Facelift: Q&A

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Facelift in Hospital Versus in ASC?

I am considering a consult with an exceptionally well-credentialed surgeon, but was taken aback when I learned that he performs all facelifts in a hospital or, and requires an overnight stay in the hospital.

While on first blush a hospital might appear to be the ultimate in safety, when I think of hospitals, I think of (a) staph infections; (b) medication errors; (c) malfunctioning or uncalibrated equipment; (d) lots of green interns/residents/fellows running around; and (e) the 2004 mishaps at MEETH in NYC.

Apart from the issue of likely higher fees, does anyone have any thoughts on having a facelift in a hospital versus ASC?

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16 Doctor Answers | Asked by Doberman in Los Angeles

Doctor Answers (16)
Community Comments (0)

Facelift in Hospital or ASC

Facelift surgery can be performed safely in either a hospital or ASC. Most of the hospitals in which facelift surgery is performed actually have an associated ASC so the procedure is not really performed in the environment where nosocomial infections may occur. I would be certain that the facility in which you are operated in is certified (AAAHC being one of the more difficult certifications to obtain). Although an overnight stay is not a routine part of a facelift procedure, a more... more

Facelift in hospital vs ASC

Dear Doberman, You have asked so many questions that you are running the risk of "paralysis by analysis." At some point you are going to have to pull the trigger and decide what to do, where to do it and with whom! For a healthy patient, I will estimate that 90+% of plastic surgeons would do this in an ASC. There is no particular medical need to be in a hospital unless it is one that is set up to specifically cater to cosmetic patients for their comfort. I sincerely hope you... more

Facelift in Hospital vs ASC

You raise valid questions about cosmetic surgery in the hospital setting. While I've been on the staff of Cedars-Sinai hospital in Los Angeles for over 35 years, I have not done a facelift in the hospital since 1982. Most surgeons responding to questions on Real Self do their facelift surgery in an ASC, although all have hospital privileges. Patients are more comfortable in a private setting where the entire staff is devoted to their care and needs, not surrounding emergencies and... more

Richard W. Fleming, MD

9 reviews

Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Hospitals versus office, outpatient or ambulatory surgery centers

IF you are otherwise healthy there are few reasons you should have the plastic surgery in a hospital other than the surgeon whom you chose based on his/her excellent results prefers to perform surgery there. However, this may be a very good reason. They may be better able to control your postoperative blood pressure and You clearly are well acquainted with the process as can be revealed by your knowledge of the terminology and events. The problems that occurred at MEETH can occur anywhere.... more

Otto Joseph Placik, MD

33 reviews

Chicago Plastic Surgeon

Facelift in hospital or ASC

In spite of many problems in hospitals, when different organizations have looked at procedures like facelifts done in either hospitals, ASC’s, or fully accredited office OR’s, there is no difference in the safety between any of them. For a full facelift, an overnight stay is also the safest plan, whether this is in a hospital or other overnight facility. If you are concerned with costs, because of competition, many hospitals charge no more than other facilities. I used to do all... more

Facelift is typically an outpatient procedure

While a facelift can be safely performed in either an outpatient surgical setting or a hospital, my preference is in a credentialed outpatient setting. The risks of noscomial (including staph) infections are lower and it is typically less costly. Also, as far as safety is concerned this is very little difference since the safety equipment is virtually and should be essentially the same. As a surgery center surveyor for a large accrediting organization, I would say the outcomes are excellent... more

Scott Trimas, MD

3 reviews

Jacksonville Facial Plastic Surgeon

www.facesonly.com

Most facelifts done as outpatient

The issues you raise are valid ones, in that hospitals are for sick people and ASC's are often designed more specifically for aesthetic surgery patients. However, if you have any medical conditions such as diabetes or heart disease, it may make more sense to do it where you can be monitored afterwards, assuming the risk of having the procedure is acceptable. But outpatient surgery requires that there be someone with you as a caregiver, regardless of your medical status, and so practical... more

Facelift in hospital vs ASC - which is better?

Most facelifts are performed in an ASC, hopefully a highly credentialed outpatient facility. The operating room in a credentialed facility should look very much like a hospital, especially if they have the same accreditation (i.e. Medicare). There are certainly pluses and minuses of each, anesthesia providers (MD vs. nurse anesthetist), who is doing your surgery (attending or resident), etc. so you should seek answers to those questions before undergoing your procedure. While it probably... more

Hospital outpatient surgery centers not necessarily more expensive.

I agree with Dr. Rand! If you are not comfortable, don't have surgery. It is ridiculous to think that hospitals are less safe than private office-based surgery centers. Yes, things happen, but I can assure you that hospitals have much more active and transparent mechanisms from quality assurance (and more at stake) than does a one or two room surgery center based in someone's office. However, office based surgery centers also go through accreditation (at least in California if they are... more

Kenneth D. Steinsapir, MD

8 reviews

Los Angeles Oculoplastic Surgeon

Facelift in an ASC is very safe

I would agree with Dr. Rand. Having seen several questions that you have recently posted, while all very important and meaningful questions, if you are having this much indecision and concern, I would suggest just not doing anything. As to your current question, facelifts are very safely done in an ambulatory surgery center (ASC) setting all of the time. In my practice, all of my facelifts are done in an ASC without overnight hospitalization. As to your questions about a hospital: 1) There... more

D.J. Verret, MD

4 reviews

Dallas Facial Plastic Surgeon

innovationsfps.com

Most facelifts are performed in ASC

Facelifts are not traditionally done in the hospital setting for fear of MRSA infection, cost, and most nurses are too busy dealing with medical issues such as patients recovering from a gallbladder surgery. In twenty years we have never performed a facelift in the hospital. There are significant additional costs with performing a facelift in the hospital and overnight stay. Most facelifts in the United States are performed as an outpatient procedure in the ambulatory surgery center... more

Facelift in a hospital

You made some very valid points in your question, and clearly hospitals are full of "sick people". Today, most busy surgeons have built their own private facilities where surgery is performed in an accredited operating room. This offers complete control over the staff, supplies and the entire experience. Depending on where a surgeon is in their career however, you may still see some people use a hospital.

Many plastic surgeons use the hospital as well as free standing facilities

In Florida a surgeon operating in their office or a free standing facility must have hospital privileges and a "transfer agreement' so that the facility is backed up by a hospital. That is a good thing and means that plastic surgeons have to keep up their access to a hospital. unfortunately that is not required throughout the country. In areas where the hospital offers rates competitive with free standing facilities it is easier for the plastic surgeon to use the hospital so his... more

Nathan Mayl, MD

7 reviews

Fort Lauderdale Plastic Surgeon

Facelift operating facility

Of course, once you choose a surgeon, you should have the facelift done where he or she feels most comfortable. Most facelifts are done in accredited outpatient surgery centers because they are less expensive, often owned by the surgeon, and are more geared to cosmetic procedures -- although your other points are well-taken. Most surgeons will advise going to an after-care facility for a night or two after extensive facial rejuvenation surgery.

Robin T.W. Yuan, MD

4 reviews

Beverly Hills Plastic Surgeon

A facelift in the hospital or ASC is OK either way

There is no evidence that having a facelift in the hospital is safer than in a certified office operating room or ASC. I don't think it really maters where you have the procedure. If it maters to your surgeon, then you will have to go along with their desire. Many surgeons feel more comfortable using the hospital and keeping the patient over night, but there is no indication that this is any safer. Modern hospitals have excellent infection control so I don't see that as a issue.... more

Facelifts are safely done in both hospitals and ASC

The key to having a successful procedure is having it done in the environment in which you and your physician feel most comfortable and safe. I woudl agree with Dr. Rand's statements, as well, and would echo the fact that all ASCs are not the same and neither are all hospitals. It is a good bet that your physician feels best about doing the procedure where he or she has the best help available within your community. I would trust his or her judgment. In Sacramento, most facelifts are done in... more