What Do Think of a Physician Assistant (PA) Performing Liposculpture?

There is a new facility in San Diego,Calif. They offer very competitive prices,such as $750.00 per area,which is all inclusive. Lipo of the Love Handles would cost ~$1,895.00. This is performed by a PA who's been doing them fulltime for the last 5 years. What are you thoughts on a PA versus a surgeon perfoming this precedure?

Doctor Answers 16

PA Performing Liposculpture/Liposuction

PA's are qualified to perform various procedures including liposuction under the supervision of a physician.


New York Facial Plastic Surgeon
4.5 out of 5 stars 59 reviews

Skilled surgeons for liposuction in Los Angeles

A consultation with your treating clinician can help you determine if that person has the credentials and aesthetic acumen to do your liposuction. Raffy Karamanoukian Los Angeles

Raffy Karamanoukian, MD, FACS
Los Angeles Plastic Surgeon
5.0 out of 5 stars 61 reviews

What Do Think of a Physician Assistant (PA) Performing Liposculpture?

The laws differ from state to state and I am not sure about whether this is legal in California. PA's must be supervised by a physician but that doesn't mean that this is a good idea. I would recommend choosing your plastic surgeon based on their experience and reputation. Price is obviously important but shouldn't determine who you see for a surgical procedure that could potentially cause harm to you. I would recommend that you seek out a board-certified plastic surgeon to take care of you. They have the experience and tools to perform the correct procedure for you and the experience to deal with any and all of the potential problems that might arise.

Stephen Weber MD, FACS

Stephen Weber, MD, FACS
Denver Facial Plastic Surgeon
5.0 out of 5 stars 76 reviews

A Physician Assistant's Acting as an Independent Surgeon without Supervision and training - Scary at best

Let's start with training - it takes a PA approximately 2 years of training to become a PA and includes all areas of medicine and often little or no plastic surgery training. Compare this to a Plastic Surgeon which requires a minimum of 10 years (4 years medical school plus 6 years of residency - with a minimum of 3 years only spent in plastic surgical training).

A Physician Assistant's Acting as an Independent Surgeon without supervision when a patient is under general anesthesia or IV sedation is Illegal and that goes for Liposuction. There is a loop hole apparently in the scope of practice rules which hopefully will be closed soon. Basically it states that for procedures usually performed under local anesthesia a PA can perform surgery without supervision. Obviously, the intent was to allow PA's to do minor procedures such as removing moles,  superficial cysts,  open boils, or skin biopsies rather than liposuction.  Except or this loop hole, as most liposuction in this country is performed under sedation - usually IV or general anesthesia - in those situations, it  is illegal for a non-physician to practice medicine without supervision in general. The PA must therefore be using local anesthesia only or would be guilty of practicing medicine without a licence at least in the state of California (and I suspect just about all the other states). You need a MD or DO licence to do this type of surgery and to perform direct supervision if sedative anesthesia is used.  

??Why would you want a non-surgeon perform surgery on you???

It is bad enough that  many doctors performing cosmetic surgery in the USA are not actually plastic surgeons or even cosmetic surgeons which is  a claim made by a growing number of board certified cosmetic surgeons around the country allege. That is, these doctors specialize in other fields and have little to no experience in plastic surgery. Examples include: gynecologists,dermatologists, pediatricians, family physicians, dentists, radiologists and others who were never trained during their residency in the cosmetic procedures they are performing..

Now imagine if these same doctors "trained" a physician assistant to do cosmetic procedures like liposuction on their own without supervision. Scary at best !!! Loop hole (local anesthesia only) or no loop hole in the current law, I could not imagine anyone in their right mind choosing this option. Whether or not they have done thousands or for how long, doesn't make up for their lack of proper training.

 

Board certified cosmetic surgeons have started campaigning in order to make patients aware that their cosmetic surgery doctor may not be a board certified cosmetic surgeon. I would recommend that readers of this answer contact their local medical board and request stricter guidelines to protect the public. 

The bottom line is that  In-depth training in addition to  experience is required to perform plastic, cosmetic, and reconstructive surgery with high degree successful outcomes and minimal complications.

If a physician or PA from another specialty does a weekend course on cosmetic surgery, this in no way qualifies them as a board certified cosmetic surgeon. According to Dr. Malcolm Z. Roth, president of the American Society of Plastic Surgeons (see below link) , said in September 2011 " that one of the major problems in cosmetic surgery is the lack of proper training and practical skills which causes rookie surgeons to leave patients with some serious problems, including excessive scarring, the removal of too much fat, infections, and even gangrene." "Sometimes, lengthy procedures will be done on people who are not medically suitable for them ..... If you have somebody who's not surgically trained, they [don't know] how to decide who's a good or bad candidate for surgery. We've had people go to the ER with deep vein thrombosis, heart attacks, and unfortunately, not infrequently now, we're hearing about death."

As the safest places for surgical procedures are:
accredited hospitals and nationally certified out-patient facilities physicians and by extension PA's who are not board certified in plastic surgery lack privileges to perform plastic surgery  and are only able to do them in their office setting. This may put you at risk.

 

My advice:  Stay away from PA's as the primary surgeon - as their title implies they are supposed to be a "Physician Assistant" not the main surgeon. Secondly verify  your surgeon's qualifications before allowing them to perform a plastic surgery procedure. (see below link on finding a board certified plastic surgeon and how to choose the best one).Dr. Reisin made a list of five questions that every patient should ask before selecting a surgeon:
Are you board certified in plastic and reconstructive surgery
Did you complete a residency in plastic surgery and are you board certified (or board eligible in plastic surgery?)
Does your malpractice insurance cover this surgical procedure?
Do you have privileges to perform the plastic surgery procedures in hospitals? Which hospitals?

Be Safe and select the best for the best result.

Larry S. Nichter, MD, MS, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 63 reviews

Physician assistant performing liposcuplture?

    It is possible that you may be mistaken in your facts, since it is probably not legal for a PA to do this if a true surgical procedure is involved.  Since this forum verifies the training and the experience of the physicians who respond, it is doubtful that there is anyone here who would think that it is a good idea to have such a procedure by a person who is not as well trained.

Lawrence Kass, MD
Saint Petersburg Oculoplastic Surgeon
5.0 out of 5 stars 68 reviews

PA's are Physician Assistants not Surgeons

Whenever you are considering body-contouring, I would recommend that you seek out treatment by a board-certified plastic surgeon with extensive experience in liposuction.  A physician assistant may be an integral part of the surgical team, but they are not qualified to work independently as a surgeon.  Whenever you consider cosmetic surgery, price alone should not be the determining factor in choosing a provider.  Look at qualifications and experience rather than at price alone.  Your safety and results are highly dependent on your choice in this area.  Subsequent health problems, unsatisfactory results, and subsequent revisions are, unfortunately, a possible outcome when lowest price is the sole determinant in choosing a surgeon.  

Steven L. Ringler, MD, FACS
Grand Rapids Plastic Surgeon
5.0 out of 5 stars 39 reviews

Physician Assistant performing liposuction

I also don't think this is legal?!?! Please be careful.  Do not go somewhere just because of the low price - this is your body and this is actual surgery! If you do research regarding liposuction surgeries that have gone poorly with the patient having horrible complications (even death), you will see that usually these are cases of "non board certified plastic surgeons" performing these procedures.  There are so many potential risks and complications associated with any cosmetic procedure, you really should be looking for someone who will reduce the chances of those risks (not increase them).  Not only would I not recommend you doing this surgery with a PA, I would not recommend doing this procedure with a non board certified plastic surgeon.

What Do Think of a Physician Assistant (PA) Performing Liposculpture?

I am not sure if this legal. Physician Assistant are suppose to assist not perform surgery and a physician must be the responsible person who oversees the PA. Although some surgeons do allow their assistant to do certain procedures during surgery such suturing skin etc., it is not legal unless the assistant has a First Assist certificate or is a physician.

Mohsen Tavoussi, MD, DO
Newport Beach Facial Plastic Surgeon
4.5 out of 5 stars 7 reviews

No I would not want a Physician Assistant to perform any surgery on their own

There are many unqualified specialties and professions who are performing plastic surgery today.  A board certified plastic surgeon undergoes two residencies - one in gerneral surgery or ear nose and throat surger (ENT) and then a three year plastic surgery residency.  This is all after medical school.  Even after all that training I would not recommend that you go to a person until they have some experience.

Hilton Becker, MD
Boca Raton Plastic Surgeon
5.0 out of 5 stars 7 reviews

You answered your own question

Liposculpture is liposuction.  Liposuction is Surgery, and you've just asked, "Do I want to have this done by a Physician's Assistant or a Physician?"    If I were you, I'd get it done by a surgeon, who by definition is a physician.     Also, I'd check the credentials of this place that is allowing a PA to perform liposuction.   It is not only dangerous, but illegal. 

Charles K. Lee, MD
San Francisco Plastic Surgeon
5.0 out of 5 stars 5 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.