The risks of scarring - never rush into surgery ill-informed

Posted: 23/04/2014

Scarring can be a major concern following cosmetic surgery and certainly something to give serious consideration to before ‘going under the knife’. It should always be a big part of the consenting process and the surgeon should be upfront with his advice and the patient realistic with their expectations.

As patients generally look to cosmetic surgery for an aesthetic enhancement, to be left with extensive or even excessive scarring can be devastating. Patients may say that the scar was not expected, has ruined the result, affected their relationship and even damaged their self-esteem. The whole point of having surgery is then defeated.

A surgeon needs to make sure that his patient understands where the scar is going to be, how long it will be and how visible it is likely to be. Some surgeons will physically draw scar lines onto a patient and send them home with the unequivocal knowledge of the scar’s planned location. That said, there are still uncertainties and uncontrollables with scarring. Genetic history, colour of skin and thickness of the dermis can all play a role in how the patient heals and the scar forms.

No surgeon should ever assume that the patient fully understands and accepts the uncertainty of scarring. A surgeon may inadvertently over-reassure a patient if he or she fears that too much detail about the risks would frighten the patient off. However, our experience from talking to clients is that the more the surgeon explains and the longer he gives the patient to make a final decision, the greater the respect and trust the patient has for the surgeon and, conversely, the more likely they are to proceed.

We have recently settled a case where our client decided to undergo gastric banding for weight loss. She understood this to be a ‘keyhole’ procedure and was not advised by the surgeon that, if he encountered problems in the surgery, he would have to convert to an open procedure. In the event, due to a bleed, this is what happened. As a result, our client has been left with a large, very visible, permanent scar on her abdomen of which she is very self-conscious. She feels she is now worse off in terms of her confidence and appearance than before the surgery. We settled her claim on the basis that, with proper advice, she would never have gone ahead with the procedure – for more details click here.

Our advice to patients considering cosmetic surgery who may be worried about the risk of scarring is to remember that, while the surgeon may have carried out that particular operation hundreds of times, he has never operated on you before. Your anatomy is unique so encourage the surgeon to discuss the scarring risk until you are completely satisfied that you understand what may happen and have enough information to make your decision before going ahead.

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