What to do when plastic surgery goes wrong

Interview with Dr. Petra Berger, doctor of plastic surgery (Frankfurt am Main and Zurich), on the subject of reoperation in aesthetic surgery.

Doctor, we’ve learned a lot from you about modern trends and possibilities in aesthetic surgery. Yet we still continue to see cases of unsuccessful plastic surgery because, it seems, some doctors overstep the boundaries of what is good for their patients. Cosmetic surgery which results in an ugly scar can hardly be described as successful.

Dr. Berger: I think so, too. Unsightly scars are just one of the things that patients can be disappointed about. Yet scar revision and correction is also entirely possible with the help of aftercare. The list of potential problems, however, is unfortunately much more extensive. You need sufficient experience to be able to correctly assess the situation and then employ the appropriate operative method.

What kind of mistakes do you see most frequently?

Dr. Berger: It can be the wrong choice of implant, incorrect positioning of the implant, a badly operated nose, droopy lower eyelid, unrecognised breast deformity, chest deformity which goes  unrecognised until complications arise after surgery, for example when the wound is healing.

This list doesn’t exactly act as an incentive for people to undergo aesthetic surgery. What motivates you to talk so often about the dangers?

Dr. Berger: I am keen for those interested in undergoing surgery to  choose their surgeon well, so that any potential risks are averted. As I already mentioned, a lot is possible in modern aesthetics but you need to choose good methods and be able to execute them well. It cuts me to the quick when patients who received poor treatment in the truest sense come to the sobering realisation: ‘Oh, I wish I’d left things as they were.’ That can’t be the goal of a responsible plastic surgeon.

You can’t turn back the clock, though. In spite of this, how can you help those affected?

Dr. Berger: In these situations, the patient needs a qualified plastic surgeon who understands anatomy and reconstructive surgery well. An experienced physician can determine what is possible and achievable so that reoperation can achieve a better outcome. This is indeed what happens in many cases – most patients really can be helped.

We have a rather personal question for you, Doctor: What do you prefer as a plastic surgeon – the initial operation where you get to do everything properly, or reoperation where you can correct the mistakes of others?

Dr. Berger: (laughs) Good question and something I think about myself from time to time. Of course it makes me happy when I can convince a patient who has no prior negative experiences of the progress in aesthetic surgery. On the other hand, I feel that reoperation is a unique challenge. It is, after all, the aspiration of every surgeon in such situations to achieve an attractive result. Still add to this the human component – those with an unsuccessful cosmetic procedure behind them deserve particular sensitivity and understanding. I like that, because it is important for me to establish a trusting relationship with my patients based on absolute honesty. This is the first step towards seriously helping those affected.

It sounds like there may even be a happy ending for unhappy patients. Thank you, Doctor, for discussing the important subject of reoperation.