Post Op Complications / Healing Issues

I have just started reading this board with hopes of learning more before I pursue any plastic surgery next year. My question is... how common are complications ?  It seems there are TONS of posts about dehisced wounds and things opening up weeks down the line. It seems there are more complications than seen in the weight loss surgery itself.... or is it simply that people post only problems. Do some surgeons not put in enough sutures ?

There is the good a d the bad that can happen in any procedure.
You just happened te read my postings!
Mikimi in Israel

I'm a midwife, so I do a fair bit of suturing. I can tell you the complications from plastic surgery are likely not related to surgeons not putting in enough sutures. I'm not a surgeon, but from what I understand of it, plastic surgery is more technically challenging than weight loss surgery. There is a much larger area of incisions, for example, in a tummy tuck than there is in a laparascopic procedure, which leaves a much higher risk for infection and wound dehiscence. There is also a longer recovery time for most plastic surgery procedures than for WLS. And, depending upon the WLS, patients who have plastic surgery after WLS may have nutritional deficiencies that make wound healing challenging.

I went into my plastic surgery with unrealistic expectations of what the recovery would be like. I knew it would be more difficult than the WLS and the gallbladder surgeries I had, but I did not anticipate any complications at all. I mistakenly assumed that because I had never had any complications from surgery before, I would not have any complications from my plastic surgery. What I didn't consider was that I was taking a huge risk by having both my breast reduction and anchor cut abdominoplasty done at the same time. I was under anesthesia for 7 hours. That's a LONG time, much longer than with my WLS. I had incisions under both breasts, around the areolas, from sternum to pubic bone, and from hip to hip. There are several layers of sutures, too. That's a lot of surface area that needs to heal. The complications aren't due to not enough sutures being placed. A lot of the complications are because of the large areas that are being sutured at one time. The larger the area being sutured, the more likely the complications in wound healing. And, at points where the stress on the sutures is the greatest, the wound healing challenges are even greater.

Looking back on it, it is amazing that I didn't have MORE complications than I did! I think that's a testament to the skill and judgment of my surgeon, as well as my meticulous self-care and nutrition post-op.

I think if you're considering doing plastics, you need to understand the commitment you are making. You should really research the procedures and the risks, and be realistic in your expectations regarding recovery and results. I am thrilled with how my results, but I am still recovering, and it is more than 4 months since my surgery.

 Yes - I do understand the commitment and researching is exactly what I am doing. Thanks.

 This is an excellent response, Kim. I'm almost a month out from my upper back lift and implants, and just this weekend my back opened up on one side, and the other side looked like it was about to -- I needed stitches, and fortification on the other side. Five years ago my whole lower back opened about a month after my lower body lift. You are so right about the plastics being so much bigger in terms of opening up the body than the WLS. I watched the LBL procedure on TV AFTER I had it done, and it really hit me what a huge risk I had taken -- and I DID get MRSA, which I found out when the lower back opened up. I'm sort of glad I hadn't seen the procedure before I had it, or I might have been scared off. Or at least I wouldn't have done my arms at the same time. Recovery from these things is very slow going, at least for me.

Thank you for your response to this questioner -- it reminded me that I had a big procedure last month and I should give myself a break about taking so long to recover. Its not like I'm 30 years old (though I usually feel closer to 30 than I did 28 years ago!).

Hang in there!!! You've been through a lot!  MRSA is HUGE! Hopefully, the issues you're having with this newest surgery will be short-lived, and you'll quickly move forward towards a complete recovery!

 I think it has to do with the overstretched skin that we have, along with the size and location of hte inciisions, as well as potentially compromised nutrtional status after massive weight loss.

I had two rounds of plastics, and before both my lab levels were great.  I upped my protein.  I babied my incisions.  My plastic surgeon is one of the best in post bariatric plastics.  Yet, I still had a few small openings come apart each time.  The first area was under my arms, and the second was on my back above my butt crack.  From what I understand both areas are very common.  Both of them healed from the inside out in a matter of a few weeks.  The first time it happened it was very distressing to me to look at, but it turned out to not be a big deal.

 Joanne - Thanks for the direct, clear, non preachy reply :)

Hi,
I had extensive conversations with my PS about my numerous procedures, I had 2 Board certified PS, and stayed overnight at a surgery facility. Part of the issue as I understand it from my docs, is that we bariatric patients have to rely on supplements to ge enough nutrients, but is will not help our muscle thickness. So going into my procedures my PS said my muscles were very thin so he took extra time and caution and place 3-4 layers of stitches if you have the opportunity to increase your muscle mass through eating right and weight lifting that may also help.

Seperation only happened to me because I was allergic to the non-absorbable stiches, which happened to have been placed in tension points, which also are a high sweat gland area, such as under the breast and arm pits.

My last comment, they give us rules, like don't lift your arms, don't sit straight up, dont bent over, and all the other don'ts, these are to reduce the risk of stress on the suture points, plus putting stress on the scar will make it widen. Recovering from this is WAY HARDER the WLS, but the results come about within days to weeks. Pain is very easy to control, take the pills. Coughing and sneezing are the worst, no amount of pain pills can kill it, and a few weeks out when you don't want to take any pain pills just be prepared to feel achey like you've been working out muscles you haven't used for a while, and pre-prepared for numbness, and randon *****ly shocks of your nerves healing.

Sorry about the long winded reply. Good Luck.
Shelly

 I have had two rounds of plastics and no complications but I did need my neck revised because it loosened up again.  Add me as a friends to see my plastics pics.