Is having a Breast Augmentation in the Doctors own office normal and/or safe?

The doctor I am looking into opened his own office and offer surgery done "in house". I am there fore not paying the extra fees for a hospital or a privately owned surgery center. I am just really nervous because I have never been under iv sedation. The doctor is board certified with a Certified Registered Nurse Anesthetist. Should I be worried or is normal to have surgeries in office?

Doctor Answers 11

Surgery in office

here in florida, office surgery has to adhere to state standards. Most plastic surgeons do surgery in their own facility. I am sure you checked their reputation. When I built my office surgery center I choose to make it an ambulatory surgery center. We get safety inspection every year. Good luck.

Vero Beach Plastic Surgeon
5.0 out of 5 stars 7 reviews

Surgery center vs in office

You will likely have the best care if you have your procedure in a fully accredited surgery center. Ask you surgeon about what type of certification his "office" has and find out if you can have it performed at a surgery center.Best wishes,Dr.Bruno

William Bruno, MD
Beverly Hills Plastic Surgeon
4.9 out of 5 stars 353 reviews

Breast augmentation "in house" or surgery center/hospital?

There is no absolute right or wrong answer to your question. My personal preference is to perform breast augmentation in a fully accredited ambulatory surgery center. With most breast augmentations the implants should be placed beneath the muscle and this may possibly require a deeper anesthetic than IV sedation alone. Also, in extremely rare circumstances, if an emergency issue arises there is certainly more help and expertise available to attend to you within this type of facility. My overall  bias is that an actual free standing  surgery center is the safest environment to receive a breast augmentation. Yes the overall cost is a bit higher due to the additional facility fees, but well worth it! On a final note, you mention that your surgeon is board certified. Be certain he or she is certified only through the American Board of Plastic Surgery (ABPS). Best of luck!

Breast augmentation in office?

Hello Ashley and thanks for your question. You have to be very careful, any implant procedure requires special handling with the cleanest enviroment to prevent its contamination. An operating room has these conditions with sterile instruments, special clothing, etc, not an office. You could be paying much more if you have a complication apart from your health risk.

Hector Milla, MD
Mexico Plastic Surgeon
4.4 out of 5 stars 31 reviews

Office based surgery - breast augmentation?

  This is a very good and very important question. The first and most important item to find out is if your surgeon is board certified by the American Board of plastic surgery? Some surgeons are cosmetic surgeons, oral surgeon, or other types of surgeons performing  plastic surgery. They will not have the proper credentials from the American Society of plastic surgery when you ask them. If the surgeon is board-certified and holds a current active license, then that surgeon must have met minimum requirements to perform surgery at this office based surgery center. The next question is whether an office-based surgery center is as safe as an ambulatory surgery center with a board-certified anesthesiologist? That is debatable, as some office based surgery centers have operated very safely, however, most surgeons not practicing in a state licensed and certified surgery center are doing that for a reason. Cutting costs to save money, by not going throught the strict licensing and safety measures that most surgery centers have to pass in order to become licensed. Please ask these questions prior to undergoing surgery. Hope this helps, Good luck. 

Erez Sternberg, MD
Jacksonville Plastic Surgeon
4.9 out of 5 stars 30 reviews

Is having a Breast Augmentation in the Doctors own office normal and/or safe?

In the State of Florida- there are certain  written requirements and State inspections that are performed on a regular basis to protect the public. Your Doctor should be able to show you his/her certificate of inspection by the State of Florida. Also, there  are 2-3 other Organizations which guarantee  compliance with the State requirements. IV-sedation is considered Anesthesia of the level 3 designation. Personally, I favor General Anesthesia for most all cosmetic procedures including Breast Augmentation.

In office surgery

Make sure that his/her office is certified by one of a number of organizations such as the state medical board or AAAASF. If they have the appropriate certification, then the OR is "safe" to have surgery performed. As for IV sedation vs true general anesthesia, that is a personal preference of you and your surgeon. Lots of plastic surgeons have office based operating rooms that are very safe.

Is having a Breast Augmentation in the Doctors own office normal and/or safe?

Ask if the office surgery suite has an inspection certificate, from FL Board of Medicine, AAAASF, AAAS..And be sure the surgeon is boarded by the Am Board of Plastic Surgery, Inc..

Is having a Breast Augmentation in the Doctors own office normal and/or safe?

I share your concern.  My personal recommendation would be that he'll only have your breast augmentation performed in a hospital operating room for a certified ambulatory surgery center.  Having a significant surgical procedure and a private office  sounds dangerous to me. In addition, submuscular breast augmentation  in my experience  usually requires a general anesthesia.

It is normal to have surgery "in office" as long as the "office" is properly accredited

First I want to acknowledge you for coming on here and asking these very, very important questions.  Not only are you gathering the correct information for yourself, but you are asking these important questions for a lot of ladies who are either too uncomfortable, embarrassed, or uneducated about plastic surgery to ask for themselves.  Hopefully many people will see the answers you get to these questions here, and they will be properly informed.  One of the great things about is that they limit involvement on the website to only board certified doctors.  Thus, I think you will find a lot of consistency in the answers that you get here.  As to your questions, you have packed your post with a lot of important issues.  The first one is about the safety of having surgery in an "in office" setting.  That could mean a lot of things to a lot of people.  I have had offices in which we had our own private operating room, and I currently have an office which has no OR, so I use other OR's to do my surgery in.  The key is not the physical location of the OR per se; the key is what kind of accreditation the OR has.  There are a number of different bodies that conduct evaluations for safety and performance and certify operating rooms.  Not all of them are widely recognized.  The most commonly seen accreditations for private "in-office" operating facilities and the ones most widely recognized are: AAAASF (American Association for Accreditation of Ambulatory Surgical Facilities) and AAAHC (Association for Accreditation of Ambulatory Health Care).  Larger hospitals and surgery centers that treat insurance and Medicare patients will usually have Medicare or JCAHO (Joint Commission on Accreditation of Healthcare Organizations - also called "TJC" or "The Joint Commission")  accreditation.  In order for a surgeon who is board certified in plastic surgery - that is certified by the American Board of Plastic Surgery - and who maintains membership in the American Society of Plastic Surgeons or the American Society for Aesthetic Plastic Surgery, to perform surgery (this would include breast augmentation), he or she MUST meet the following requirements:  1) the surgeon must have privileges for THAT OPERATION BEING PERFORMED at a hospital nearby, and 2) the surgeon must perform the surgery at a facility accredited by one of the four certifying bodies I mentioned above.  Thus, if your surgeon's office operating facility is currently accredited by AAAASF, AAAHC, JCAHO (or TJC), or Medicare, it should be OK.  If it's not, you should ask why not, and find out who does accredit it, if it's accredited at all.  If it's not, I would seriously think twice about having surgery there, not only because it's an unaccredited facility, but also because a surgeon who is willing to perform surgery like that in an unaccredited facility is in violation of several rules and is demonstrating a lack of concern for your safety.  Additionally, you should be sure that your surgeon is properly certified as well.  The American Board of Plastic Surgery is the ONLY board recognized by the ABMS (American Board of Medical Specialties - the body which oversees and promotes the certifying requirements of the 24 member boards in the US), to certify surgeons to perform aesthetic or reconstructive surgery of the breast.  This is important because this is the best way to ensure that your surgeon and his or her office facility meet up to the proper standards for safety and performance to perform your surgery as it should be performed.  In the event that your surgeon is "board certified" by another "board," like the American Board of Cosmetic Surgery, the requirements for accreditation and hospital privileges of the surgeon may be different, and you will not be assured of the same levels of safety, competence, and professionalism.  Many surgeons will tell you that they are "board certified" or that they "have privileges at the hospital," but if they are not ABPS board certified or have privileges specifically FOR BREAST AUGMENTATION AT THE HOSPITAL, then I would be concerned and consider a different surgeon who has the proper credentials for this type of surgery.  In addition to being certified by the American Board of Plastic Surgery, your surgeon should also voluntarily participate in the Maintenance of Certification program administered by that board. This is the best way to know that your surgeon not only has the best training and experience for the procedure, but that he or she has maintained currency in the certification requirements as opposed to practicing on a "lifetime" certificate which has only been reviewed once at the beginning of his or her career. For more information on this particular issue, you can visit or  I know I have thrown a lot at you that seems like "alphabet soup" with all of the initials and letter designations, but this is vitally important in our specialty today, and you should look into these specific things at the VERY LEAST as you are evaluating surgeons and facilities for your surgery.  
As far as anesthesia goes, there are many ways to accomplish proper anesthesia for breast augmentation.  The best way is the one that is most comfortable for you, that works for your surgeon in order to do your operation the best, and that has the highest degree of safety for the operation.  Many surgeons perform breast augmentation very safely under local anesthesia with IV sedation, or “twilight” anesthesia, while many of us, myself included, prefer general anesthesia.  As far as who performs the anesthesia, again, I think it’s more a matter of proper credentialing and certification and safety; sometimes those two things go hand in hand.  Many surgeons have CRNA’s, or Certified Registered Nurse Anesthetists, perform anesthesia, while others, myself included, use only the services of board certified MD anesthesiologists.  I think either is fine as long as there is proper certification of the provider and a good safety record and working relationship between surgeon and anesthetist.  The one scenario I definitely do not agree with personally is a surgeon directing a registered nurse on staff to inject sedatives while he is operating too.  One of the biggest risks with conscious sedation/“twilight anesthesia is loss of airway control and breathing problems due to oversedation, and if an anesthetist isn’t right there monitoring that particular aspect of the case, the risk is intolerable to me.  Thus, I would consider IV sedation only if there was a properly certified anesthetist - CRNA  or MD - in actual attendance at all times.  One of the main advantages of performing surgery in outpatient facilities or with providers like CRNA’s is that costs are lower than using more advanced facilities or MD providers.  This is important for sure, but just be sure also that you are not compromising safety for money.  There is sometimes a reason why certain things cost a little more than others, in my opinion, and that reason shouldn’t be cast aside and overlooked.  Do your homework before your surgery, and that way you will not only have peace of mind as you go into the surgery, but you will very likely enjoy the results of a safe and well-executed operation performed by competent people in an appropriate facility for the procedure.  Best of luck!

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.