The safest plastic surgeries are minimally invasive procedures performed under local anesthesia, with eyelid surgery (blepharoplasty) and liposuction consistently ranking among the lowest-risk options. Across all outpatient cosmetic surgeries, the overall mortality rate is roughly 1 in 50,000 procedures. But “safest” depends on more than just the procedure itself. The type of anesthesia, your personal health profile, and where the surgery takes place all shift the risk significantly.
Procedures With the Lowest Complication Rates
Eyelid surgery is widely considered one of the safest cosmetic procedures. It typically takes under two hours, involves minimal blood loss, and can be done with local anesthesia and light sedation. The infection rate sits around 2%, and serious complications like significant bleeding or vision problems are rare. Because the procedure works on a small area of thin skin with a rich blood supply, healing tends to be quick and predictable.
Liposuction, when performed on its own in an outpatient setting, also carries a low risk profile. A national analysis of more than 246,000 liposuction cases in accredited ambulatory facilities found an overall confirmed complication rate of just 0.40%. The most common issue was an unplanned visit to the emergency department afterward, which accounted for about a quarter of all reported complications. Serious events like blood clots were uncommon and most strongly associated with patients who had a higher body mass index.
Other procedures generally considered low-risk include ear reshaping (otoplasty), fat transfer to the face, and minor skin procedures like mole or lesion removal. What these all share: limited surgical area, shorter operating times, and the ability to use local rather than general anesthesia.
Why Anesthesia Type Matters So Much
One of the biggest factors separating a safer procedure from a riskier one is whether you go under general anesthesia. Procedures performed while you’re awake with local numbing carry fewer cardiovascular and respiratory risks. According to the American Society of Plastic Surgeons, recovery after an awake procedure is “notably smoother,” with little to no time needed in the recovery room. Most patients can drive themselves home the same day, unless the procedure involves the eyes.
General anesthesia, by contrast, requires a breathing tube, affects your heart rate and blood pressure, and leaves you groggy for hours afterward. It’s also riskier for people with heart disease, obesity, obstructive sleep apnea, or lung conditions. That doesn’t mean general anesthesia is dangerous for healthy people. It means that when two procedures offer similar results and one can be done under local anesthesia, the local option is inherently the safer choice.
Procedures That Carry More Risk
On the other end of the spectrum, surgeries that involve larger areas of the body, longer operating times, or general anesthesia carry higher complication rates. Tummy tucks (abdominoplasty) are a good example. When cosmetic breast surgery is combined with a tummy tuck, the estimated mortality rate rises to about 1 in 24,000, roughly triple the rate of breast surgery alone (about 1 in 72,000). The added risk comes from longer time under anesthesia, greater tissue disruption, and increased potential for blood clots.
Brazilian butt lifts (BBL), which involve transferring large volumes of fat to the buttocks, have historically had one of the highest mortality rates in cosmetic surgery due to the risk of fat entering the bloodstream. Body contouring procedures after massive weight loss also tend to be more complex, with longer incisions and greater fluid shifts during surgery.
A useful rule of thumb: the more tissue a surgeon has to cut, move, or reshape, and the longer you’re on the operating table, the higher the overall risk.
Your Health Profile Changes the Equation
No procedure is universally safe. Your individual risk depends heavily on factors you can control. Smoking is one of the most significant. Nicotine constricts blood vessels and impairs wound healing, which raises the chance of skin death, infection, and poor scarring. The American Society of Plastic Surgeons recommends quitting cigarettes (and e-cigarettes) at least four to eight weeks before surgery and staying off nicotine for at least four weeks afterward. Studies on breast reconstruction patients have confirmed that those who quit at least four weeks before surgery had significantly fewer complications than active smokers.
Higher body weight also increases risk. In the large liposuction analysis, blood clots were most common among patients with a BMI around 30 or above. Conditions like uncontrolled diabetes, high blood pressure, and bleeding disorders further shift the safety calculus. A procedure that’s low-risk for a healthy 35-year-old may be moderate-risk for a 60-year-old with multiple health conditions. Your surgeon should evaluate your full medical picture, not just the procedure in isolation.
How to Minimize Your Surgical Risk
Choosing a board-certified plastic surgeon is the starting point, but where the surgery happens also matters. Accredited surgical facilities are held to specific safety standards for equipment, staffing, and emergency protocols. Research on ambulatory surgery centers has found that patients treated at accredited facilities had roughly 10% lower odds of unexpected hospitalization within a week compared to non-accredited centers, at least for certain procedures. The differences aren’t dramatic across the board, but accreditation does provide a baseline quality floor.
Beyond facility choice, a few practical steps meaningfully reduce your risk:
- Limit combined procedures. Having multiple surgeries in one session extends anesthesia time and increases complication rates. Staging procedures weeks apart is safer.
- Choose local anesthesia when possible. If your surgeon offers the option, awake procedures with sedation carry fewer systemic risks than general anesthesia.
- Optimize your health beforehand. Quit nicotine well in advance, manage chronic conditions, and follow any pre-surgical instructions about medications and supplements that affect bleeding.
- Stay close to home afterward. Traveling long distances immediately after surgery delays your ability to get help if a complication arises. The Southeast region in the U.S. accounted for the highest share of liposuction complications and deaths in one national study, a pattern researchers partially attributed to “medical tourism” patients traveling for lower-cost procedures.
The safest plastic surgery is ultimately the one that matches a low-complexity procedure with a healthy patient, an experienced surgeon, a proper facility, and the lightest anesthesia that gets the job done. Eyelid surgery and small-volume liposuction fit that profile for most people, but even a “simple” procedure becomes riskier when those surrounding factors aren’t in place.