61, Type 2 diabetes, sleep apnea: Acceptable facilities for surgery - should I be concerned it's not a hospital?

Neat760869,
When evaluating a patient for surgery, we use the American Society of Anesthesiologists (ASA) Physical Status classification system. Someone with well controlled diabetes and sleep apnea is typically ASA 3. For an ASA 3 patient to be a candidate for surgery at an ambulatory surgery center, their comorbidities must be well-controlled, and the surgery center must have the appropriate resources and an agreement with the surgeon and anesthesiologist to perform the procedure safely. If all these are met, you can proceed.
Dr Stein

General anesthesia can suppress upper airway muscles. This may slow down your breathing rate, and decrease your oxygen levels. Therefore, general anesthesia can be dangerous for people with sleep apnea. Sleep apnea can also make it harder for you to wake up from surgery. However, this doesn’t mean that you will have these issues. It is just letting you know in advance that there is a small risk. I suggest you inform your surgeon beforehand and choose a facility with intensive care unit just in case of a problem. Best of luck to you.

Dear Neat760869,

generally speaking, as long as your medical conditions are under control you should be safe. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.

Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Reputable surgical facilities certified by your province’s medical governing body are considered safe for most patients. If a patient has specific medical conditions that put them at a higher risk of complications, then your surgeon may choose to schedule your procedure in a hospital if they have hospital privileges. It would be best to express your concerns to your surgeon so that they may determine the most suitable facility for you.

You should not have any concern as long as the facility is accredited and credentialed as it should be for the surgeries they are doing. I do all of my patient's surgeries in my own Surgery Center attached to my clinic. This is very nice for patients as they are already familiar with staff and location. There is much less risk for infection as elective plastic surgery patients generally aren't "sick" like typical hospital patients. Your surgeon should have medial privileges at the nearest hospital in case there is a need for transport. I make all of my diabetic patients have an AIC below 7, all patients have to have BMI less than 32 and you will want to wear your CPap as directed with no other sleep aids from the surgeon.

Your surgeon should have credentials at a hospital even if primarily surgeries are performed in an outpatient clinic. If your surgeon feels sure that you are safe to have surgery outside of a hospital make sure the facility is accredited and speak with your surgeon about the plan if something unexpected should occur. Also be sure that your surgeon is working with a board certified anesthesiologist who is aware that you use a CPAP as they may request that you bring it the day of surgery.

Well let’s hit the truth button. You are not “healthy”. You have diabetes and sleep apnea. That probably means you are significantly overweight.

With that you are at increased risk for surgery. It is your condition not the facility that is of concern.

More information and health screening is needed to evaluate the relative risks. Good luck.

Without posting photos, very difficult to discuss your question and concerns. Always best to post photos and do a virtual consultation. Questions for you or is the surgery being done in your hometown? Or you flying somewhere else in the world or United States or Canada for the surgery? If you’re coming to a clinic that is not under the name of the doctor I would be very apprehensive proceeding. Best to go to a private practice board certified Plastic surgeon. You must ask if the surgeon can do your surgery in a hospital. Though the hospital fees would be double or triple the cost. Again best to virtual concert with to get a full examination and explanation. Plus, a mommy makeover surgeries are many different combinations which you did not specify exactly what you’re looking to have. Therefore the fee ranges could be anywhere from $10,000-$30,000. Again, best of virtual concert with regards.