the best possible outcomes.

How to Educate Patients About Safety and Informed Decision-Making?

Educating patients and the broader public about safety and informed decision-making as patients seek cosmetic surgery is critical. The following are critical points to convey:

• Board-certified plastic surgeons in accredited facilities perform safe cosmetic surgery, including elective operations.

• Outpatient surgery has a low fatality rate of 0.25 to 0.50 per 100,000 procedures.

• Qualified specialists ensure liposuction safety with a 1 in 50,000 death rate.

• The mortality rate for abdominoplasty is 1 in 10,000 to 13,000, indicating its general safety.

• Buttock augmentation with fat grafting has a mortality risk of 1 in 15,000 to 20,000, making surgery statistically safer than previously thought.

Patients should do the following to guarantee their safety and make the best decisions:

• Look for board-certified plastic surgeons who specialize in that procedure.

• Ensure that a Certified Registered Nurse Anesthetist (CRNA) or a board-certified anesthesiologist delivers anesthesia.

• Check if the surgical facility is accredited and meets all safety requirements.

• Quit smoking or vaping since it raises the chance of complications in every aspect of surgery.

Conclusion

Patient safety and better outcomes remain important priorities as cosmetic surgery grows. By assessing recent information, studying advancements in technique and technology, and prioritizing education and training, cosmetic surgeons can deliver the best therapy while avoiding risks. Any cosmetic surgery must be safe to be successful and continue to be practiced. Although new procedures and techniques may carry higher morbidity and mortality risks, adequate training for skilled practitioners can frequently reduce these risks. Patients can confidently pursue cosmetic procedures, knowing that their safety is always the top priority due to open communication and informed decision-making.