Plastic surgery is generally safe when performed by a board-certified surgeon in an accredited facility. The mortality rate for outpatient cosmetic procedures is estimated at 0.25 to 0.50 per 100,000, making it comparable to other routine surgeries. Complications affect roughly 6% of patients, and the vast majority of those are minor, local issues that resolve with proper care.
That said, “safe” isn’t a yes-or-no answer. Your individual risk depends on the procedure you’re considering, where it’s performed, who performs it, and what health factors you bring to the table.
What the Complication Numbers Actually Look Like
A review of more than 2,300 patients undergoing over 7,000 plastic surgery procedures found that 6.3% of patients experienced some form of complication. When measured per procedure rather than per patient, the rate dropped to 2.2%, since many patients had multiple procedures done at once.
Of those complications, 93% were local, meaning issues at or near the surgical site like swelling, bruising, or minor wound problems. Only 7% were systemic complications affecting the body more broadly. About 5% of patients who had complications needed a follow-up surgical procedure to correct the issue. For context, that’s roughly 5% of the 6% who had problems in the first place, so a small fraction of the overall patient population.
Some Procedures Carry More Risk Than Others
Not all plastic surgeries sit at the same point on the risk spectrum. Minimally invasive procedures like eyelid surgery or injectable treatments carry significantly less risk than operations involving general anesthesia, large areas of tissue, or deep fat layers.
The Brazilian Butt Lift (BBL) has historically been the highest-risk cosmetic procedure. In 2017, the estimated mortality rate was 1 in 3,448, an alarming figure that prompted surgical societies worldwide to issue new safety guidelines. Those guidelines, which changed how and where fat is injected, brought the mortality rate down to 1 in 14,952 by 2019. That’s still higher than most cosmetic procedures, but the trend shows how technique and protocols directly affect outcomes.
Procedures that combine multiple surgeries in a single session, sometimes called “mommy makeovers” or full body contouring, also carry elevated risk simply because of longer time under anesthesia and greater physiological stress.
How Anesthesia Affects Your Risk
The type of anesthesia used plays a meaningful role in safety. Local anesthesia, where only the surgical area is numbed, carries the lowest risk profile. Toxicity from local anesthetic agents is rare at the concentrations used in cosmetic procedures, though early warning signs include numbness around the mouth, ringing in the ears, and lightheadedness.
General anesthesia, where you’re fully unconscious, introduces additional variables. Post-operative nausea and vomiting are common side effects, and the use of certain pain medications during the procedure can make this worse. General anesthesia also requires more intensive monitoring and extends recovery time. For procedures where either option is viable, discussing anesthesia type with your surgeon is one of the most practical ways to manage your overall risk level.
Smoking and Weight Raise Complication Rates Significantly
Your personal health profile matters more than most people realize. Smoking is one of the strongest predictors of complications after plastic surgery, and the effect varies by procedure. A systematic review and meta-analysis found that smokers face roughly 1.5 to 3.5 times the complication risk depending on the operation. For tummy tucks, smokers had 64% higher odds of complications. For facelifts, the risk nearly tripled. Breast reductions and breast augmentations both showed about double the complication rate in smokers.
Interestingly, the link between smoking and complications wasn’t statistically significant for every procedure. Rhinoplasty and breast lifts didn’t show a clear increase, though the trend still pointed in the wrong direction. The reason smoking is so damaging is straightforward: nicotine constricts blood vessels, reducing oxygen delivery to healing tissues. This slows wound closure and increases the chance of infection, tissue death, and poor scarring.
Most surgeons require patients to stop smoking at least four to six weeks before surgery and to remain smoke-free during recovery. This isn’t a suggestion. Elevated BMI is another well-established risk factor, as excess weight increases the likelihood of blood clots, wound healing problems, and anesthesia complications.
Why Facility Accreditation Matters
Where your surgery takes place is a safety factor you can directly control. Accredited outpatient surgical facilities must meet specific standards that significantly reduce risk. These include having emergency equipment, medications, and trained personnel on-site at all times. At minimum, two staff members must be present during any procedure, and at least one must hold current certification in advanced cardiac life support.
Accredited facilities also require a written transfer agreement with a nearby hospital, meaning there’s a pre-established plan to move you to a higher level of care if something goes wrong. The surgeon performing your procedure must have admitting privileges at a local hospital, or have a formal arrangement with someone who does. These facilities maintain documented protocols for handling serious complications, including how to notify your emergency contact, ensure your medical records travel with you, and provide continuous care until a transfer is complete.
Unaccredited facilities, including some medical spas and overseas clinics, may not have any of these safeguards. The low complication and mortality rates cited in the research come from settings that meet these standards. Surgery performed outside them carries risk that’s harder to quantify and likely higher.
What Recovery Actually Looks Like
Understanding the normal recovery timeline helps you distinguish expected healing from genuine problems. According to the American Society of Plastic Surgeons, most incisions take about six weeks to heal through three distinct phases.
The first phase is inflammatory. You’ll notice redness, swelling, and pain around the surgical site. This is your body’s normal immune response, not a sign that something has gone wrong. Next comes the proliferative phase, when your body regenerates tissue and forms new blood vessels. During this period, the wound closes and a scar begins to form. The final phase is scar maturation, where the scar gradually becomes flatter and lighter over months.
Final results from most plastic surgery procedures don’t stabilize for several months to a year. Swelling can persist far longer than patients expect, and the tissue continues remodeling well after the surface looks healed. Patience during this period is genuinely important, as many people who are unhappy with early results find their outcome improves significantly over time.
Warning Signs During Recovery
While most recovery follows a predictable path, certain symptoms require immediate attention. Blood clots are one of the more serious risks after any surgery that involves prolonged immobility. Watch for one-sided leg swelling, pain or tenderness in the calf, or unusual warmth and redness in one leg. These can signal a deep vein thrombosis.
Shortness of breath or chest pain after surgery is an emergency. These symptoms can indicate a pulmonary embolism, which occurs when a blood clot travels to the lungs. This is rare, but it’s one of the leading causes of serious post-surgical complications across all types of surgery, not just cosmetic procedures.
Signs of infection, including increasing redness that spreads from the incision site, fever, or discharge with an unusual color or odor, also warrant a call to your surgeon. Most infections caught early respond well to treatment, but delaying care allows them to become far more serious.
How to Minimize Your Risk
The safest outcomes in plastic surgery come down to a handful of controllable decisions. Choose a board-certified plastic surgeon, not just someone with a medical license who offers cosmetic procedures. Verify that the facility is accredited. Be completely honest during your pre-operative health screening about medications, supplements, smoking habits, and medical history.
If you smoke, quit well before your procedure date. If your BMI is elevated, your surgeon may recommend reaching a more stable weight before operating, both for safety and for better long-term results. Avoid combining too many procedures in a single session unless your surgeon specifically recommends it and you understand the added risk. Follow post-operative instructions precisely, especially regarding activity restrictions and compression garments, as these directly affect healing and complication rates.