From Botox to breast implants: The dangers of cosmetic surgery

Considering cosmetic surgery? Here’s how to weigh up the risks before deciding.

Words by Libby Hakim
December 2019

In Australia, it’s estimated we spend about $1 billion each year on cosmetic procedures.

Around $350 million of that is spent on the anti-wrinkle treatment Botox, and about 8,000 breast augmentation surgeries and 30,000 liposuction procedures are performed a year, reports The Australasian College of Cosmetic Surgery.

Dr Nicholas Moncrieff, a specialist plastic surgeon from Hunter Plastic Surgery in Newcastle, says the growth in cosmetic surgery is likely “due to it being more accepted now, in part due to popular TV shows and social media”. However, wanting to look our best, or better, is nothing new, he adds.

Egyptian eye makeup, Indian henna hair dye, Victorian-era corsets and Georgian lead-based face-whitener: since ancient times people have been striving to keep up with the beauty trends of their day – whether to look younger, healthier, wealthier, or slimmer.

What are the most popular cosmetic surgeries?

A 2015 study sheds light on what Aussies are searching for when thinking about cosmetic procedures. RealSelf, an aesthetic medicine website, collected data from 650,000 Aussies to find the top five most-searched-for procedures, both surgical and non-invasive:

•  Breast augmentation and breast implants
•  Rhinoplasty (nose surgery)
•  Tummy tuck to reduce the bulk of the lower abdomen
•  Facelift surgery to reduce signs of ageing in the face and neck
•  What the study called a “mummy makeover”: a combo of a tummy tuck and breast surgery, sometimes with liposuction added in.

What are the risks of cosmetic surgery?

Whether to look younger, to change an unloved feature, or simply to look different, there are plenty of reasons people consider cosmetic surgery.

Some people require reconstructive cosmetic surgery after illness or accidents, for example. There are also instances where cosmetic surgery can have functional benefits, says Dr Moncrieff: for those with large breasts, reductions can “significantly reduce neck and shoulder pain”, while some women whose bodies have changed after birth have found that tummy tucks have reduced back pain and incontinence.

When making decisions about cosmetic procedures, it’s important to look beyond Instagram images and the ideal result you dream about.

“So many people have started seeing procedures like breast augmentation as almost like a beauty treatment,” Dr Moncrieff says. “But it isn’t – surgery is serious, and things can go wrong, especially in untrained hands, as we have tragically seen in the media over the last couple of years.”

The Australasian College of Cosmetic Surgery highlights that both surgical and non-invasive cosmetic procedures carry an element of risk, from minor side effects such as redness or bruising through to severe infections or scarring.

With the more common surgical procedures, Dr Moncrieff says the main risks are complications related to anaesthetics, including pneumonia, blood clots and, rarely, death. He adds: “There can also be infections, fluid collection, bleeding, poor scarring or skin breakdown and numbness from nerve damage. All of these may result in additional surgery.”

For breast procedures, he says it’s important for women to understand the further risks, which include “a loss of nipple sensation, asymmetry and difficulty breastfeeding”.

For tummy tucks and body lifts, the main issues are wound breakdown and delayed healing, he says. “This risk is much higher in patients who have smoked or have a higher body mass index.”

Perth-based specialist plastic surgeon Dr Guy Watts also highlights the importance of evaluating risk. “Make sure you’ve had more than one consultation with your surgeon, have been given information on your procedure, and are fully informed of the risks and possible complications of your chosen surgery.”

He says it’s important not to be complacent about non-surgical procedures such as Botox and fillers, too, since these can carry some serious risks such as drooping eyelids, skin necrosis (skin death) and, in very rare cases, blindness.

The dangers of lip and cheek fillers

Lindy Moran says she wishes she’d used a reputable cosmetic company when she opted to have lip fillers injected: “I was working in advertising and one of my clients was offering discounted lip injections, so I decided to take advantage of the offer.”

Lindy had had lip injections before, with no side effects, so assumed this was a straightforward beauty top-up.

“At the clinic, after discussing the lip injections, the cosmetic nurse disappeared into the next room and returned with the needle. She applied an anaesthetic, so the injections weren’t painful, but as I was leaving, she suggested I visit my doctor for an antihistamine and antibiotics in case the area became infected. She explained she’d injected a slightly different ingredient than usual, and that it would last longer.”

The next morning Lindy woke to a swollen face and sore, red lip area. “I couldn’t go into work, it looked so bad. But I went to the GP for a course of antibiotics in case it got worse.”

Lindy returned to the cosmetic surgeon where she’d previously had cosmetic work done and was told that there was cheek filler in her lip, which made the area harder than it should be, and lumpy.

“On the second day, a lump and lesion appeared,” which became infected. “The cosmetic surgeon who I’d had my first lip injections with lanced the pus out of my lip and dissolved the fillers. I had to go back every few days until the area was healed. My lips are now back to normal, but one small lump on my lips took a few years to completely go away.”

Lindy has now sworn off any type of cosmetic injections and urges anybody who is considering having them to closely check the qualifications of their practitioner. “I wouldn’t risk going through this again. I don’t want to mess with my face for a second time: I’d prefer to rely on makeup to get a similar look.”

In Australia, non-invasive procedures like Botox should only be administered by a doctor or a cosmetic nurse under the supervision of a doctor.

What questions should you be asking about cosmetic surgery?

Dr Watts says the number one question you should consider when deciding about cosmetic surgery is: what do I hope to achieve?

Evaluate your expectations and discuss them with your doctor. “It’s important to have realistic expectations about the physical results of surgery and the emotional outcome. Having cosmetic surgery to make others happy or in the hope of addressing emotional insecurities will never end well.”

What are the costs of cosmetic surgery procedures?

For elective cosmetic surgery (not required for medical reasons), it’s unlikely you’ll receive any benefit from Medicare or your private health insurer. For reconstructive surgery and procedures required for medical reasons, such as breast reconstruction following breast cancer surgery or liposuction for a morbidly obese person, you may be eligible for Medicare and private health insurance benefits.

Choosing a provider: Are cosmetic surgeons and plastic surgeons different?

When choosing a doctor or treatment provider, you should consider their qualifications, training and experience. According to the Australian Society of Plastic Surgeons, these are two of the key terms:

• Specialist plastic surgeon:
  A doctor with extensive surgical education and training, including a minimum of 12 years’ medical and surgical education. After completing their surgical education and training, specialist plastic surgeons become Fellows of the Royal Australasian College of Surgeons (FRACS).
  
  
• Cosmetic surgeon:
  Any medical doctor can legally perform many cosmetic surgery procedures. Ask your treatment provider about their specific experience in carrying out the procedure you’re considering and whether they have any reviews from previous patients.

These websites provide useful information to help guide your decision:

• Australian Society of Aesthetic Plastic Surgeons
• Australian Society of Plastic Surgeons
• Australasian College of Cosmetic Surgery