Risks and complications: the honest list

Common and manageable

Seroma: fluid under the lifted skin, presenting as a soft swelling that grows; drained in clinic, sometimes more than once — the seroma article explains. Wound-healing delay: a small separation at the point of highest tension, usually at the centre or the side ends, managed with dressings and time. Scar widening or thickening: at tension points; treated early with silicone, steroid or laser, revised after month 12 if wanted. Asymmetry: slight differences between sides are normal; meaningful ones can be revised. Numbness: around the scar, recovering over months — the numbness article maps it.

Rare and prevented

Infection: rare with hospital sterility, antibiotics at induction and wound care; treated early if it occurs. Bleeding/haematoma: rare; blood-thinning supplements and medications are stopped beforehand. Deep vein thrombosis / pulmonary embolism: rare and taken seriously — compression, early walking, and injections for higher-risk patients; the flying article covers the trip home. Skin necrosis: very rare in non-smokers; the reason the nicotine rule exists.

The nicotine rule

Four weeks fully nicotine-free before surgery and four after — cigarettes, vapes, patches, gum and pouches all count, because it's the nicotine molecule that constricts the small vessels feeding a long, tensioned closure. Pre-operative testing is used when history is unclear; a positive test moves the date, not the outcome.

What reduces every risk on the list

Honest candidacy (stable weight, nicotine-free, medical fitness), a plastic surgeon with verifiable boards operating in an accredited hospital, tension-managed closure and compression, a recovery plan you actually follow, and a follow-up channel that answers the same day. That is the whole list; none of it is a secret.