Facelift in Hospital Versus in ASC?

Facelift surgery can be performed safely in either a hospital or ASC. Most of the hospitals in which facelift surgery is performed actually have an associated ASC so the procedure is not really performed in the environment where nosocomial infections may occur. I would be certain that the facility in which you are operated in is certified (AAAHC being one of the more difficult certifications to obtain). Although an overnight stay is not a routine part of a facelift procedure, a more extensive procedure may require 24 hour observation. Also, make certain that your surgeon has hospital privileges in case a complication should arise which would require hospital admission.

The majority of Facelifts in the United State are performed in outpatient facilities for a reason.  Facelift surgery is an elective cosmetic procedure usually applied to healthy patients.  Hospitals are geared more for operative procedure requiring some form of postoperative hospitalization, for trauma patients, and for sicker patients requiring emergent intervention.  For these reasons, most hospitals tend to have higher infection rates and generally do not cater to the elective plastic surgery patient. As far as safety, the ABFPRS mandates that its members perform surgical procedures in accredited facilities and most states do the same.  Accreditation requires monitoring equipment, a crash cart, medications, policies, staffing, and safety procedures that you would find in a hospital.  There is certainly nothing wrong with having a  Facelift in a hospital, but it would best be a facility that generally takes care of aesthetic patients.

IF you are otherwise healthy there are few reasons you should have the plastic surgery in a hospital other than the surgeon whom you chose based on his/her excellent results prefers to perform surgery there. However, this may be a very good reason. They may be better able to control your postoperative blood pressure and
You clearly are well acquainted with the process as can be revealed by your knowledge of the terminology and events. The problems that occurred at MEETH can occur anywhere.

You made some very valid points in your question, and clearly hospitals are full of "sick people". Today, most busy surgeons have built their own private facilities where surgery is performed in an accredited operating room. This offers complete control over the staff, supplies and the entire experience.

Depending on where a surgeon is in their career however, you may still see some people use a hospital.

While a facelift can be safely performed in either an outpatient surgical setting or a hospital, my preference is in a credentialed outpatient setting. The risks of noscomial (including staph) infections are lower and it is typically less costly. Also, as far as safety is concerned this is very little difference since the safety equipment is virtually and should be essentially the same. As a surgery center surveyor for a large accrediting organization, I would say the outcomes are excellent at the vast majority of centers and is more dependent upon the surgeon than the actual center itself. As far as medication errors, I don't know that there is a whole lot of difference there and whether students are used or not is up to you always and your treating surgeon. I hope this information helps.

The issues you raise are valid ones, in that hospitals are for sick people and ASC's are often designed more specifically for aesthetic surgery patients. However, if you have any medical conditions such as diabetes or heart disease, it may make more sense to do it where you can be monitored afterwards, assuming the risk of having the procedure is acceptable. But outpatient surgery requires that there be someone with you as a caregiver, regardless of your medical status, and so practical considerations may steer you toward hospital surgery. In the end the choice of surgeon is most important so if your doctor prefers to do it in hospital then that is the way to go.

Most facelifts are performed in an ASC, hopefully a highly credentialed outpatient facility. The operating room in a credentialed facility should look very much like a hospital, especially if they have the same accreditation (i.e. Medicare).
There are certainly pluses and minuses of each, anesthesia providers (MD vs. nurse anesthetist), who is doing your surgery (attending or resident), etc. so you should seek answers to those questions before undergoing your procedure.
While it probably doesn't make much difference at the end of the day whether the surgery is performed at a fine hospital or a highly credentialed ASC, the doctor performing the surgery makes all the difference in the world, and should have privileges at both a fine hospital and an ASC so the patient can choose.

I agree with Dr. Rand! If you are not comfortable, don't have surgery.
It is ridiculous to think that hospitals are less safe than private office-based surgery centers. Yes, things happen, but I can assure you that hospitals have much more active and transparent mechanisms from quality assurance (and more at stake) than does a one or two room surgery center based in someone's office.
However, office based surgery centers also go through accreditation (at least in California if they are doing general anesthesia) but the quality assurance committee for an office based surgery center simply lacks the resources of the hospital based surgery centers.
Please let us know how your facelift goes.

Facelifts are not traditionally done in the hospital setting for fear of MRSA infection, cost, and most nurses are too busy dealing with medical issues such as patients recovering from a gallbladder surgery. In twenty years we have never performed a facelift in the hospital. There are significant additional costs with performing a facelift in the hospital and overnight stay. Most facelifts in the United States are performed as an outpatient procedure in the ambulatory surgery center (ASC) setting. One of the criteria to look for in the surgery center setting is the Medicare certification, which is one of the highest standards of care that exist in the ASC industry.

Of course, once you choose a surgeon, you should have the facelift done where he or she feels most comfortable.
Most facelifts are done in accredited outpatient surgery centers because they are less expensive, often owned by the surgeon, and are more geared to cosmetic procedures -- although your other points are well-taken. Most surgeons will advise going to an after-care facility for a night or two after extensive facial rejuvenation surgery.