Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

The difference between a complication and a trade off.

Seattle Plastic Surgeon clears up some confusion about postoperative “issues.”

imagesCAOSLYZTI recently did a pre-operative visit on a lady who will be having a face lift next month.  We have patients read an extensive informed consent document and discuss any issues that arise from that document.  She was most concerned about nerve damage that may leave her face “paralyzed and numb.”  This got me thinking about surgical complications and trade offs.

Facial paralysis after a face lift is an exceedingly rare (as in it has never occurred in any of my face lift patients) but possible complication of face lift surgery.  That is in contrast to facial numbness after a face lift which is not a complication at all.  It is a trade off meaning that it happens because of what the surgeon must do to accomplish the face lift.  In raising or peeling up the skin on the face, many teeny, tiny sensory nerves are cut and this leaves the face numb until those teeny, tiny sensory nerves grow back and the sensation returns (this usually takes about a year).

Here is another example:   A trade off for a tummy tuck is the hip to hip scar.  An incision must be made to remove the excess skin and all incisions heal with a scar so a normal scar is not a complication.  It is a predicatble and expected trade off.   Now if the skin on either side of the incision becomes infected or falls apart  and the scar ends up being really wide or indented, that is considered a complication.  It was not expected.

Complications are not expected but can happen and patients need to be aware of their risks.  Trade offs are expected and will happen and patients need to be accepting of them.

Wow, it was good to get that cleared up, at least for me it was.  Thanks for reading!  Dr. Lisa Lynn Sowder


Category: Postoperative Care, Scar, Surgical Eductaion | Tags: , , , , , , , , ,

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