Homescientific articlesComplication Rates in Cosmetic Surgery: Evidence from PubMed-Indexed Meta-Analyses 2024–2025
Published on: 08/06/2026
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Complication Rates in Cosmetic Surgery: Evidence from PubMed-Indexed Meta-Analyses 2024–2025
Edited by Dr. Skerdi Faria, with the contribution of the Scientific Committee of the KEIT Day Hospital.
Complication rates in cosmetic surgery vary according to the procedure, surgical technique and patient-specific risk factors. The most recent PubMed meta-analyses include evidence on liposuction, abdominoplasty, rhinoplasty with rib cartilage grafting, reduction mammaplasty and labiaplasty, showing that complications are not uniform but depend on the type of surgery, tissue healing, operative planning and patient selection.
Table of Contents:
How the evidence was selected: PubMed criteria for the latest meta-analyses
This review synthesizes five PubMed-indexed meta-analyses published between 2024 and 2025, selected because they report quantitative data on complications, risk factors or complication-reduction strategies in cosmetic surgery procedures or plastic surgery procedures with significant aesthetic relevance. Priority was given to studies with a systematic review and meta-analysis design, pooled numerical data, a direct focus on postoperative complications, procedures commonly requested in aesthetic practice and recent publication. The final evidence set includes aesthetic liposuction, abdominoplasty, rhinoplasty with rib cartilage grafting, reduction mammaplasty and labiaplasty, providing a cross-sectional overview of the main risk patterns in modern cosmetic surgery.
Central message: Complications exist, but risk varies greatly by procedure
Recent meta-analyses show that many complications in cosmetic surgery are relatively uncommon when the procedure is performed on appropriately selected patients, using proper surgical technique and adequate follow-up. However, certain complications occur predictably more often: contour irregularities in liposuction, seroma in abdominoplasty, dehiscence or swelling with specific labiaplasty techniques, graft-related complications in structural rhinoplasty and healing problems in reduction mammaplasty.
Aesthetic liposuction: Low overall complication rate, but a real risk of contour irregularities
A meta-analysis included 39 studies and 29,368 patients who underwent liposuction. The overall complication rate was 2.62%, with contour irregularity being the most frequent event, accounting for 2.35%. Other reported complications, occurring less frequently, included seroma, hematoma, hyperpigmentation, infection, skin necrosis, superficial burns, generalized edema, allergic reactions, venous thromboembolism and local anesthetic toxicity. From a clinical perspective, the finding is clear: in liposuction, the most common risk often concerns the quality of the aesthetic outcome rather than a major medical complication. For this reason, preoperative consultation should explain both medical and aesthetic-functional risks, particularly when the final result may be influenced by skin quality, the volume of fat removed, surgical technique and patient selection.
Abdominoplasty: Seroma remains the dominant complication
In abdominoplasty, seroma is the most common local complication: an accumulation of fluid within the space created by surgical dissection that may delay recovery and require aspiration or additional follow-up. One review showed that preservation of Scarpa’s fascia significantly reduces the risk of seroma, with an OR of 0.38 and a 95% CI of 0.16–0.91. This suggests that prevention depends substantially on intraoperative technique, not only on postoperative management. In practice, abdominoplasty should be regarded as a procedure with a moderate local risk profile, particularly when combined with liposuction, in patients with elevated BMI, smokers, those requiring extensive dissection or those who have experienced massive weight loss. Reduction of dead space, appropriate drain management and preservation of anatomical planes remain key safety factors.
Rhinoplasty with rib cartilage grafting: Limited complications, but considerable variability
In rhinoplasty with rib cartilage grafting, the 2025 meta-analysis included 6 studies and 888 patients. The overall complication rate was 7% according to the fixed-effects model and 8% according to the random-effects model. The reported complications were mainly minor and included infection, warping and graft displacement. Patient satisfaction was also high, although significant variability was observed across the studies. The clinical message is clear: rib cartilage grafting can be useful in complex or revision cases, but it should not be presented as a risk-free solution. It is an advanced structural procedure in which the outcome depends on proper indication, graft harvesting technique, graft shaping, stabilization and long-term follow-up.
Reduction mammaplasty: Clinical factors that increase risk
In reduction mammaplasty, the 2025 meta-analysis included 61 articles and 71,149 patients. The factors most strongly associated with increased complications were BMI ≥30 kg/m², smoking, diabetes, previous radiotherapy and some variables related to surgical technique. In particular, BMI ≥30 was associated with a higher risk of delayed healing, fat necrosis, wound infection and dehiscence. Smoking, by contrast, was mainly linked to an increased risk of infection and dehiscence. The clinical point is that risk also depends on the patient’s profile. For this reason, weight optimization, smoking cessation, glycemic control and assessment of any previous radiotherapy should be considered an integral part of preoperative preparation.
Labiaplasty: Low rates, but technique-specific risks
In labiaplasty, the 2024 meta-analysis showed that complications are generally rare, but they are not the same across all techniques. In particular, wedge resection was associated with an 8% dehiscence rate, while composite reduction was associated with a 13% swelling rate. In delicate tissues, technique selection can directly influence healing, swelling, bleeding and the possible need for revision. For this reason, labiaplasty requires clear informed consent, careful technical selection and realistic expectations: rare complications do not mean a risk-free procedure.
Common risk patterns identified by the meta-analyses
Three recurring messages emerge from the five selected meta-analyses. 1. The most common complications are local. In most cases, the risk involves problems such as contour irregularities, seroma, dehiscence, hematoma, superficial infection, swelling or delayed healing, rather than severe systemic events. 2. Surgical technique makes a difference. Decisions such as preserving Scarpa’s fascia, reducing dead space, selecting the type of graft, using appropriate instruments or choosing the correct pedicle can have a direct impact on the risk of complications. 3. The patient’s profile has a significant influence on the outcome. Elevated BMI, smoking, diabetes, previous radiotherapy and poor tissue quality may increase the risk, particularly for complications related to wound healing.
Clinical implications and conclusion
– Cosmetic surgery should be communicated through evidence, not marketing. Complication rates are often limited, but they are not zero; informed consent should include medical risks, aesthetic risks, the possibility of revision and individual risk factors. – Risk varies according to the procedure, the surgical technique and the patient. Liposuction: mainly contour irregularities. Abdominoplasty: seroma. Rhinoplasty with rib cartilage grafting: limited but variable complications. Reduction mammaplasty: greater influence of BMI, smoking, diabetes and radiotherapy. Labiaplasty: low risk, but dependent on the surgical technique. – Prevention begins before surgery. Patient selection, management of modifiable risk factors, appropriate surgical technique and preoperative risk assessment are essential. – Conclusion: cosmetic surgery is safer when risk is measured, assessed and managed before the procedure.
Bibliography: The five PubMed-indexed meta-analyses considered
"To offer patients an approach based on excellence, safety, and innovation in the field of aesthetic surgery, with high-level protocols and natural, harmonious results."
Education and Specializations:
• Degree in Medicine and Surgery (1995)
• Specialization in Public Health (2002, with honors, La Sapienza University, Rome)
• Specialization in Anesthesia and Resuscitation (2009, with honors, Tor Vergata University, Rome)
• PhD in Hospital Infections (2005, with honors, La Sapienza University, Rome)
Career and Recognition:
• Founder and Director of KEIT Day Hospital (since 2011)
• Author of numerous scientific studies published on PubMed and Google Scholar
• Expert in aesthetic surgery, hospital infections, and advanced anesthesia protocols
• Gold Medal (1989, Ministry of Public Education – Albania), Energie per Roma (2025, European Center for Cultural Studies – Rome) and others.
Media and Public Recognition:
Dr. Skerdi Faria has been recognized as one of the most influential doctors in the field of aesthetic surgery and has been interviewed and cited by major media outlets in Albania and Italy, including:
• Italy: Rai 1, Rai 2, Rai 3, Mediaset, La7, Corriere della Sera, Il Sole 24 Ore, Il Messaggero, La Gazzetta del Mezzogiorno, Il Tempo, Adnkronos.
• Albania: Top Channel, Klan TV, Vizion Plus, Shqiptarja.com, Panorama, Gazeta Express.
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