In-Office Cosmetic Surgery: The Good, Bad and Ugly
These days it’s common for cosmetic surgery to be performed outside a hospital. In fact, other elective procedures such as arthroscopies and bariatric surgery are very often performed in surgical suites as well, and with excellent outcomes.
Then why has the Australian Society of Plastic Surgeons recently “taken aim at ‘office-based cosmetic surgery,’” according to the online news.com.au?
It turns out that, in many countries including the U.S., when a cosmetic surgery patient elects surgery in a non-hospital setting, the site can range from these two extremes:
1. A fully accredited, ultra modern surgical suite with up to date lifesaving equipment, staffed with a board certified plastic surgeon and M.D. anesthesiologist skilled in all anesthesia options
2. An office room with minimal equipment, staffed by a doctor with limited cosmetic surgery experience and only local anesthesia available
The fact that the field of cosmetic surgery is not well regulated extends to the operating room, particularly when that room is outside a hospital. Unfortunately, it falls to the patient to safeguard himself or herself by making wise choices.
The Australian news website reported on the case of a young woman who was rushed to a hospital after suffering an allergic reaction to local anesthesia administered in a cosmetic surgery clinic. The article also mentioned one other case of adverse reaction to anesthesia and one of cardiac arrest in outpatient surgery in New South Wales this year.
Just like right here in New York, cosmetic surgery can be performed in New South Wales by any medical doctor with no specialized training in the field or in anesthetics. Furthermore, the article noted that there’s no requirement that lifesaving equipment be on hand.
A bit scary, right? As a prospective patient considering cosmetic surgery in New York, Sydney, or elsewhere, what should you do?
First, you don’t need to insist on having your procedure in a hospital. Indeed, when you select a credentialed plastic surgeon with an operating suite like the first one described above, you can expect a safer, more comfortable experience than you would have in a large medical facility.
Here are four steps you can take to give yourself a safety advantage:
• Verify that your cosmetic surgeon is board certified in the field of plastic surgery (in the U.S., this means certification by the American Board of Plastic Surgery). That way you’ll know that your doctor has extensive formal training in the specialty and has performed a variety of surgical procedures under more than just local anesthetic.
• Ensure that the operating suite your doctor uses is inspected and approved by a reputable organization that performs this service. Our Manhattan surgical facility is accredited by the Joint Commission—the same group that inspects hospitals across the country. Another good one is the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF). You can find information about these two on the web.
• Ask about the background of the anesthesiologist you’ll have. Your best bet is a professional who is also an M.D., meaning she or he is a doctor with extensive training in lifesaving measures. A highly experienced nurse anesthesiologist can also be a good choice. What you don’t want is just one doctor doing both surgery and anesthesia.
• Find out about technology on hand in the surgical suite. Ask to see the operating area, and inquire about equipment like defibrillators. While you’re at it, you can ask about infection control measures, staff hiring practices and anything else that may come to mind.
For some patients, it makes sense to have cosmetic surgery in a hospital. If there are health conditions present, it can sometimes be advisable to elect a hospital setting for the procedure and recovery. You can also go that route if you are simply more comfortable in a hospital, or if the board certified plastic surgeon you choose operates there.
But don’t be alarmed if your chosen surgeon uses an outpatient facility, as long as you understand what to look for. Certification requirements by both the American Board of Plastic Surgery and organizations like the Joint Commission and the AAAASF are extremely rigorous. Cosmetic surgeons who have chosen to go these routes have your safety at heart.
Photo by Ted Eytan, available through a Creative Commons attribution license
