Risks and Complications Sydney, Australia

AHPRA mandatory steps before any cosmetic procedure

Before discussing risks, it’s worth being clear on the framework that exists to manage them. Under AHPRA cosmetic surgery practice guidelines effective 1 July 2023, four steps are required before any cosmetic surgery in Australia can proceed:

1. GP referral. A referral from your general practitioner is mandatory. This gives an independent medical professional the opportunity to review your overall health and identify any conditions that may affect surgical safety.
2. Minimum two consultations. At least one face to face with the operating surgeon. Risks will be discussed in detail at consultation as part of informed consent.
3. Psychological assessment. Patients are screened for body dysmorphic disorder and psychological readiness for surgery.
4. Cooling-off period. A minimum seven-day cooling-off period applies between consultation and the booking of surgery, giving you time to consider the information without pressure.

These steps exist because thorough patient assessment, time for considered decision-making, and full disclosure of risks demonstrably reduce poor outcomes. A practice that is not following them is not operating to current standards. For more on what this looks like in practice and how to verify a surgeon’s qualifications, see choosing your surgeon.

General surgical risks

The risks below apply, in varying degrees, to most cosmetic surgical procedures. Some are common and minor. Others are uncommon and serious. They will all be discussed in detail at consultation in the specific context of the procedure you’re considering.

Anaesthesia-related risks

General anaesthesia in a healthy patient is a low-risk intervention when administered by a specialist anaesthetist (FANZCA) in an accredited hospital. Mild reactions such as nausea, sore throat from the breathing tube, or grogginess are common and resolve quickly. Serious complications, including allergic reactions, malignant hyperthermia, or cardiac or respiratory events, are rare. Patients with significant pre-existing medical conditions, particularly cardiovascular or respiratory disease, should be assessed thoroughly before surgery is planned.

Bleeding and haematoma

All surgery involves cutting tissue, and some bleeding during and after surgery is expected. A haematoma is a collection of blood that develops under the skin after the incision is closed. The reported incidence varies by procedure, ranging from approximately 1 to 5% in facelift surgery to under 4% in breast surgery. Most haematomas are managed conservatively. A larger one may require return to theatre for drainage. Risk increases with hypertension, blood thinners that were not adequately stopped before surgery, and certain supplements that affect clotting.

Seroma

A seroma is a collection of clear inflammatory fluid that can develop in the surgical space after larger procedures, particularly abdominoplasty, breast surgery, and body contouring. Reported rates range from approximately 1 to 4% depending on the procedure. Smaller seromas resolve on their own. Larger ones are managed by aspiration in clinic, sometimes serially. Compression garments, drains, and progressive activity reduce the risk.

Infection

Surgical site infection is uncommon in elective cosmetic surgery, with reported rates typically under 1 to 2% across most procedures. Intravenous antibiotics during surgery, sterile technique, accredited operating environments, and clear post-operative wound care instructions all reduce the risk. Diabetes, smoking, obesity, and immunosuppression increase it. Recognising the early signs of infection (increasing redness, warmth, throbbing pain after day 3 to 5, fever, discharge with odour) and contacting your surgeon quickly is the most important thing you can do if it occurs.

Blood clots (DVT and pulmonary embolism)

Deep vein thrombosis and the more serious pulmonary embolism are uncommon but recognised risks in any surgery requiring extended operating time or post-operative immobility. Risk-reduction measures used routinely include mechanical compression during surgery, early mobilisation, hydration, and where appropriate medical thromboprophylaxis. The oral contraceptive pill and hormone replacement therapy increase the risk and may need to be paused before surgery. This conversation needs to happen at consultation, not the week before surgery.

Nerve injury and altered sensation

Many procedures involve dissection in or near nerves that supply sensation or movement. Temporary altered sensation (numbness, tingling, pins and needles) is common after most facial, breast, and body procedures, and typically resolves over weeks to months as small sensory nerves regenerate. Permanent sensory changes can occur in a minority of patients, particularly with extensive tissue removal. Motor nerve injury (affecting movement) is rare in well-trained hands but is a recognised risk in face, neck, and certain body procedures, and will be specifically discussed for the procedure you’re considering.

Scarring

Every surgical incision leaves a scar. The visibility of that scar depends on incision placement, the procedure, the closure technique, your individual healing characteristics, and your post-operative scar management. In most patients, surgical scars fade significantly over 12 to 18 months. A minority of patients (particularly those with a personal or family history of keloid or hypertrophic scarring) will scar more visibly. Mention any scarring history at consultation so it can be factored into surgical planning. Sun protection on healing incisions for the first 12 months is non-negotiable.

Wound healing complications

Wounds can sometimes break down, heal slowly, or open partially. The risk is higher at junction points where multiple incision lines meet (such as the T-junction in breast reduction or breast lift), in patients who smoke, in patients with diabetes or vascular disease, and where wound tension is high. Most cases are managed with conservative wound care; occasionally a revision is required once healing is complete.

Need for revision surgery

Cosmetic surgery is not a guarantee of a specific result. A proportion of patients across all procedure types will choose to undergo revision surgery, either because of dissatisfaction with the original outcome, asymmetry, or a complication. Revision rates vary by procedure. Realistic expectations and thorough pre-operative discussion reduce the likelihood substantially, but the possibility cannot be eliminated.

Mortality

The risk of death from elective cosmetic surgery in a healthy patient is very low, but it must be acknowledged as part of full informed consent. The most common contributing factors when serious adverse outcomes do occur are inadequate patient selection, surgery performed outside an accredited hospital environment, anaesthesia administered by under-qualified personnel, and unrecognised post-operative complications. Each of these is addressable through appropriate practice standards.

Risk factors that change your individual risk profile

Risk is not a fixed number. The same procedure carries a different risk profile depending on who you are and what your overall health looks like. The factors below are the most significant.

• Smoking and vaping. Nicotine constricts blood vessels and reduces oxygen delivery to healing tissue. Smoking is one of the single largest modifiable risk factors for surgical complications, particularly wound breakdown, skin necrosis in flap-based procedures (facelift, abdominoplasty, breast lift), and infection. Nicotine cessation is required for a minimum of six weeks before and six weeks after surgery for most procedures. This includes vaping, patches, gum, and lozenges.
• BMI and weight stability. Higher BMI increases the risk of seroma, wound complications, infection, and blood clots. Weight stability for several months before surgery is generally preferable to active weight loss in the immediate pre-operative period.
• Diabetes. Well-controlled diabetes is not a contraindication to most cosmetic surgery, but it does increase wound healing and infection risk. Poorly controlled diabetes (HbA1c above target range) should be addressed before elective surgery is planned.
• Age. Healthy older patients can undergo cosmetic surgery safely, but age above 60 to 65 is associated with somewhat higher rates of certain complications and warrants careful pre-operative assessment.
• Cardiovascular and respiratory disease. Conditions affecting the heart, lungs, or vascular system increase anaesthetic and surgical risk. They are not necessarily a barrier to surgery but require specialist input before proceeding.
• Blood thinners and supplements. Aspirin, NSAIDs, prescription anticoagulants, fish oil, ginkgo, garlic, and several other supplements affect clotting. These need to be reviewed and, where appropriate, stopped before surgery. Do not stop prescription medication on your own; this conversation involves your surgeon and the prescribing doctor.
• Previous surgery in the operative area. Prior surgery creates scar tissue that complicates dissection, reduces blood supply, and increases revision complexity. Mention any previous procedures at consultation, even if they were minor.
• Psychological readiness. Body dysmorphic disorder, untreated depression or anxiety, and unrealistic expectations are all associated with poorer satisfaction with surgical outcomes and are screened for as part of the AHPRA-mandated pre-operative process.

Procedure-specific risks

Every procedure has its own specific risk profile in addition to the general risks above. The pages below cover the detailed risks for the most commonly requested procedures in this practice. If you’re considering one of these procedures specifically, the dedicated page will give you a much more detailed picture than this overview can.

Face

• Facelift surgery risks and complications — including haematoma rates, facial nerve risk, scar visibility, and recovery considerations.
• Rhinoplasty risks and complications — including septal perforation, smell changes, breathing concerns, and revision rates.
• Eyelid surgery (blepharoplasty) — including dry eye, asymmetry, lower lid malposition. Discussed in detail on the upper blepharoplasty and lower blepharoplasty pages.

Breast

• Breast augmentation — including capsular contracture, implant rupture, BIA-ALCL, BII, and revision rates. See the breast augmentation procedure page.
• Breast reduction risks and side effects — including delayed wound healing, nipple sensation changes, and asymmetry.
• Breast lift and breast lift with implants — including scar position, recurrence of ptosis, nipple sensation. See the breast lift and breast lift with implants pages.

Body

• Abdominoplasty — including seroma, wound dehiscence at the T-junction, scar visibility, and venous thromboembolism risk. See the abdominoplasty procedure page.
• Gynaecomastia surgery — including contour irregularity, recurrence, and pigmentation changes. See the gynaecomastia procedure page.

Nose

• Septoplasty and functional rhinoplasty — including persistent nasal obstruction, septal perforation, and the relationship between functional and cosmetic outcomes. See the functional rhinoplasty page.

If your procedure is not listed above, the relevant procedure page on this site contains the specific risk information for it.

How risks are minimised in this practice

No surgeon can eliminate surgical risk. What can be done is to address the modifiable contributors systematically. The standards applied in this practice include:

• Surgery is performed only in accredited private hospitals, never in clinic-based or office theatres. Operating venues are Bondi Junction Private Hospital (Eastern Suburbs) and Delmar Private Hospital, Dee Why (Northern Beaches).
• Anaesthesia is administered by specialist anaesthetists (FANZCA), not by GP anaesthetists or sedation technicians.
• Two pre-operative consultations are conducted personally by Dr Turner, with no patient coordinators or representatives substituting for the surgeon at any stage.
• Comprehensive pre-operative assessment including detailed medical history, medication and supplement review, BMI assessment, smoking status verification, and any specialist clearance required.
• AHPRA-mandated psychological assessment as part of the pre-operative pathway.
• Detailed informed consent with written information provided to take home and a minimum seven-day cooling-off period before surgery is booked.
• Continuity of post-operative care with scheduled follow-up appointments and direct access to the practice for any concerns during recovery.
• Surgery performed personally by Dr Turner from skin incision to closure, with no part of the procedure delegated to trainees.

Recognising complications after surgery

Most patients recover from cosmetic surgery without significant complications. When complications do occur, early recognition and prompt management substantially improve the outcome. Contact the practice promptly if you experience any of the following after surgery:

• Sudden, severe, or rapidly increasing pain that is not controlled by your prescribed medication.
• Sudden swelling or firmness in the surgical area, particularly if one side is noticeably different from the other.
• Increasing redness, warmth, or red streaking spreading beyond the immediate incision area.
• Discharge from the wound that is purulent, foul-smelling, or unusual in colour.
• Fever above 38°C, chills, or feeling generally unwell.
• Calf pain, swelling, or tenderness, or sudden shortness of breath or chest pain (these can be signs of blood clot).
• Any concern that something is not right, even if it doesn’t fit one of the categories above.

For after-hours concerns, call the rooms on 1300 437 758 — instructions for after-hours contact are provided in your post-operative pack. In a medical emergency, call 000 or attend the nearest hospital emergency department.

About Dr Scott J Turner

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS, AHPRA MED0001654827) with over a decade of independent practice focused on cosmetic surgery of the face, nose, breast, and body. Hospital affiliations are Bondi Junction Private Hospital and Delmar Private Hospital, Dee Why. All surgery is performed in accredited Sydney private hospitals with specialist anaesthetists (FANZCA).

Dr Turner conducts every consultation personally and personally performs every procedure from start to finish. For full credentials, training pathway, and memberships, see Dr Scott J Turner — Sydney Plastic Surgeon.

Booking a consultation

Consultations are available at Dr Turner’s Sydney clinics in Bondi Junction and Manly. A GP referral is required before your first appointment in line with current AHPRA guidelines. Risks specific to your procedure will be discussed in full at consultation as part of the informed consent process.

To book, call 1300 437 758 or email [email protected], or use the contact form.

Related resources: choosing your surgeon, plastic surgery prices, out-of-town patients.

Disclaimer: This page provides general information about the risks and complications of cosmetic surgery and does not constitute medical advice. The risks specific to your procedure and your individual health profile will be discussed in detail at consultation as part of informed consent. All surgical procedures carry risks. Consult a qualified Specialist Plastic Surgeon registered with AHPRA for advice on your specific situation.