How Much Less Would A 23 Year Old Female Pay The Risk of a Stroke During Plastic Surgery

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The Risk of a Stroke During Plastic Surgery

A tacit concern

While most plastic surgeons will describe the risks of performing elective surgery, very few tend to speak directly about safety issues and postoperative complications. Often, a surgeon will make a general statement about the risks of surgery, such as: “All surgery has risks, including bleeding, infection, difficulty breathing, swelling, clots, and other illnesses in a small percentage of patients” and then jump right into talking about the benefits of the procedure. Patients should inform themselves of the real risks associated with cosmetic surgery procedures, especially the risk of stroke or stroke. As a doctor, I understand that there is no point in scaring our patients for no reason. Yet I still firmly believe that patients should never be too quick to decide on elective surgery without fully realizing the potential for devastating complications.

Patients and physicians should recognize that most patients who receive cosmetic treatments are generally considered healthy people. Thus, neither the patient nor the doctor are necessarily ready for the appearance of a complication. This fact alone can make a complication much more serious than if the same complication occurred during a medically necessary procedure. For example, even during routine knee surgery, doctors do not consider their patients to be perfectly healthy and are more protected against the onset of blood clots or other stroke risk factors.

While about one to two percent of cosmetic surgery patients who will have a stroke seem to be a very limited number of patients, the effects of these strokes can be devastating.

Who is at risk?

Few patients really consider themselves at risk of a possible stroke because they associate the disease with an event that occurs in people over 55 years of age. If, in some cases, age plays a role, it is far from being the determining factor in a stroke. In fact, a healthy 65-year-old woman may be less likely to have a stroke than a 35-year-old woman who has invasive cosmetic surgery. Patients need to understand the causes of stroke in a postoperative environment in order to more realistically assess their level of risk. However, as a doctor, I can testify to the fact that sometimes there is no way to determine why a stroke happened to one person and not to another with the same medical history, the same factors of risk and the same surgery.

Most postoperative strokes occur when a blood clot dislodges, which usually occurs in the lower part of the body. This blood clot then travels through the body and can lodge in the brain or more commonly in the lungs. This action of a blood clot passing through the body after surgery is commonly referred to as an embolism and is usually from a larger blood clot that usually forms in the lower body, known as deep vein thrombosis or “DVT” . DVT is a major concern for surgeons and can be considered a precursor to stroke.

Understand the potential danger

Blood clots usually get trapped in the lungs or brain when they are released from other parts of the body. When the blood clot gets stuck in a blood vessel in the brain, a stroke or stroke results. When trapped in a blood vessel in the lungs, it is called a pulmonary embolism or PE. Either condition is life-threatening and can lead to serious consequences.

While blood clots and strokes pose a significant risk to all patients undergoing any type of invasive surgery, plastic surgeons face a unique scenario that generally makes it a little more difficult for our patients to get treatment and help in no time. Incidents of blood clots and strokes can occur between several hours after the operation and up to about ten days after the surgery. Thus, these incidents rarely occur in a medical environment and usually occur at home. Patients who stay in the hospital or medical center after a medically necessary procedure are more likely to have these incidents in the hospital.

Patients, who are going to undergo a cosmetic procedure, or any type of surgery for that matter, should familiarize themselves with the general symptoms of post-surgical pulmonary embolism or stroke. Symptoms that include shortness of breath, chest pain, disorientation, and sometimes even a feeling of altered mental status are likely to be related to a pulmonary embolism or stroke. Patients and physicians should also understand the basic risk factors for these complications and before surgery. While there are still ongoing studies, which will help determine a patient’s level of risk in the future, there are some pretty basic factors that point to a likely candidate.

Risk factors for patients

Women are more likely to experience these types of complications than men, as are smokers. There are many medications that put patients at higher risk for postoperative blood clots, including but not limited to hormone replacements and birth control pills. Weight plays an important role, as does the level of activity the patient typically participates in. Patients who generally lead a sedentary lifestyle are at higher risk. Obese patients are at even higher risk. Advanced age and a history of deep vein thrombosis are more obvious risk factors. Patients who have a current diagnosis of cancer are at particularly high risk.

Reduce risk factors for safer surgery

Whenever a patient is booked for surgery in my practice, I always insist that they have medical clearance from an internist to determine their overall risk level for elective surgery and the possibility of complications. medical conditions, including the risk of abnormal blood clotting. I also take into consideration the type of surgery I am performing on the patient. In general, surgeries that have a longer operating time and involve body contouring carry a higher risk than those that are minimally invasive and are performed on the head and neck. The internist will review a list of current and recent medications, as I do myself, and verify that the patient is physically able to tolerate the desired procedure. There are still no guarantees, but knowing a patient’s medical history, their obvious risk factors, and having a second pair of eyes looking at the same information presented to me ensures that I take all possible precautions.

I also use what are called pneumatic compression boots for every patient undergoing surgery and urge other doctors to do the same. These boots are able to keep lower extremity muscles moving in a manner similar to walking, which can help prevent blood clots from forming. I urge my patients to lead active lives, to help prevent DVT from forming, and to directly assist with preoperative and postoperative care. Correct positioning in the operating room also provides additional prevention of blood clots.

Physicians and patients should understand that the potential for serious complications from cosmetic surgery can be devastating. Knowledge is power and education can help reduce the number of blood clots and such rare but devastating complications as strokes that occur after surgery. With current research and education practices, we should be able to reduce the number of postoperative strokes and blood clots in the next few years.

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