Patient guide · Deciding on surgery
The risks of cosmetic surgery explained honestly: the common complications, how often they happen, what makes them more likely, how to lower your risk and when to get help.
Medically reviewed by Dr Spyridon VlachosSpecialist Plastic Surgeon · FEBOPRAS · GMC 7522950
Last reviewed
Written by the Centre for Surgery clinical team
Key points
Every operation carries some risk, and cosmetic surgery is no different, but serious complications are uncommon and most people recover without any problems. The most detailed figures come from a large US registry of cosmetic surgery (CosmetAssure) covering 129,007 patients: about 2 in every 100 had a major complication within 30 days, meaning one that needed a visit to A&E, a hospital admission or a return to the operating theatre[1]. The risk depends heavily on the operation: a 2015 analysis of 25,478 tummy tucks in Plastic and Reconstructive Surgery ↗ found a major complication rate of 4.0%, against 1.4% for other cosmetic procedures[2].
At our Baker Street hospital, in the 2025/26 reporting year, there were 1,623 procedures, all day cases, with one post-operative infection, two unplanned returns to theatre and a revision rate of 0.6%: our clinical outcomes and patient safety page has the detail. If your question is simply whether surgery is safe for you, read is cosmetic surgery safe? alongside this guide, which sets out what can go wrong, how often, what makes it more likely, and when to get help.
These figures are for major complications in the US registry unless stated, so they describe the more serious end of each problem; minor versions are more common and usually settle with simple treatment.
| Complication | How common | What it feels like | What happens next |
|---|---|---|---|
| Haematoma (a collection of blood) | The commonest major complication: 0.91% overall, 1.4% in men[3] | Swelling on one side that grows quickly, with tightness and pain, usually in the first 24 hours | Small ones settle; a larger one may need a short return to theatre to drain it |
| Wound infection | 0.46% overall: 0.9% after body operations, 0.2% after breast or face surgery[4] | Spreading redness, heat, discharge or worsening pain after the first few days, sometimes with a fever | Antibiotics, and occasionally drainage |
| Seroma (a collection of fluid) | Mainly after a tummy tuck or body contouring | A soft swelling that moves like fluid under the skin | Drained with a needle in clinic; your compression garment helps prevent it. See seroma after a tummy tuck |
| Blood clots (DVT or pulmonary embolism) | About 1 in 5 of the major complications after a tummy tuck[2] | Pain, swelling and warmth in a calf; or sudden breathlessness or chest pain | Prevention matters most: walking little and often, compression and staying hydrated |
| Wound healing problems | More likely in smokers and after body operations | Wound edges opening, or skin darkening near the wound | Dressings, and occasionally a small revision |
| Raised or stretched scars | Varies with your skin and the site | A thick, red or itchy scar after the first few months | Silicone, steroid injections or revision: see scar management and hypertrophic scars |
| Numbness or altered feeling | Common, and usually temporary | Numb, tingling or patchy skin | Usually recovers gradually over months |
| Asymmetry or an unexpected result | Our revision rate in 2025/26 was 0.6% | An uneven contour or shape once the swelling has settled | Review with your surgeon; revision if appropriate |
Of the common cosmetic operations, the tummy tuck carries the highest risk, and combining operations adds to it. In the 2015 tummy tuck analysis, the major complication rate rose from 3.1% for a tummy tuck alone to 3.8% with liposuction, 4.3% with a breast operation, 6.8% with other body contouring, and 10.4% with liposuction and body contouring together[2]. Facelifts, by comparison, had a major complication rate of 1.8%: 1.5% for a facelift alone, rising to as much as 3.7% when combined with other operations[5]. Combining operations can still be the right choice, for example in a mummy makeover, but your surgeon will weigh the extra risk with you and may suggest doing them in stages.
One rare complication deserves a mention because it needs urgent action: bleeding behind the eye after eyelid surgery. It happens in about 1 in 2,000 operations, mostly in the first few hours, and leads to permanent loss of vision in about 1 in 22,000[6]. Sudden severe eye pain, bulging or a change in vision after eyelid surgery is an emergency.
Much of your risk is in your hands. Blood clots are the complication most worth preventing: reviews of tummy tuck and liposuction recommend that every patient’s clot risk is assessed before surgery, with prevention matched to it[8]. Tick off the steps below as you go.
Lowering my risk
For choosing a surgeon, see how to choose a plastic surgeon; for preparation, preparing for cosmetic surgery; and for the weeks after, reducing complications during recovery. If you are thinking of having surgery abroad, read about the risks of surgery abroad.
Serious problems with anaesthesia are rare. Most larger operations at our hospital are done under TIVA, given by a consultant anaesthetist who stays with you throughout; TIVA is as safe as gas anaesthesia and makes feeling sick afterwards less likely. A sore throat and drowsiness are common and pass quickly; damage to teeth and serious allergic reactions are rare. Read anaesthesia for cosmetic surgery for the figures, and why we only operate on people who are fit and well.
Bleeding, breathing changes and small irregularities in shape are the main concerns, and a small proportion of people need a revision once swelling has settled, which takes up to a year. See rhinoplasty risks.
Dry or gritty eyes and temporary difficulty closing the eyes fully are common early on. Bleeding behind the eye is rare but urgent. See eyelid surgery risks.
Haematoma is the most common major complication, especially in men; nerve weakness is uncommon and usually temporary. See facelift surgery.
The main long-term concerns are capsular contracture (scar tissue tightening around the implant) and implant rupture. We use smooth or micro-textured implants, not macro-textured ones, and our implant warranty runs for ten years, covering grade III and IV capsular contracture and rupture. BIA-ALCL, a rare lymphoma, has been linked mainly to textured implants: see BIA-ALCL and breast implants, capsular contracture and breast implant safety.
Wound healing problems where the scars meet, changes in nipple sensation and, after a reduction, a possible effect on breastfeeding. See breast reduction risks and breast lift risks.
The highest-risk group of common operations, mainly because of seroma, wound healing problems and blood clots. See tummy tuck risks.
Contour irregularities, loose skin and, with larger volumes, fluid shifts in the body; we remove up to five litres of fat in one session. See liposuction and loose skin after liposuction.
Dissatisfaction with the result is the commonest reason for a second operation, and expectations matter as much as technique. Body dysmorphic disorder, in which a person is preoccupied with a flaw others barely notice, affects around 1 in 5 people seeking plastic surgery, according to a 2024 meta-analysis of 65 studies ↗[9]. Surgery rarely helps it, so your surgeon asks about how you feel about your appearance at your consultation.
Swelling takes months to settle, so final results are judged at around six to twelve months. If you are unhappy, talk to your surgeon at your review: they will examine you, explain whether anything can be improved and, if a revision is appropriate, what it would involve. Read what happens if you are not happy with your results and revision cosmetic surgery. If you are unhappy with your care, our complaints policy explains how to raise it with us, and you can also contact the CQC or, about a doctor, the GMC.
For the first 24 hours after surgery, call your surgeon on the direct number in your discharge summary. After that, our phone lines are open 9am to 6pm, Monday to Saturday, on 020 7993 4849. Outside those hours, call NHS 111 for urgent advice, or 999 in an emergency.
Bruising, even swelling, tightness, numbness, tiredness, mild itching and firm areas that slowly soften are all normal in the first weeks: mention them at your next review. The NHS advises calling 999 for breathlessness or chest pain, and getting urgent advice for a painful, swollen leg[10]. If you are unsure, ring us: patients very rarely regret ringing; they sometimes regret waiting.
I would rather a patient rang me about a bruise that turns out to be nothing than waited a day with a haematoma. Smoking is the other thing I talk about at every consultation: it nearly triples the complication rate after body contouring surgery, and it is completely within your control.
Dr Spyridon Vlachos, Specialist Plastic Surgeon and medical reviewer
Our hospital is rated Good overall by the CQC, and almost all our operations are day cases. For practical tips on avoiding a poor result, see avoiding botched cosmetic surgery.
Guidance comes from the official sources listed. Registry figures are from the United States and describe major complications.
No question matches that. Try another word, or ask a patient coordinator.
Of the common cosmetic operations, a tummy tuck carries the highest rate of major complications, about 4 in 100 in a large US registry, and the risk rises further when it is combined with liposuction or other body contouring. Face and breast operations have lower rates.
In cosmetic surgery, the commonest major complications are haematoma (a collection of blood), wound infection and blood clots. Together they made up about four in five of the major complications after tummy tucks in the US registry.
Most people recover without problems. In a registry of 129,007 cosmetic surgery patients, about 2 in 100 had a major complication within 30 days. Your own risk depends on the operation, your weight, whether you smoke and whether operations are combined.
Deaths after planned cosmetic surgery are very rare. The most serious risk is a blood clot travelling to the lungs, which is why your clot risk is considered before surgery, and why walking early, staying hydrated and wearing your compression garment matter so much.
There is no reliable ranking. Regret is linked less to the operation than to expectations: people who expect surgery to change how they feel about themselves, or who have body dysmorphic disorder, are more likely to be unhappy. That is why your surgeon talks about your reasons at your consultation.
Check that your surgeon is properly trained and registered, that the hospital is registered with the CQC, take your time to decide, and be wary of discounts and pressure to book. Read how to choose a plastic surgeon and avoiding botched cosmetic surgery.
Yes. Smokers have more wound infections, and in a large registry almost three times the rate of major complications after body operations. Stop all nicotine, including vapes, four weeks before surgery and stay off it for four weeks after.
A slight rise in temperature in the first day or two can be normal. A temperature of 38°C or more, especially with redness, swelling, discharge or feeling unwell, needs checking: call us. If you are confused or very unwell, call 999.
Yes. Major complications rise steadily with BMI, and a BMI of 30 or more more than doubles the risk of infection and blood clots. Many operations have a BMI limit for this reason.
The registers to check, the qualifications to expect and the warning signs.
Read the guide →
TIVA and local anaesthetic with sedation: how they work and how safe they are.
Read the guide →
What is normal after surgery, and when to call us.
Read the guide →What our patients say
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Patient Library
52 articles on choosing a clinic, anaesthesia and safety, written for patients and medically reviewed by Dr Spyridon Vlachos, Specialist Plastic Surgeon.
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