Introduction to the Risks
of Plastic Surgery
Bleeding and Hematoma
Since a suture is technically a foreign body, it is
not uncommon for your body to react to it. This can
be manifested as a "spitting suture", a suture
granuloma, or a suture abscess.
A spitting suture can occur weeks to months after surgery
if your body rejects the suture and tries to get rid
of it by pushing it out to the surface of the skin.
A suture granuloma appears as a bump under the skin
and occurs when your body makes a tiny wall of scar
tissue around the suture to separate it from the body.
A suture abscess occurs when bacteria enter the area
around the suture and cause a small-scale infection.
This can manifest as redness, tenderness and pus around
the suture. If left untreated, the infection may spread
through the skin.
If you know from previous surgeries that you have had
problems with sutures such as sensitivity or sutures
that don't dissolve in a timely manner, let your doctor
know before surgery. He or she may be able to adjust
the technique or choice of suture material to minimize
your risk of problems.
Your body can react to medications used during or after
surgery or to topical products applied to the skin after
surgery. The most common reaction is to the adhesive
in bandages or tapes that causes redness, itching, and
small blisters under the adhesive.
Neomycin, Neosporin, or triple antibiotic ointments
also can cause an allergic reaction in about 5% of the
population, so many doctors recommend Polysporin, Bacitracin
or a generic double antibiotic ointment instead. (The
third ingredient in a triple antibiotic is the Neomycin).
If you develop a rash, hives, or itching all over your
body, call your doctor immediately. This is a systemic
reaction, usually to a medication and can progress to
breathing problems if severe.
Most mild cases of skin reactions can be treated with
hydrocortisone cream and Benadryl or other antihistamine
pills. More severe cases of sensitivity or allergy may
require oral steroid medication and admission to a hospital.
Anytime an incision is made, there is a chance that
it will not close properly. Bleeding, swelling, nicotine
use, excessive movement, shearing forces, oral steroid
medication, uncontrolled blood sugar, hematoma, and
infection can all contribute to poor wound healing.
Surgical technique, the amount of tension placed on
the wound, and premature suture removal are also contributing
factors that your plastic surgeon has some control over.
If your wound separates, your plastic surgeon may prefer
to let it heal on its own without tension and then revise
the scar once it's healed. In some cases, it may be
possible to re-suture the incision immediately, especially
if it's still within the first 24 hours after surgery.
To Next Section - Necrosis,
Nerve Damage, and Anesthesia