Cosmetic Surgery in an office setting

By Dr. James White

From breast augmentation to facelift , if you have cosmetic surgery in an office-based setting you will certainly not be alone. Since 2005, an estimated 10 million procedures have been performed annually in office settings. Advances in medical technology have made it possible for cosmetic plastic surgeons to perform more advanced and complex surgical procedures in their offices. Whether it is a tummy tuck or a brow lift, every surgical procedure performed in a cosmetic surgeon’s office involves some form of analgesia or anesthesia to make the surgery painless. Some office-based procedures might even involve general anesthesia that provides total loss of consciousness.

Benefits of office-based cosmetic surgery

Since most patients want to avoid an overnight hospital stay after surgery and reduce costs, ambulatory surgical procedures have become very popular. More recently, though, there has been a growing trend for cosmetic surgery to be done right in the cosmetic practice’s office. Office-based surgery can offer the convenience of having a procedure done in a more private, comfortable setting and a quick return home with significant reduction in cost without compromising safety.

The same anesthetic techniques used in hospitals and ambulatory surgical centers are used in office-based surgery. Patients undergoing office-based procedures will be asked to follow precautions similar to those in a hospital. From the simple removal of a mole to facelift, liposuction, varicose vein laser or tummy tucks, a rapidly growing number of cosmetic procedures are being performed in the surgeon’s office rather than in hospitals or surgical centers.

Questions to ask before undergoing cosmetic surgery in an office setting

In considering your options when surgery is advised, here are some questions you should ask before undergoing surgery in an office setting:

Who will be providing my anesthesia , and has this person been trained to give anesthesia?
Ideally, anesthesia should be delivered or supervised by an anesthesiologist or Certified Registered Nurse Anesthetist medically trained to evaluate your health needs and decide whether you are a good candidate for surgery in an office setting. At a minimum, a person extensively trained in the delivery of anesthesia should be involved. Anesthesia needs are determined by your medical condition as well as by the type of operation you will have. Your cosmetic or plastic surgeon will discuss your anesthetic care with you before the surgery. Blood pressure, pulse rate, EKG and oxygen levels are some of the important vital signs that should be monitored during your surgery. You should have a qualified individual monitoring your vital signs in addition to the surgeon.

A surgeon’s office [like a hospital] should have the necessary emergency drugs, equipment and procedures in place to care for you in the rare event of a life-threatening complication. In rare instances, serious complications may require that you are transferred to a local hospital. Many states require licensing or accreditation by a recognized agency. These agencies regularly inspect such offices to ensure that the minimum standards of the patient are met. The State of Tennessee does not require licensing or accreditation; but requires surgical suite review prior to complex, Level III surgeries.

Surgical Suite Accreditation

Centers of excellence usually request voluntary accreditation by the Accreditation Association for Ambulatory Health Care [AAAHC ] or the American Association for Accreditation of Ambulatory Surgery Facilities, Inc [AAASF]. Today, about one out of 10 surgeries are performed in a doctor’s office. Ask your cosmetic plastic surgeon if his or her surgical suite has been accredited.

Although our surgeons have hospital permissions, we perform the majority of our procedures in our AAAHC accredited , office-based surgical suites.

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