A consultation is extremely important for all plastic surgery procedures, especially for major procedures, where complications can occur. Pre-morbid conditions that can lead to surgical complications have to be taken into account.

"One has to rule out any medical conditions or medical complaints that could pose a problem at surgery," Dr. Arscott told Flair.

Some of these common conditions, Dr. Arscott pointed out, include: uncontrolled diabetes, hypertension, bleeding disorders and arthritic problems (collagen vascular disorders).

Other common things that can cause adverse effects are smoking and the intake of supplements or herbal products.

"Some of these (supplements/herbal products) can actually have adverse effects at the time of surgery. And because they are called supplements, they are not recognised as medications, and it's quite easy in the consultation to leave out that information and they may cause bleeding problems during surgery," Dr. Arscott elucidated. Smoking, he says, can affect wound healing.

Physical fitness is vital as it reduces the patient's recovery time. "If it is a young, fit patient, then complications will be minimal. If it's a person in the more mature age group, then one would want to undergo a proper physician assessment which would look into these conditions in more detail before recommending them for surgical procedure," the surgeon noted.

For an unfit patient, however, fitness can be achieved by taking certain steps such as: exercise, dietar and in older patients, physiotherapy is recommended, particularly for the chest, because of the length of the surgery.

"In the investigations pre-operatively, one may look at the blood profile, things like the blood count and the bleeding indices to see whether they have clotting problems," Dr. Arscott stressed.

The blood sugar level and anaemia are also important to note.

Major surgical procedures, such as breast reduction and abdominal lipectomy, can last for two and a half to five hours, sometimes longer. Despite the length of the surgery, it is still considered to be safe because only healthy patients should be operated on.

"Our procedures tend to be more lengthy. It usually involves extensive dissection of tissue and tissue transfer. Therefore, the risk of this surgical dissection has to be borne in mind. So you would want to know that the patient is as healthy as possible before you proceed," Dr. Arscott further points out.

Pulmonary embolism

"(With) an unfit patient or a patient who is overweight, one of the fears is that the patient will develop pulmonary embolism which can be a lethal complication. Fortunately, it is extremely rare in our experience," Dr. Arscott said.

Intro-operatively also, the surgeon can carry out manoeuvres and procedures to limit the possibility of developing clots that could result in fatal pulmonary embolism.

Post-operatively, more mature patients or those who have had double procedures are monitored more closely.

Additionally, after surgery, the patient should be treated with antibiotics to prevent chances of developing bone, chest and in some cases, urinary infections post-operatively.

Complications that could occur post-operatively include: bleeding (but there is electrical equipment that can control this), backing up of fluids after surgery, wound infection and wound healing problems that can reduce recovery time and increase down time, and noticeable scars which may require a revision and treatment of the scar.

Patients need to be realistic about scars. Locally, Dr. Arscott says that scarring is the most common concern. This is different for each patient as some persons may heal with immaculate scars while some don't. This is dependent on the skin type.

According to Dr. Arscott, if the advantages outweigh the disadvantages, then go ahead, but if not, leave it alone.

Tummy tuck

On the issue of abdominal lipectomy, the surgeon says he wouldn't advise it for a patient who has not had a child or someone who is of child bearing age. In this case, he would recommend liposuction.

However, this must not be done as it could cause metabolic problems.

So if you are considering plastic surgery, ensure you find a reputable plastic surgeon, do your research and go with realistic expectations in mind.