Safety of outpatient surgery
Although it is certainly beneficial to have a hospital adjacent to an outpatient surgery center where you will be having your facelift procedure, the more important issue is what kind of credentials the outpatient center has independent of the hospital. Unless the outpatient center has been set up by the hospital, physician owned outpatient centers are essentially on their own.
You should seek a center that is AAAHC certified or an equivalent certification. Check out the level of training of the Anesthesiologist at the outpatient center, and finally, ask your surgeon what kind of complications you can expect during and immediately following a facelift procedure.
Location of Accredited Surgery Center
Proximity to a hospital is not a an important consideration when evaluating a free-standing accredited surgery center. Accredited centers have the necessary equipment and drugs to handle emergency situations. If personal health problems are a concern, I question the decision to have cosmetic surgery.
Importance of surgery center distance to a hospital
It is very rare to have a medical issue during a facelift operation. The chances of being admitted to a hospital after a facelift are very rare in healthy people. It is slightly more advantageous to have the surgery center located across the street rather than twenty minutes across town. Also ask about using a board-certified physician anesthesiologist versus nurse anesthetist. It is also important to ask if it is a general or local anesthesia.
Know your accreditation and doctor credentials
Complication rates for cosmetic surgery performed by board certified surgeons in accredited surgery centers is very, very small - but not zero. Obviously, close proximity to a hospital can be beneficial if a life threatening emergency occurs. More important though, even if the surgery center is next door to a hospital, is that the surgeon is board certified, the center is accredited, and the anesthesia provider is board certified. Surgery center certification can come from several areas including the AAASF, AAAHS, JCAHO, state health department, or Medicare. Accreditation means that the facility is evaluated on a regular interval (usually ever 1-3 years) to ensure that it meets standards of quality for patient care.
While much attention is paid to ensuring that your surgeon is 'board certified,' make sure that your anesthesia provider is also board certified. Also ensure that your surgeon has admitting privileges at a hospital near the facility where you are having surgery. Just because a surgeon is board certified and operates in an outpatient surgery center does not mean that they have to have privileges to admit to hospitals.
Accredited surgery center is hospital adjacent
More than the ASC being adjacent to a hospital, is does the operating surgeon have at least admitting privileges and operating privileges at that hospital! My rule of thumb is to be within 2 miles of a hospital that I can operate at, as my office is. Regards.
Outpatient surgery for plastic surgery patients
In general, the risks of anesthetic complications from an elective plastic surgery procedure are rare at approximately 1 in 50,000. Life threatening complications are even rarer. In my opinion, it is safer to have surgery at an accredited surgery center since they have to meet national and state safety standards than a surgery center that is not accredited but located closer to a hospital.
Really, the surgery center needs to be fully equipped and ready for any emergency regardless of the proximity to a surgery center. If a life threatening complication occurs, it needs to be treated within the first few minutes and regardless of how close you are to a hospital, life saving measures need to be immediately instituted. In fact, the patient should be stablized before they are even sent to the hospital or the chances of success are slim.
While certain things like Malignant hyperthermia and a heart attack are best treated if you are closer to a hospital, those are rarer risks. I hope this information helps. By the way, I am a surveyor for a national accrediting agency. I would check to see who has certified your physician's surgery center. A good one is AAAHC.
This is a minor issue unless you have any health problems
Accredited surgery centers are pretty darn safe, especially for healthy people getting surgery. Yes, to be accredited to perform general anesthesia, a surgery center must follow pretty tough standards. However for me it is always an issue of staffing. Even the largest office based surgery centers for cosmetic surgery have very few anesthesia personal. There are no respriatory therapy staff. A hospital based surgery center is an entirely different matter. These are larger centers with many more operating room, anesthesia personal, respiratory technicians and a world of resources at the adjacent hospital. For these reasons I am very comfortable taking my patients to a hospital based surgery center.
However, if you are healthy, statistically you should do just fine at the doctor's surgery center. Go with the surgeon you are comfortable with.
Which is SAFER a Surgical Center NEAR a Hospital or ACROSS TOWN from a Hospital
Plastic surgery done by a Board Certified Plastic surgeon (check www.PlasticSurgery.org), on healthy patients in an accredited surgical facility is extremely safe but never complication free. In the very rare emergency when hospital intervention is needed, the closer the facility is to the hospital, the higher the likelihood of earlier intervention.
Dr. P. Aldea
Accredited surgery center is across the street from the hospital
In the event that something happened, there is probably a small advantage to getting to the hospital a few minutes earlier. It depends on exactly what has happened. As you said, the chances of having something actually happen requiring a hospital are very small. Keep in mind that very sick patients call ambulances in major cities and their transport can be very delayed and in most cases they do OK.
As Dr. Rand pointed out, you will be supported until your arrival at the hospital. If I thought the surgeon that was 10 minutes away from the hospital was a superior surgeon compared to one that is closer, I would choose the superior surgeon over the closer surgeon. You are definitely having surgery and the aesthetic result is very important. You are not definitely having a complication requiring hospitalization (in fact the chances of this is very low), so the advantage of the closer surgeon will never be realized. This assumes that you are healthy and are a good candidate for surgery in an ambulatory surgery center setting.
Hope this helps.
For accredited surgery centers, the difference is small
All properly accredited surgery centers are required to have safety equipment and training for management of medical emergencies. In the unlikely event that a true emergency occured, transfer to a hospital would occur after stabilization of the patient. The most important factor in your safety is the surgical and anesthetic staff you choose to care for you. In my opinion, the skill of the staff and quality of the surgical facility is more important than physical proximity to a hospital.