Patients often expend enormous efforts to find the right surgeon, but may give little thought to where the surgery is to be done. Most cosmetic plastic surgery procedures are done as an outpatient, often in an office-based facility attached to the surgeon’s office. In the past these were largely unregulated, but plastic surgeons have been placing safety front and center for years. Around the year 2000 the American Society of Plastic Surgeons (ASPS) passed a requirement that all office-based surgery facilities used by its members be fully accredited by independent agencies such as the American Association for Accreditation of Ambulatory Surgical Centers (AAAASF). The accreditation process, renewed annually, adheres to the same standards as hospital-based surgical centers.

 

With the world of cosmetic medicine and surgery expanding, not everyone doing facelifts and liposuction is a plastic surgeon, and so not subject to ASPS guidelines. For this and other reasons, several states have passed laws requiring licensure of ambulatory surgery centers. Here in Washington State, facilities such as mine have both AAAASF accreditation and state licensure.

 

Advantages of office-based accredited facilities include cost savings, privacy, and convenience. Hospital-based facilities are not often geared toward the private-pay cosmetic surgery patient, while plastic surgeons set theirs up specifically for that purpose. Hospitals are for sick people, and you are more likely to be exposed to drug-resistant germs. Because hospitals have to be all things to all people, they are inherently less efficient than facilities doing one category of surgery exclusively. What I like most about my facility is the ability to have control over the patient’s experience and the continuity of care. The same staff that you see with me in consultation is there for your surgery and your after care.

 

So the smart consumer should be armed with several questions, fist of which is whether or not the surgical facility is independently accredited. Secondly, the doctor should have hospital privileges to do the specific procedure being planned; this means that an outside committee has reviewed their training and qualifications. And third, don’t conceal anything in your health history from your plastic surgeon. Surgery and anesthesia are safer than ever, but only if everyone is playing by the rules.