A revolution is occurring in the field of cosmetic surgery as it has become an accepted, requested, and welcome part of contemporary society. Many changes have happened over the past 40 years. Cosmetic facial surgery has been around in some shape or form for centuries. However, it became a predictable procedure only after advances in anesthesia, surgery, and antibiotics. Forty years ago, cosmetic surgery was a well-kept secret of the rich and famous. People who sought out the procedure then were on average older then those seeking it today, and many of them would sneak away to have the procedure done secretly. The procedures were expensive and extensive, and many produced an unnatural appearance. Much has changed. Baby boomers, now in their sixth decade, don't want to look old and hence are having surgery earlier. They tend to prefer smaller procedures at a younger age to avoid the “overhaul” their parents had. With the increased focus on youth, health, and beauty, cosmetic surgery has worked itself into the fabric of mainstream life and pop culture and has become a rite of passage in aging for many patients.

Along with this phenomenal growth of cosmetic surgery came another paradigm shift: Numerous specialties began providing cosmetic procedures. Although plastic surgery controlled cosmetic surgery in the past, today 80% of cosmetic surgery is performed by non-plastic surgeons. So, now we have had exponential growth of patients with a similar growth of providers. It only made sense that the number of surgery complications would also grow.

Complications are a normal part of surgery. No surgeon is immune. Complications can stem from uncontrollable factors, such as the patient's immune system and healing; from preventable or controllable factors, such as nonsterile surgical environments; or from incompetence or mistakes on the part of the surgeon or staff. Complications can occur in the preoperative, intraoperative, and postoperative phases of cosmetic facial surgery. Someone once said, “Most complications are proximal to the scalpel,” which means that they are the fault of the surgeon. It is probably safe to say that the average surgeon has more complications on the upslope of his or her learning curve. Having said this, even the most competent and experienced surgeons experience complications. Although dreaded, complications have much to teach surgeons about preventing them or limiting them in the future. One of the biggest mistakes a surgeon can make is to see a patient from another colleague and “bad-mouth” that colleague's ability or competence. What goes around comes around and surgeons who speak badly of colleagues will most likely be subject of similar remarks some day.