When is the "cell saver" procedure implemented? Before surgery; during surgery?

Question

I previously asked this question, but I neglected to be a little more specific. I had my BBL done a month ago yesterday. When receiving my quote, I was informed my doctor required a mandatory cell-saver; in which I was charged an additional $525 for. Yes, a mandatory cell-saver for a BBL. Clearly I am aware this was not done prior to my surgery. So would this have been done during my surgery or does someone owe me a refund $525?

Richard H. Tholen, MD, FACS · Answer

Cell saver is not a procedure, it is a device utilized to collect blood lost during surgery, allowing the red blood cells to be transfused back to the patient when blood loss is serious enough to warrant its use.If your surgeon utilizes this "routinely" during BBL surgery, then the liposuction phase of the procedure must be inappropriately bloody, because I have been a plastic surgeon for 30 years and have NEVER used a cell saver, much less "mandatory" usage! Ask your surgeon if the blood you lost was returned to you. If not, where did the blood go? Is this "surgeon" an ABPS-certified plastic surgeon? If "Board-certified" ask which board. Does he sell blood to a blood bank? Lots of red flags here. I'd be much more concerned about the questions above rather than if you should have a refund. How is your surgical result? Hope all is well. Dr. Tholen

Alexander Zuriarrain, MD, FACS · Answer

Hello and thank you for your question. The use of this device in cosmetic plastic surgery is controversial and would only benefit the patient if there is a significant amount of blood loss during surgery. In general, if the procedure is done appropriately, the use of a cell saver should not be necessary. If the cell saver device was used, it would have been during your procedure while you were under anesthesia. Hope that helps answer your question.
Alex Zuriarrain, MD, Plastic Surgery

Kenneth Hughes, MD · Answer

Cell saver should not be necessary to provide during these procedures.Kenneth Hughes, MDLos Angeles, CA

Chad K. Wheeler, MD · Answer

the use of a cell saver is usually during vascular procedures when a lot of blood loss is expected.  This would be very unusual to use in any cosmetic procedure.

Erika Sato, MD, FACS · Answer

A "cell saver" is a machine that collects blood lost in a case so it can be given back to the patient. This is mainly used in surgeries where a high life threatening volume of blood is lost such as traumas. I have never heard of someone using the "cell saver" in a cosmetic plastic surgery case.

Brian Kubiak, MD, FACS · Answer

Thank you for your question.  The cell saver is implemented throughout a procedure.  It is a suction system that recovers blood and allows it to be placed back into the patients blood stream.  I have personally not found it to be useful with plastic surgery procedures.  The cell saver is best for cases with large amounts of blood loss (i.e. trauma and vascular surgeries).  The presence of fat in the blood is a relative contraindication to using the blood retrieved with the cell saver.  This limits its use with liposuction procedures such as there Brazilian Butt Lift.

Mats Hagstrom, MD (license on probation) · Answer

The cell saver separates red blood cells from the fluid removed during surgical procedures.
The red blood cells can then be transfused back into the patient.
This technology is a great tool for high blood loss surgery. The great majority of cosmetic surgery cases really need blood transfusions.
Re-perfusing your own blood it's generally very safe but you can have some potential risks involved.
Even small amounts of blood loss can make people feel weak after surgery.
The majority of cosmetic surgery is done without cell savers. 
Best,
Mats Hagstrom, MD

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