|
|
|
Facial Plastic and Reconstructive Surgery Handbook |
|
Risks with Facial Plastic Surgery
Throughout this handbook we have continually referred to risks and complications with facial plastic surgery. Even in the very best of hands with the best of care, complications do occur. The following information is excerpted from the surgical experience at UCLA between 1972 and 1974. Under the categories of facelift, otoplasty, chin implant, nose surgery and blepharoplasty surgery, the different kinds of complications are listed and the percentage of cases in which these occurred are also listed. These complications occurred in a training program and, it is hoped, are less likely in our hands with the techniques and equipment available to us in the 1990's.
Nonetheless, these complications do occur, and the following statistics will give you some idea about the kinds of complications that occur, and how frequently they might occur.
Percentage of complications by procedure
| Facelift (114 cases, 1972-74) |
|
Major Complications |
|
Large blood clot under skin |
2.6 |
|
Motor nerve damage |
0.9 |
|
Visible skin loss |
0.9 |
|
Major infection |
0.9 |
|
Unacceptable scarring |
0.0 |
|
Total major complications |
5.3 |
|
Minor Complications |
|
Small blood clot under skin |
2.6 |
|
Skin loss behind ear |
12.2 |
|
Numbness of ear or scalp |
4.4 |
|
Suture line infection |
3.5 |
|
Extensive bruising |
0.9 |
|
Increased scar |
0.9 |
|
Total minor complications |
24.5 |
| Otoplasty (21 cases, 1972-74) |
|
Major Complications |
|
Major hematoma |
0.0 |
|
Infection |
0.0 |
|
Cartilage loss |
0.0 |
|
Hypertrophic scars |
0.0 |
|
Total major complications |
0.0 |
|
Minor Complications |
|
Unsatisfactory correction |
9.5 |
|
Revision required |
4.8 |
|
Total minor complications |
14.3 |
| Chin Implantation (21 cases, 1972-74) |
|
Major Complications |
|
Major skin loss |
0.0 |
|
Nerve damage |
0.0 |
|
Total major complications |
0.0 |
|
Minor Complications |
|
Minor movement |
4.8 |
|
Infection |
4.8 |
|
Total minor complications |
9.5 |
| Rhinoplasty (368 cases, 1972-74) |
|
Major Complications |
|
Severe bleeding |
0.8 |
|
Psychosis |
0.3 |
|
Septal perforation |
0.3 |
|
Skin laceration |
0.3 |
|
Postoperative hypotension |
0.3 |
|
Total major complications |
1.9 |
|
Minor Complications |
|
Minor mid-nose deformity |
2.4 |
|
Pyramid deformity |
4.3 |
|
Tip deformity |
1.9 |
|
Unsatisfactory airway |
4.1 |
|
Unspecified dissatisfaction |
1.1 |
|
Tape allergy |
0.3 |
|
Total minor complications |
14.1 |
|
Revision Rates |
|
Mid-nose |
1.9 |
|
Pyramid |
1.1 |
|
Tip |
0.8 |
|
Airway |
1.4 |
|
Total revision |
5.2 |
| Blepharoplasty (156 cases, 1972-74) |
|
Major Complications |
|
Vision loss |
0.0 |
|
Lower eyelid droop |
0.0 |
|
Corneal damage |
0.0 |
|
Large blood clot under eye |
0.0 |
|
Total major complications |
0.0 |
|
Minor Complications |
|
Temporary droop of lower eyelid |
1.3 |
|
Noticeably uneven scars |
1.3 |
|
Wound separation |
1.3 |
|
Lack of expected results |
1.3 |
|
Suture line infection |
0.6 |
|
Lid droop |
0.6 |
|
Keratin pearl of skin |
0.6 |
|
Milia |
0.6 |
|
Total minor complications |
7.7 |
FROM Smith, et al. Risk of Facial Plastic Surgery in an Otolaryngology Program. Archives of Otolaryngology, 104:137-139, 1978.
Terence Davidson, M.D., F.A.C.S.
UCSD Otolaryngology Division
200 West Arbor Drive
San Diego, CA 92103-8895
(619) 543-6631 |