In recent years, cosmetic surgery has become a boom industry. For a large percentage of the population, it’s an elective choice, to make them look better and be more confident. Others aren’t so lucky and require it following some disfiguring accident or disease. Whatever the reason, many procedures are now widely and readily available but at the end of the day, surgery is still surgery and therefore still carries risks.
The list of most common cosmetic surgery procedures is fairly extensive, so here’s an overview of what the main ones are and what potential areas there exist for medical negligence (and resulting compensation claims):
Or to use its correct name, botulinum toxin. (And yes, that word is “toxin” as in “toxic” or “poisonous”.) It’s not often that clinicians happily inject toxins into their patients, but in the case of this particular procedure, it’s becoming increasingly more commonplace. Botox has proved hugely popular because of its ability to iron out wrinkles, mainly in the face. Although it’s a prescribed medicine, rather worryingly you don’t have to be a registered healthcare professional to administer it. That fact in itself suggests that you’re never too far away from a medical negligence compensation claim if you use an unlicensed non-professional. Some of the unasked-for complications following a bad Botox injection include bleeding, unintended muscle weakness, eyelid droop, speech and breathing difficulties, infection or an allergic reaction to the procedure. On no account, submit yourself for Botox if you are pregnant.
Breast enlargement or augmentation
This is the most popular cosmetic surgery procedure for women in the UK. There are usually two reasons why women opt for breast implants: reconstruction following a mastectomy or for purely cosmetic purposes. As it’s a fully fledged surgical procedure, only a fully qualified surgeon can carry it out. If you’re opting for a breast enlargement or enhancement, you have the choice of two types; the most popular choice is silicone gel implants while the alternative is saline (sterile sea water). The implant is positioned between the breast and the chest muscle, or sometimes behind the latter. As it’s such a popular procedure there are some very experienced surgeons out there who can handle this operation very efficiently. However, the sad truth is one in three women will require further surgery within 10 years of their first operation. Additional surgery is often necessary to rectify scar tissue complications, sagging or if the implant ruptures. Also bad scarring, bleeding, infection, numbness and loss of nipple sensitivity, discomfort, implant palpability and visibility, asymmetry (ie, your breasts don’t look aligned), creasing and seroma (fluid build-up around the implant) are all signs that your breast surgery has been mishandled. Another thing to be wary of is PIP implants which are made from industrial silicone rather than medical-grade filler. These are much more prone to rupture.
Also known as mastopexy, this procedure is designed to uplift and reshape sagging breasts. Fortunately, this is a relatively straightforward operation and complications are very rare. But still, there’s always a possible risk factor and you should be on the look-out for some of these tell-tale signs: scarring, bleeding, pain, infection, an adverse reaction to anaesthesia, asymmetrical breasts, varying nipple positioning or height, permanent or temporary loss of sensation in the nipples, inability to breastfeed, internal bruising, and – in some very rare cases – deep vein thrombosis.
Also known as reduction mammoplasty, this is obviously an operation to reduce the size of the breasts. How is that done? Fat glandular tissue and skin is sculpted out of the breasts which are then reshaped and the nipples repositioned. This is an operation usually had by women who experience real physical discomfort such as backache or neck pain due to the size of their breasts. Gynaecomastia is the male equivalent, obviously less common but still a valid consideration for a small percentage of men. The procedure itself is relatively straightforward but there always exists the possibility of complications. Scarring, unevenly shaped breasts or nipples, wounds that refuse to heal quickly, loss of nipple sensation, a bad reaction to anaesthesia, excessive bleeding or infection are all pointers that the procedure has not gone according to plan.
This involves applying chemical products to the skin to remove the outer layer of “dead” skin cells. It peels off to reveal the fresher, more youthful looking skin underneath. As it’s a non-surgical procedure, it can be performed by anyone. Obviously, we would recommend that it’s left in the hands of a medical professional, otherwise you run the risk of burns, infection, scarring, changes in your skin pigmentation, altering of your skin’s texture and persistent redness.
If you have an excess of unwanted body fat, liposuction is a simple surgical procedure to remove it. Fat generally collects on the buttocks, hips, thighs and abdomen but liposuction can also be used for under the chin, the neck, the upper arms, breasts, knees, calves and ankles. Of course having fat sucked out of you is going to alter your body shape and it doesn’t guarantee permanent weight loss at all, especially if you have an unhealthy diet and don’t exercise. As liposuction is mainly required to enhance someone’s appearance and not for health matters, it’s not normally available on the NHS. But here are some of the possible adverse reactions that some might experience if medical negligence factors into the procedure:
- Embolism – this may occur when the fat is loosened and some of it enters the bloodstream with pieces of fat getting trapped in the blood vessels.
- Visceral perforations – when some of the organs are punctured
- Seroma – fluid build-up
- Nerve compression – paresthesias is an altered sensation at the site of the liposuction, ie, it doesn’t feel like it should. You may be experiencing increased sensitivity or no feeling at all.
- Skin necrosis – dead skin cells
- Fluid imbalance – fat tissue contains a lot of fluid causing an imbalance when it’s removed. Conversely some liposuction techniques involve the injection of large amounts of fluids which can create the same problem.
- Toxicity from anaesthesia
- Death – a mercifully rare occurrence
This is a little like Botox in that it’s an injectable product used under the skin to smooth out wrinkles. Almost all the instances where they’re used are not medically related, they’re strictly for cosmetic purposes, so in most of these instances, they’re not carried out by medically trained professionals. Which leaves the door wide open for cases of medical negligence. Examples of that where the use of dermal fillers have gone wrong include:
- Acute or chronic infection
- Raised nodules or lumps, some of which may be chronic and lead to progressive destruction and deformity
- Formation of ulcers or open sores
- Vascular occlusion which is the blockage of a blood vessel
- Tissue necrosis where tissue starts to die off because the blood supply has been compromised
- Allergic reactions
- Prolonged swelling and bruising
- Blindness has been reported in some cases involving filler injections around the eye area though it is quite rare.
If your eyelids are looking a little droopy and tired, then they can be rejuvenated with a spot of surgery. This involves removing excess skin or fat around the eyes to make them look a bit more alert and youthful. Surgery can also help alleviate some of that puffiness that afflicts some people first thing in the morning. The surgeon will cut along the natural lines and creases of your eyelid so that your scars will seamlessly blend in with the natural folds of your eyes. He’ll then remove the excess fat, muscle and loose skin before stitching you back up. If all he’s taking out is fat, then there won’t be any excess skin. He may even use a laser to tighten up any looseness and reduce wrinkles. Lasers don’t leave a scar but they can leave you with redness for a few months afterwards. A lot of these procedures are carried out under local anaesthetic (keeping you alert also helps the surgeon make sure that your eyelids are level on both sides). Swelling is an obvious side effect of eyelid surgery and usually lasts several weeks. Likewise bruising. Blurred vision is another byproduct but that too clears up after a few days. Indeed complications from the procedure are relatively rare but can include bleeding under the skin – if it persists, you might require an operation to drain off the excess blood. Cysts can sometimes develop on the scar line; these will have to be removed by a needle. An uneven appearance is never an ideal result and will require corrective surgery. Overcorrection of a drooping upper lid can lead to cornea damage. And of course, like all operations, there is always the risk of bacterial infection.
Arm Lift Surgery
Brachioplasty is an operation that reshapes the upper arm by removing skin and fat. Its main aim is to give some tone and shape to the area and smooth out the skin. Bleeding and infection can be outcomes of botched surgery here, with nerve damage also a possibility. The operation will always result in a permanent scar which will be quite dark for the first six months after the procedure; if it doesn’t, then questions should be asked. Numbness, discoloration and swelling should all wear off eventually too.
Not only does an aging face lose its skin elasticity and become droopier, it also loses fat and muscle tone. Rhytidectomy (aka a face lift) is designed to hold that at bay which it can generally do for about 10 years before the need for another one arises. Recovery time from a face lift is remarkably only a week with some people able to get back to their normal lives the day after surgery. Pain and discomfort are usually fairly minimal too. The procedure itself is fairly well documented (you’ve probably seen a gruesome documentary or two about it) but it involves slicing open the face, removing the skin and fatty tissues off the face’s underlying muscle and connective tissue, tightening those underlying muscles up and then sewing the face back on. As it’s a fairly common operation, there are many practiced surgeons but still unforeseen occurrences have been known to take place. Bleeding, bruising, infection, loss of muscle function or sensation, scarring, skin necrosis – all of these are possible after a face lift but should be temporary. If they’re not, and they persist, then there could be a strong suit for medical negligence.
Scar revision and reduction
Scars occur for all sorts of different reasons – from burns, injuries, surgery, even acne and chickenpox. The aim of this type of surgery is to remove, reduce or just make less visible any scars that the patient is unhappy with and, depending on the complications of the surgical procedure, it can either be done with local or general anaesthetic. Obviously there are inherent risks with any kind of anaesthesia but other possible unfavourable outcomes from scar surgery include bleeding, infection, delayed healing, changes in skin sensation, damage to underlying elements like the nerves, blood vessels or muscles, skin discoloration or swelling and deep vein thrombosis.
Brow Lift Surgery
Years of facial expressions can take their toll and quite a few people have opted to reverse the ageing process by getting their forehead lifted. The procedure will correct sagging skin on the forehead, whilst also tightening up the upper eyelids and eyebrows. This involves the surgeon manoeuvring tissues around and removing segments of muscles and skin from the face, the ones that cause all those wrinkles and deep frowns. Adverse side effects include all the usual suspects – scarring, bruising, bleeding, anaesthesia reactions and infection – but you should also watch out for nerve damage too. You wouldn’t want this procedure to end up with you losing the sense of sensation in parts of the face.
Abdominoplasty (Tummy tuck)
Tummy tuck surgery involves removing the excess fat and skin from the abdomen but can also include tightening up the abdominal muscles to create a more toned appearance. It’s also used for removing stretch marks and unwanted scars. In a standard tummy tuck, the surgeon will make a long cut in your abdomen above the pubic area (he may also make a second cut to remove the belly button). He’ll then pull the stretched abdominal muscles together and stitch them in place. Then the excess fat will be sucked out, and the skin and belly button are repositioned with any remaining excess skin cut off. All of this will then be stitched up again. Scars are a natural by-product of such an invasive procedure and will often take a few months to settle down. But watch out also for infections, bleeding under the skin (haemotoma), seroma (a collection of fluid around the wound) and numbness.
This procedure exists because noses are easily broken and often need to be reconstructed. But it’s also there for those people who live with breathing difficulties due to congenital nasal deformities or to remove any tumours or growths. The end result is an altering of the external appearance while restoring the form and function of the nose. As the reasons for reconstructing a nose differ so widely, there’s no set pattern for any procedure but a few things do remain constant – the side effects. Bleeding, wound infection, tissue necrosis are all possibilities and if they persist to any degree, malpractice is a consideration.
Rhinoplasty (nose job)
Whereas nasal reconstruction springs out of a medical need to reshape the nose, rhinoplasty is an elective procedure where people choose to have their nose changed because they don’t like the look of it. Reduction rhinoplasty is all about making the nose smaller by removing or rearranging bone and cartilage to achieve the desired shape. The skin over the nose isn’t altered with this procedure – it will shrink to fit the new nose. Your nostrils may have to be reduced in size to fit with the new proportions. Augmentation rhinoplasty on the other hand involves making the nose bigger or bulkier. Your surgeon may need extra bone for this procedure which he may take from the back of your elbow, skull or hip bone while the extra cartilage needed will come from the ears or ribs. Sometimes an artificial implant such as Gore-Tex is used. Expect a degree of soreness to follow an operation like this, your eyes will feel stiff and numb because of it and the tip of your nose will ache for some time. You also might have some difficulty breathing through the nose. Unless something has gone drastically wrong, this will pass in time. Nose bleeds are a very common occurrence following rhinoplasty, while blood clots are possible too. If things get really bad, blood clots have been known to form in the lungs of patients. Some augmentation rhinoplasties have resulted in the nasal implant breaking through the lining of the nose which is naturally upsetting for the patient involved, while damage to the septum (the cartilage wall between the nostrils) has also been recorded.
For some people, the quest to lose weight involves the rather drastic step of having an operation to reduce the size of their stomach. By doing that, and shortening the length of the small intestine, these people can only eat small amounts before feeling full. It’s an operation option that’s mainly only taken up by the morbidly obese. It’s usually done through keyhole surgery with the surgeon using surgical staples to make a pouch out of the top of the stomach, thereby separating it from the rest of the stomach. He then will make an opening in this new pouch and attach a section of the small intestine. Bruising, pain and swelling are all to be expected with an operation of this nature but there are other possible complications that could cause some serious issues:
- Wound or chest infection
- Blood clot in the lung (pulmonary embolism)
- Leaks at the joint where the small intestine has been stitched up to the stomach pouch – this is a very serious development and will require further surgery to fix it
- The opening from the stomach to the intestine can become narrowed preventing any food getting in
- The new stomach pouch becomes stretched – this mainly occurs through overeating and can only be repaired through further surgery
Many people undergo cosmetic dental procedures to make their teeth look better. Common practices include porcelain veneers, bridgework, teeth bleaching and orthodontic work. Nerve damage, the need for repeated procedures because of a failing of the dentist the first time round, working on the wrong tooth or teeth and ongoing pain after the dental work have all been cited by patients who feel they’ve been badly treated.
It’s estimated that 10 million men and 8 million women are affected by hair loss in the UK. Some of those are prepared to resort to cosmetic surgery to cure themselves of this, submitting themselves to a procedure that involves lifting a piece of hair-bearing scalp from a donor site and placing it on a bald or thinning area. It’s actually a fairly straightforward procedure, simply relocating hair to another part of the head. It however can result in the death of hair follicles, scarring, infections (though these are very rare), poor growth or badly positioned grafts.
Lasers have become a very useful medical tool with two different types being commonly employed for cosmetic surgery work. An ablative laser vaporises the top layers of damaged skin while nonablative lasers do their work deeper down in the skin without damaging the outer layers. As you can imagine with such powerful devices, lasers can also be fairly damaging if used improperly or incorrectly. Here are some of the procedures that involve the use of lasers:
- Treatment of fine lines and wrinkles – a combination of skin resurfacing and skin-tightening is used for this procedure.
- Removal of warts and skin tags
- Treatment of pigmented lesions – this refers to the removing of sun spots and age spots.
- Precancerous lesions – nearly all surgeons agree that cancerous lesions need to be removed using a scalpel. Lasers are used for removing the precancerous ones as a preventive measure.
- Vascular lesions – these include broken blood vessels in the face, unsightly veins on the legs and certain birth marks.
- Tattoo removal
- Hair removal
- Treatment of acne and acne scars
Whatever the need for cosmetic surgery – whether it’s for personal appearance or reconstruction after an accident or repairing a birth defect – hopes are generally very high for a transforming result. That’s why it’s all the more devastating for the patient if things turn out badly. Our level of experience in these matters give us a unique understanding of the personal pain that the patient is going through. A compensation claim for botched cosmetic surgeon can go some way to alleviate that pain. At the very least, it can help cover some of the expenses you might have incurred as relatively few cosmetic surgery procedures are available on the NHS. But it can also go towards helping you through your personal trauma and dealing with any potential loss of income you might have suffered if you’ve had to take time off work. We can help guide you through all this with experience, expertise, compassion and the best legal minds.