I have a consultation with a board certified plastic surgeon, and was told that he can do the blepharoplasty in his office. Is this a good idea? I know the procedure is done with a local, but I thought that at the least, it should be done in a surgi center.
Is It Safe to Get a Blepharoplasty in the Doctor's Office?
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Doctor Answers 11
Best done in a surgery center not an office setting
Surgical procedures are best performed in a Medicare-certified surgery center. Removing fat from the eyelids tends to be very painful and uncomfortable, so sedation is required. When sedation is required, instrumentation for heart rate, oxygen, and blood pressure all need to be performed, which is best done in a surgery center, not in an office setting.
Regulations vary according to Anesthesia administered.
In most states office based surgery is regulated if more than mild sedation is given. If your surgery is done with local anesthesia or local plus mild oral sedation it may not be regulated.
Upper blepharoplasty is a low risk and usually low pain procedure so if you are not being given IV sedation it can be safely done in an office setting. If you have a medical history or low pain tolerance you may want to have IV sedation given in which case you should be monitored in an accredited office based or ambulatory surgery center.
The largest accreditation organization for outpatient surgery is the Accreditation Association for Ambulatory Health Care (AAAHC) with over 4000 facilities accredited.
Members of the American Academy of Facial Plastic & Reconstructive Surgery are required by membership standards to perform surgery only in Accredited facilities if more than mild sedation is administered.
Disclosure: Dr. Gentile is member of the Board of Directors of the Accreditation Association for Ambulatory Health Care (AAAHC) and serves on its Standards Committee.
Go where you are comfortable.
There is nothing wrong with having blepharoplasty in an office operating room environment. The key is your comfort level. Personally I favor performing eyelid surgery with my patient awake so I can judge the effect of the upper blepharoplasty. WIth the patient awake the eye can be open and closed and the effect of tightening the eyelid platform skin and its effect on lifting the eyelashes can be assessed. Believe me, this can not be done if the eyelid surgery is perform when the patient is asleep.
On the other hand, if I know that a given person will need a certain level of sedation to be comfortable or if there are heal issues, I will often recommend that surgery be performed at the surgery center. I am on staff at the UCLA Medical Center which is a fantastic resource and provides a level of safety that no office operating room can match. Performing surgery there certainly costs a little more than in the office setting but it is not worth compromising safety.
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Most of the time the procedure is done using not only local but also some sedation. The most important fact is to see that the Office has an operating room that is certified by one of the three certifying agencies. AAAASF, AASF or the Joint Comission. As blephs are usually done as an out patient, it is commonly done in the doctor's office -- just make sure the office is certified and the doctor board certified by the American Board of Plastic Surgery and that the doctor is on staff of a good New York hospital.
Accreditation for office based surgery is a must
Eyelid rejuvenation can be performed under local anesthesia, though most of our patients prefer sedation to make the experience more comfortable. Safety is the most important consideration in selecting where a cosmetic procedure will be done. Cosmetic surgery is often performed in private in-office surgery facilities to control the cost and improve the experience. However, the office should be accredited by one of the several agencies available such as AAAASF or JACO to ensure the highest safety standards and regular peer review. Your surgeon should also be expected to have privileges at a hospital in the area to perform the same procedures as performed in the office facility.
Best of luck,
What is available in the office?
If you are just getting your upper lids done by removing excess skin, this can usually easily be done under local anesthesia, like taking off a skin lesion. More difficult procedures like removing fat of the lower lid will require more instruments and assistance with a surgical technician or nurse. Cautery to control bleeding is necessary. Ask your surgeon what he s planning to do specfically. Some doctor's office are very well-equipt with a minor procedure room even though it is not a true operating room or surgicenter. It also depends on if you have any medical problems or allergies that might require more close monitoring by an anesthesiologist.
Certified OR should be fine in a doctor's office
Procedures done under local anesthesia could be done in a doctor's office. This applies well to skin lesions etc. Eyelid surgery is a little more complex. Many offices have a separate Operating Room; it is perfectly fine to do upper lids in this setting. If sedation needs to be used, a certified OR will be needed. Many factors contribute to this decision. Your board certified plastic surgeon should be able to help with the best decision for you.
Many if not most plastic surgeons have their own surgery center
Most Board Certified Plastic Surgeons in private practice operate in their own nationally certified surgery centers (ie AAAASF certified) in their offices. If this is what the doctor you spoke to has to offer, it is perfectly safe to do a blepharoplasty there. If they do not have a certified surgery center in the office, ask that your eyelid surgery be done in a separate free standing certified surgery center where that surgeon has priviliges or seek consultation wiht another doctor.
Blepharoplasty can be done safely in the office with local anesthesia.
Blepharoplasty-- upper and lower eyelid surgery, can be done safely in the office with local anesthesia. However, you should talk to your surgeon speficially about your situation, and have him review your medical history to determine if there are any factors to consider.
Eyelid surgery is safest in Hospital or Surgicenter
During the surgery it is often necessary to press on the eye which in some people can cause the heart rate to slow - if this occurs action must be taken to speed up the heart rate.
If blood pressure becomes too high during eyelid surgery it can cause bleeding, thus close monitoring of Blood Pressure is necessary.
A hospital or Certified Ambulatory Surgery Center has the personnel and monitoring equipment to assure your safety. Usually an anesthesia person stands by to give you sedation during a local blepharoplasty, which is most helpful and important for your safety.
I would not do a blepharoplasty in an office - the only reason to do so is to save money, a bad idea when it comes to your health and safety.
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.