Arch Aesthetic Plast Surg.  2019 Jul;25(3):108-114. 10.14730/aaps.2018.01592.

Emergency room visits for severe complications after cosmetic surgery

• Lee WS
• Park SH
• Kang SG
• Tak MS
• Kim CH
• Lee SW

• KMID: 2454389
• DOI: http://doi.org/10.14730/aaps.2018.01592

Abstract

BACKGROUND
Because many cosmetic surgery clinics are not adequately equipped to handle emergent conditions, patients often come to a university hospital when problems occur during or after cosmetic surgery. However, few in-depth studies have been conducted of this issue. Therefore, we investigated emergency department visits due to complications associated with cosmetic surgery.
METHODS
A retrospective chart review was conducted of 38 patients who visited the emergency department of the authors' institution due to complications associated with cosmetic surgery from July 2014 to June 2017.
RESULTS
There were more women than men (30 women vs. 8 men). Their mean age was 32.4 years (range, 19-57 years). Upon presentation to the emergency department, patients' vital signs and mental status were usually normal (27 normal vs. 11 abnormal). The types of surgery included blepharoplasty, rhinoplasty, malar/orthognathic surgery, mammaplasty, liposuction, fat grafting, and filler and botulinum toxin injections. Most patients required hospitalization (26 admitted vs. 12 discharged). Eight of the hospitalized patients required intensive care unit care, of whom two died and three experienced brain death or had permanent neurologic sequelae.
CONCLUSIONS
The complications were usually minor problems, despite the need for hospitalization, but some complications were life-threatening. We recommend close monitoring and maintaining an adequate injection capacity for intravenous sedative anesthesia. When any symptom or sign of a complication occurs, it is best to transfer the patient to a university hospital as soon as possible. Taking a careful medical history is always needed, even for minor procedures.

Keyword

Anesthesia; Cardiomyopathies; Epinephrine; Plastic surgery

MeSH Terms

Anesthesia
Blepharoplasty
Botulinum Toxins
Brain Death
Cardiomyopathies
Emergencies*
Emergency Service, Hospital*
Epinephrine
Female
Hospitalization
Humans
Intensive Care Units
Lipectomy
Male
Mammaplasty
Retrospective Studies
Rhinoplasty
Surgery, Plastic*
Transplants
Vital Signs
Botulinum Toxins
Epinephrine