Although the overall incidence of major complications after aesthetic procedures is low, it can result in a potentially devastating cosmetic outcome and pose significant financial burden on the patient and the surgeon. Surgical site infections (SSIs) remain one of the most commonly occurring postoperative complications. Often, they are dealt with in the office setting, however, more severe cases may require emergency room visits, hospital admissions, or even reoperations.
A recent publication from USA looked at the occurrence of a major SSI requiring emergency room visit, hospital admission, or reoperation within 30 days of the index operation. They looked at a total of 183,914 cosmetic surgery procedures performed on 129,007 patients. Univariate and multivariate analysis evaluated potential risk factors for SSIs including age, gender, body mass index (BMI), smoking, diabetes, type of surgical facility, procedure by body region, and combined procedures.
From a total of 129,007 patients, 599 (0.46%) had a major SSI. Increased Age, Increased Body mass index, smoking, diabetes and female gender were more likely to have a major SSI. Trunk/extremity procedures had a higher incidence of SSI compared to breast or face procedures and SSI’s were higher in patients that had multiple procedures at the same time.
They concluded that SSIs following cosmetic surgical procedures are associated with numerous independent predictors, which should be taken into consideration when counseling patients undergoing aesthetic surgery.
Mr Ross believes that it is important to maximize patients preoperatively to limit the chance of SSI. Mr Ross rarely will operate on smokers and those with a BMI of over 30. Prevention of an SSI is essential for all patients undergoing combination treatments especially mommy makeover procedures.
Kaoutzanis C, Gupta V, Winocour J, Shack B, Grotting JC, Higdon K.
Incidence and Risk Factors for Major Surgical Site Infections in Aesthetic Surgery: Analysis of 129,007 Patients. Aesthet Surg J. 2017 Jan;37(1):89-99.