A recent tragic death during smile enhancement surgery of a 28-year-old man in Hyderabad highlights the risk of cosmetic procedures. In a chat with ARCHANA JYOTI, experts emphasise the need for thorough consideration before surgery, advocating stricter regulations, and increased awareness

From smoothing wrinkles to reshaping body contours, the allure of cosmetic procedures often promises transformative results and a boost in self-confidence. Cosmetic surgery has emerged as a popular option for individuals seeking to enhance their physical appearance and address perceived imperfections. However, there lies a landscape fraught with risks and complexities that warrant careful consideration.

Consider a few cases of 2023: *Chethana Raj, a promising young TV actor, who tragically lost her life after undergoing plastic surgery in Bengaluru. Her father, K Varadaraj, revealed that hospital authorities attributed her death to a cardiac arrest.

*The untimely demise of Luana Andrade, a 29-year-old Brazilian influencer, following liposuction surgery in São Paulo, serves as a chilling reminder of the risks inherent in cosmetic procedures. Complications during the surgery led to four cardiac arrests, ultimately claiming her life.

*Argentine model and actor Silvina Luna died due to complications related to a kidney illness associated with prior plastic surgery.

These reported cases involve celebrities or in some others, complainants managed to reach out to media or vice versa. The recent one that has been reported this year is of LN Vinjam (28) who lost his life on February 18 while undergoing a 'smile designing' procedure, just weeks before his wedding.

There are countless unreported instances of individuals suffering after  cosmetic enhancements. Many endure silent pain as their pursuit of an ideal appearance is botched by incompetent surgeons.

Dr Manish Jangra,  Consultant Dermatologist from Park Hospital points out that craze for cosmetic procedures is rising day by day. Minimally invasive procedures have seen an even larger increase than surgical ones. "When it comes to cosmetic dermatology, individuals often seek treatments to address a variety of concerns related to their skin's appearance and texture, correcting skin tone, smoothing wrinkles, removing hair on the face or body and reducing surface fat.

"When we talk about Botox a lot of thing comes in our mind as it is widely used by various media platforms and many famous celebritiesfor various indications. Botox is a botulinum toxin obtained from bacteria. It is basically used in dermatology for various cosmetic issues like frown lines(Forehead) Crow footprints (Lateral to Eyes). These are basically used to smooth wrinkles over face. This is also used for Hyperhidrosis of palms & for excessive sweating.

"Then there are Fillers. These are used to fill the area that has lost tissue or to fill that gap.

“Dermal fillers, sometimes called soft tissue fillers, are substances designed to be injected beneath the surface of the skin to add volume and fullness. The time they take to work, as well as how long they last, also vary. Some fillers last six months, while others last up to two years or longer. They can be used to enhance lips, enhance shallow area like undereye trough & to soften the static wrinkles. But they must be injected by dermatologist with great experience in aesthetic practice," warns Dr Jangra.

He reiterates, this must be injected by qualified dermatologist only as various quacks too are flourishing in market claiming to be cosmetologists leading to various complications. People must check qualification and experience of the doctor first and should cautious about the quacks using term "Cosmetologists." There is no such degree by this name approved by National Medical Commission (NMC), cautions Dr Jangra.

“Also you must ensure to go to dermatologist with MD/DNB/DVD (Degree in Dermatology). A lot of dentists/MBBS/non medicos/nurse have started practicing as cosmetologists, playing with health of the common people.”

Dr Sachin Ambekar,  Director, Minimal Access Surgery and Medical Director at Massh Hospital, stresses on the necessity for hospitals to be equipped to handle emergencies and emphasizes the importance of thorough patient history-taking before any surgical procedureminor or major which he's had in the previous history. If he's had a surgery, what kind of anaesthesia, did he have any kind of complications and if there is any detailed notes discharge summary available with the patient. Before any surgery the medical teams get multiple tests done that includes local anaesthesia test dose, IV antibiotic test dose. The anaesthetist or the surgeon takes a detailed history of the medical and surgical history. While it is mandatory for every centre involving dentists, oral maxillofacial, aesthetic ad plastic surgery to have qualified doctors on its panel but it is most important to keep a backup in case there is any emergency. Dr Madhu Goel, Director, Gynecologist and Obstetrics at Fortis La Femme highlights several key points surrounding the motivations, types, and potential risks associated with these surgeries.

From addressing perceived flaws to enhancing confidence and conforming to societal beauty standards, rise of social media and celebrity culture have also contributed to the desire to emulate certain looks or features, she notes.

While many cosmetic procedures are generally safe and backed by research, it's crucial for patients to be aware of the potential risks and complications involved. As with any surgical procedure, there are inherent risks such as anesthesia complications, infections, scarring, and changes in sensation. “Therefore, thorough consultation with a qualified healthcare provider and a realistic understanding of both the benefits and risks are essential steps, advises Dr Goel.

Potential complications

Hematoma: Hematoma, a pocket of blood resembling a bruise, can occur in 1 percent of breast augmentation procedures and is the most common complication after facelifts.

Seroma: Seroma, the pooling of sterile body fluid beneath the skin's surface, is a common complication following surgeries like tummy tucks.

Blood loss: While some blood loss is expected during surgery, uncontrolled blood loss can result in severe outcomes such as a drop in blood pressure.

Infection: Despite preventive measures, infections remain common after plastic surgery, affecting around 1.1 to 2.5 percent of individuals undergoing breast augmentation. Cellulitis, a skin infection, is one example, while severe cases may require intravenous antibiotics.

Nerve damage: Many surgeries carry the risk of nerve damage, leading to numbness or tingling sensations. While often temporary, nerve damage can sometimes be permanent, affecting sensitivity or function in the operated area.

Deep vein thrombosis and pulmonary embolism: Though relatively uncommon, these conditions can be life-threatening, with rates slightly higher in procedures like abdominoplasty.

Organ damage: Procedures like liposuction pose risks of visceral perforations, where surgical instruments inadvertently puncture internal organs, potentially leading to fatal consequences.

Scarring: Scarring is an inevitable outcome of surgery, with some individuals experiencing hypertrophic or keloid scars, which can be red, thick, and raised, causing aesthetic concerns.

General appearance dissatisfaction: Despite overall satisfaction rates, some individuals may experience dissatisfaction with their postoperative results, particularly if there are contouring issues or asymmetry problems.

Complications of anesthesia: Anesthesia carries its own set of risks, ranging from lung infections to tions, stroke, heart attacks, and death.