Factors that affect surgical outcomes

When talking about ‘results’ in plastic surgery, we consider both functional and aesthetic outcomes. For example, in the case of breast reduction, ‘functional’ outcomes might include less back pain, whereas aesthetic results might relate to proportion, symmetry and ‘perkiness’.

Not all plastic surgery procedures offer both functional and aesthetic improvements, for example, sometimes rhinoplasty surgery might make a nose look more proportionate, but this might mean the passageway is narrower when breathing. Or augmented breasts might be perceived as aesthetically more beautiful, but functionally might be left with some sensation loss in areas. These are all important things to weigh up before booking surgery.

Although plastic surgery involves effective and rewarding procedures, whereby the benefits significantly outweigh the risks – like every area of surgery, it is not an exact science. The extent of surgical success can be impacted by how each individual’s body responds to surgery and recovery. Although good results are expected, there is no guarantee of a specific outcome, and in some situations, it may not be possible to achieve the desired result with a single surgical procedure; in this case, revision surgery may be necessary.

This information is not shared to scare or deter patients, but they are vital considerations. Dr Sharp and his team will share a list of risks associated with your surgery; you will be asked to sign consent forms confirming that you fully understand the procedure and any risks or potential complications.  It is normal to feel a mixture of nerves and excitement; do not hesitate to ask questions or share these feelings or concerns with Dr Sharp or his team.

The following factors play the biggest role in your surgical outcome:

• your overall physical and mental health
• being in healthy or overweight BMI range (ie under 30 points)
• being well informed and having realistic expectations preoperatively 
• disclosing previous surgery, allergies, medications/supplements and pre existing health conditions prior to your surgery

Prior to surgery, your surgeon might request:

• Blood tests or xrays
• Medical evaluation by a specialist
• Psychological evaluation to ensure suitability for surgery
• Adjustment in current medications
• Cessation of smoking at least 6 weeks preoperatively
• Weight loss before surgery can optimally proceed
• Adjustments to your exercise schedule or workload to ensure safe recovery

Nurse training with Dr Sharp Plastic Surgeon

Weight and surgery

Studies show that obese patients suffer from a significantly higher incidence of perioperative complications than normal or overweight patients.

What is BMI?

BMI stands for ‘body mass index’. It takes your weight and divides it by the square of your height in meters.

BMI is a helpful indictor, but it is not always a perfect assessment as it does not take into account muscle weight for extremely  muscular people; so if you have recently used a different body fat percentage tool, please share this with your surgeon so they can use this instead when determining suitability for surgery.

What’s the difference between being obese and being overweight when having surgery?

Whether you are overweight or obese depends on your BMI -nor body fat percentage. Generally, a person between 25 – 30% body fat is considered overweight. Someone with a BMI greater than 30 is considered obese.

Most studies have shown increased perioperative complications in patient with BMI over 30. These include:
• increased anaesthetic risks and operating time
• increase in technical difficulties of surgery
• compromised healing response, necrosis and breakdown of surgical wounds
• longer hospital stays and increased likelihood of readmission to hospital due to complications 
• increase rate of infection and prolonged wound healing
• suboptimal aesthetic outcome

The complications associated with obesity can be overcome with weight reduction prior to surgery. During your pre consultation booking process, we will request your BMI. If your BMI is in the obese category we recommend postponing your appointment with Dr Sharp until such time as it is under 30; this means Dr Sharp can perform an accurate assessment of your ‘preoperative’ body habitus; and provide appropriate clinical recommendations, surgical plan and quote.

If you have trouble losing weight, we recommend speaking to your GP for advice. They might recommend seeing a bariatric surgeon or a nutritionist, dietician, food therapist/psychologist or medically supervised weightloss clinic such as LifeShape.

Once you have reached your target weight, Dr Sharp suggests maintaining a stable weight for a few months before considering plastic surgery. Weight gain after aesthetic procedures will often result in unsatisfactory results. Subsequent weight loss can also affect your cosmetic outcome.

Smoking and surgery

Smoking is also another important factor that can affect your surgical outcome. Smoking impacts your body’s ability to heal, impairing white blood cell function and causing constriction of blood vessels, reduced oxygenation of tissues and compromised healing.

In addition to its impact on aesthetic outcomes, smoking also brings a higher incidence of infection and lung problems after general anaesthesia – so quitting prior to surgery is an important overall safety measure as well. Smokers need to stop smoking for a minimum of six weeks before surgery, and must continue to abstain from smoking for two months post op. A surgeon can request testing on the day of surgery to determine the level of smoking-related toxins in the body. If healing complications occur, revisional surgery can be costly – and permanently impact your results.

Nutrition and surgery

Good nutrition is integral to a healthy recovery. From wound healing through to inflammation reduction, so much of your recovery can be assisted by a healthy, balanced diet consisting of whole foods. Investing in the advice of a nutritionist preoperatively can help you pack your cupboard and fridge with the right food and supplements for your body, ready for your recovery. We can’t emphasise the benefits of avoiding processed food enough during your healing period.

Read consent forms and ask questions

Prior to your surgery, you will be given consent forms containing important considerations associated with your procedure. It is important not to skip over these, in the excitement of preoperative preparations. We share these risks and complications because they are real, and they do happen from time to time, even when best practices are followed. Patients who undertake elective plastic surgery must accept these risks before signing their consent forms. It’s important to consider how you would feel if a complication occurred; how it might impact your mental health, finances, fitness, relationships and job.

The decision to have cosmetic or plastic surgery is extremely personal and you’ll have to decide if the benefits will achieve your goals and if the risks and potential complications are acceptable.

Most of the risks are very uncommon, but some patients may be at higher risk for specific complications due to pre existing health issues, natural anatomy or medications.

In our experience, patients who spent time considering these possibilities prior to surgery tend to have better outcomes. Perhaps this is because they have more reasonable expectations or because they are also more inclined to follow post operative instructions closely.

Follow post operative instructions

It is very important to follow all information given to you by Dr Sharp or your clinic nurse, including pre and post operative instructions. These instructions are provided because they help produce the best possible outcomes after surgery. Not following them may result in avoidable risks to your health, recovery and surgical outcome.

The power of positive mental wellbeing

The mind-body connection has long been acknowledged by science, with research showing that anxiety, depression and high stress levels negatively impact on post operative healing.

If you have recently experienced these, please speak to your GP, psychologist/psychiatrist and plastic surgeon about whether elective plastic surgery is suitable for you right now.

Anecdotally, of the hundreds of patients we see each year, those that have a positive mindset and anxiety levels tend to have healthier recoveries and better outcomes. Research also suggests that the positive or negative mindset of your post operative support person can impact pain and discomfort levels.

If you develop anxiety or depression symptoms after surgery, we recommend promptly seeking the advice of your GP or psychologist to support your optimal recovery.

Don’t rush back to the gym

Overdoing it too early is one of the most common reasons why people have complications in the two to twelve weeks following surgery.

You might feel ready to return to lifting shopping bags or trying the rowing machine at the gym a month after your breast augmentation, but your muscles, ligaments, suture line and implant pocket isn’t! When complications arise at this stage of healing it is usually evident that post operative instructions aren’t being followed.

Regularly review your post op instructions during your recovery period so you know what to expect, and when to recommence certain activities.

At any stage after surgery, if your body responds to activity with pain, swelling or shape change in your operative area, cease the activity and get in touch with the clinic. Your body might require longer time frames than usual before returning to certain activities.

If you rely upon physical activity to maintain your mental health – or for your job – it’s important to consider the impact that this extended ‘downtime’ might have.

Learn more about having plastic surgery on our Frequently Asked Questions page.

Ready to book your initial consult?

Call our friendly patient support team on 3202 4744 or email info@drdavidsharp.com.au – we’d love to assist!