Questions About Plastic Surgery

7. Where do you perform your surgical procedures?

I am credentialed at multiple hospitals and accredited out-patient surgical facilities to operate but the majority of my surgery is performed in the free-standing fully-accredited surgical centers. Plastic surgery can be performed in any of several different types of facilities. The actual location used depends largely on the individual surgeon. It is important to realize that, from the standpoint of safety and results, no accredited surgical facility is inherently superior to any other. Some surgeons operate exclusively (or nearly so) in an office-based or other free-standing surgical facility, some operate exclusively in hospitals, and many operate in either environment. Sometimes it depends on the procedure (with larger, longer, or more complicated procedures being done in a hospital) and sometimes it depends on the patient (the patient's preference, or if there are certain medical conditions that are best monitored in a hospital setting). Financial considerations may be a factor, since plastic surgery procedures can often be performed more cost-effectively in an office or outpatient setting. For these and many other reasons, there has been a dramatic shift towards office and outpatient surgery over the past decade or so. As always, there are few simple answers. What matters most is that the surgeon and team are capable, caring, and vigilant. If the procedure is being performed in the plastic surgeon’s office, be sure that the facility is accredited. The American Association for Accreditation for Ambulatory Surgery Facilities (AAAASF) www.aaaasf.org is one of the nationally recognized agencies that inspects and certifies surgical facilities. This is a voluntary program of inspection and accreditation in some states and is mandatory in others in surgery facilities to ensure safety and excellence in quality care for patients.

8. Is it safe to have surgery in an out-patient surgical facility or an office-based surgery setting?

The answer is "Yes" - even though precise statistics are hard to come by for any type of facility, including hospitals. There are several organizations that have established standards for office and outpatient facilities in an ongoing effort to maintain and improve safety. One of these is the American Association for the Accreditation of Ambulatory Surgical Facilities (www.aaaasf.org). Offices and outpatient facilities that have received accreditation from this or a similar organization have established and/or adopted standardized protocols and routines - similar to those used in hospitals - and have been subjected to rigorous inspections that examine a wide range of issues, from safety equipment and procedures (like backup power and emergency medications) to office layout, staffing, and record-keeping. Already mandatory in some states, such accreditation may eventually become so everywhere. In planning your surgery, therefore, you may want to add "Accreditation" as something to consider.

9. Who will perform anesthesia for your patients?

I work exclusively with a board-certified anesthesiologist who has extensive experience in provision of all forms of anesthesia for plastic surgery patients. Advances in anesthesia have facilitated outpatient procedures. Newer medications are stronger but shorter-acting, which allow for tighter control of the patient during the procedure and a faster "wake-up" afterwards. This is an important question to ask your surgeon.