My doctor’s office is medi-care certified and he said he could perform my liposuction there, instead of in a hospital. Is this safe?
Liposuction in a Doctor's Office?
Doctor Answers (15)
Check facility accreditation and ask questions prior to any surgical procedure
Liposuction in limited volume can be safely performed in a same-day surgery facility with an important considerations: Accreditation of the office-based or ambulatory surgical facility. State-by-state the laws defining accreditation vary; absurdly some states do not require any form of accreditation. Know what your state requires, but demand even more.
Voluntary accreditation by organizations such as the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), and the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) requires regular inspections, consistent standards of care, self-survey and peer assessments.
Ask questions not only about the status of accreditation but also about the credentials of all the staff and emergency planning. Ask to see the surgical facility. You must be confident with the facility and the people who operate the facility.
Your safety is also contingent upon your surgeon’s training and experience – a board certified plastic surgeon is trained to perform anything from limited to extensive liposuction on any part of the body. Anything more than 5000cc to be removed, added procedures performed along with the liposuction and your present state of health all influence your safety and the decision of where it is most appropriate to conduct your surgery.
Members of the American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons are required to operate only in facilities that are accredited or licensed.
Liposuction procedures performed in a surgical center vs. hospital
Choosing a plastic surgeon is as much about trust as it is about credentials. Go with your hunch before committing to a particular procedure. A well-qualified and board certified plastic surgeon will not cut corners to acheive results.
Liposuction procedures are generally safe with minimal downtime and postoperative recovery. Anesthesia type, surgical center, and physician technique are absolutely crucial factors in making a decision to pursue the procedure.
If you feel that you are not receiving the absolute best procedure, technique, and amenities, do not proceed with surgery. Meticulous attention to detail defines my personal practice in Santa Monica, CA which is an absolute necessity to obtaining superior results.
Liposuction should be performed in an accredited surgical facility, not an office. Many patients refer to an accredited surgical facility next to a doctor's office as the doctor's office, but there is a difference.
Accreditation of the surgical center means the surgery center is safe to perform surgery. All the necessary emergency equipment is there. All the emergency medications are there. Monitoring of the heart and vital signs is there. The surgery center has cleanliness standards and sterility standards. There are filters in the ceiling to filter the air. Every surgery requires an RN, a surgical technician. Safety procedures are followed. All these things cost money. That is why surgery is more expensive in an accredited surgery center than a doctor's office. If God forbid you have an allergic reaction, develop malignant hyperthermia, have a complication, you do not want to have any of these items missing.
Liposuction is a surgical procedure. You may want to inquire if your surgeon is credentialed in a hospital to perform the surgery. The hospital takes screening of physicians seriously and checks backgrounds, credentials, etc. before they issue operating room privileges.
Is the surgeon performing the anesthesia himself or is there an anesthesiologist present? The anesthesiologist's only job is your safety and your comfort. He is equipped if an airway problem or allergic reaction results, or a complication results.
This is why board certification, accredited facilities, and proper anesthesia support are so important to patient safety.
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LOW volume liposuction is absolutely safe in a truly accredited office operatin room.
See Dr. Singer's answer for a lot of great information. Check the facility credentials and make sure the anesthesiologist is board certified. If you are going to have less than 5000 milliliters removed with liposuction, by all means do it in the office. Anything more than this is considered HIGH volume liposuction, and in my opinion should be done in the hospital.
Check the credentials carefully
As described by the answers already given, safe outpatient surgical procedures are regularly performed in a physician's office as long as the office and its surgical suite have been properly accredited. Dr. Singer (answer below) has been one of the major proponents of office accreditation and has been largely responsible for the improved safety of outpatient surgery done in these appropriate settings.
So check this carefully just as you have carefully checked the credentials and skills of your doctor. It is rare these days to have liposuction done in a hospital setting.
Liposuction in office: is it safe?
According to the statistics of the American Society of Aesthetic Plastic Surgery, the vast majority of liposuctions are performed in the office based setting. There are several important factors to consider:
- make sure that the facility is certified by a credentialing agency such as the AAAASF orJCAHO
- in most states, there is no regulation as to the procedures that a physician can perform in his or her office. Make sure that your physician is credentialed at a local hospital for the same operation. This will reflect that the surgeon is actively trained and experienced in that procedure.
- The amount of fat removed should also determine whether or not this is performed as an outpatient or inpatient regardless whether the facility is credentialed or not. It is generally accepted that patients should be monitored overnight with large volume liposuctions
Sometimes Liposuction in a doctor's office is OK
Liposuction can be performed in an office when the aspirate (the material to be removed) is small. For larger cases, an accredited surgical facility (SurgiCenter) is best. It is a matter of keeping the surgical sites clean. Small areas can be done in an appropriately-equipped office. For larger cases, an operating facility is better.
P.S. A hospital is not necessary in most cases and is usually much more expensive. Be careful.
There are many safe locations for Liposuction
If you have faith in your doctor, and he or she is a board certified plastic surgeon operating in a certified facility, you are doing everything you can to minimize your potential for problems.
Of course, it is critical that you are in good health. If not, perhaps an elective cosmetic surgical procedure is not the best choice for you.
A thorough discussion with your surgeon is a must
The safety of tumescent liposuction in an office setting is well established since its inception two decades ago. Risks exist in the hospital and ambulatory surgical setting as well as the office and thorough discussion of the procedure and its risks must be held with you and your surgeon.
Bedside Manner Doesn't Matter: It's All About the Credentials
There are two major important factors to consider when choosing to have Liposuction or any other surgical procedure.
First, what are the qualifications of your surgeon? Board Certification by the American Board of Plastic Surgery (ABPS) is the gold-standard for credentialing to perform cosmetic surgery of all types. When in doubt about the qualifications of your surgeon, you should ask whether he or she has privileges in your local hospital to perform a given procedure.
Contrary to the claims of equivalent training by the Dermatologists and Facial Plastic Surgeons, you will find that they DO NOT have privileges to perform these procedures in a hospital setting, and therefore can ONLY perform them in an outpatient surgical center.
Second, what is the environment in which your procedure will be performed? Plastic Surgeons certified by ABPS and members of the American Society of Plastic Surgeons are obligated to perform surgery ONLY in a hospital or outpatient surgery center accredited by JCAHO, Medicare, AAAHC, AAAASF, or a state licensing authority.
You should ask to see the certificate under which the facility operates, to ensure that it is current. This implies that the facility meets accepted patient safety standards and is properly equipped to deal with emergencies.
A nice bedside manner is a bonus, but do your homework: check the credentials first.