Opinions on B/A in an office operating room?

My plastic surgeon performs his surgeries in an AAAASF Accredited Operating Room, but I have the option of getting it done in a hospital setting. Also, the Doctor's office is a Class C (General anesthesia, TIVA and Propofol). Could anyone explain that? When my mom (who has been a nurse for 25 years) heard about this doctor operating in an office, she said I should not do it in case something went wrong. Thinking about it now, it makes me nervous too. I would like to hear some Doctor's opinions.

Doctor Answers 10

Opinions on B/A in an office operating room?


The published scientific data from the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) shows that surgery in an office-based facility in the appropriately selected patient with a well trained appropriate anesthesia provider is safe. Many plastic surgeons who operate in accredited office based facilities have board certified M.D. anesthesiologists perform the… SHOW MORE anesthesia. Either an anesthesiologist or a CRNA is required to provide the anesthesia in a Class C AAAASF accredited facility.  Complications, while unlikely, can occur in any surgical setting, including a hospital. Whether you are a reasonable candidate for surgery in an office-based surgical facility depends on your anatomy, your medical history, realistic expectations of the outcome and an understanding of the pros and cons of the procedures.

Appropriately accredited office based facilities are generally more cost effective, more convenient for the patient, have dedicated staff who are trained to provide care for the specific procedures, usually only do "clean cases", have less interruptions of the surgical schedules, and are more indulgent of patient privacy. A recent published study reported that the rate of infections in plastic surgery procedures performed in accredited office based surgical facilities was lower than in hospitals or free standing ambulatory facilities.

Keep in mind that following the advice of any surgeon on this or any other web site who proposes to tell you what to do without: examining you, physically feeling the tissue, assessing your desired outcome, and taking a full medical history, as well as discussing the pros and cons of each operative option would not be in your best interest. I would suggest that your plastic surgeon be certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) that you trust and are comfortable with, and discuss your concerns with that surgeon in person. That way, you can have a better idea what is safe and makes the most sense for you.

Robert Singer, MD FACS

La Jolla, California

La Jolla Plastic Surgeon
4.6 out of 5 stars 19 reviews

Your surgeon's office has to meet the same standards as a hospital operating room

For your surgeon's operating room to be AAAASF certified, it has to meet the same standards as hospital and outpatient surgery centers. Some surgeons hire nurse anesthetists or anesthesiologists to administer anesthesia which could be general anesthesia or IV sedation. Studies have shown that infection rates are similar or even lower in doctor's offices that  are AAAASF certified

Joseph M. Perlman, MD
Houston Plastic Surgeon
4.3 out of 5 stars 21 reviews


I have operated in my AAAASF facility for over 25 years, thousands of patients, and have never had an incident that would have been prevented or cared for more properly in a hospital setting than in my facility.  Furthermore, hospitals are generally cold, more impersonal, more time consuming, more expensive, and present greater possibilities of infection due to the multiple use operating rooms and infection control issues.  That's why a large percentage of surgeries, particularly plastic surgeries, are performed in private facilities.  It is important that the facility is certified by a reputable agency and you should have the right to check the facility out in person prior to scheduling your surgery to make sure it looks clean, organized, and professional.  Of course, your surgeon will need to ensure you have no serious health issues that would preclude surgery in this setting.

R. Scott Yarish, MD
Houston Plastic Surgeon
4.4 out of 5 stars 39 reviews

Surgery Location

Dear TinyTexan326159,

Our practice operates in a fully state-licensed, Medicare-approved ambulatory surgery center as part of our freestanding clinic building. Frankly, I think we offer a safer experience because we do not have sick patients in the facility with resistant bacteria. State licensure is the highest qualification you can have for an ambulatory surgery center.

I hope this has been helpful.

Robert D. Wilcox, MD

Robert D. Wilcox, MD
Dallas Plastic Surgeon
4.1 out of 5 stars 22 reviews

You will be fine

Office setting with AAAASF is ok.  Make sure they are upto date with their accreditation and make sure to see the certificate.  I would not do BA in the hospital.

Andre Aboolian, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 60 reviews

Facility options

Hi, TinyTexan326159

In ordered to be accredited by AAAASF, the facility has to follow the strict guidelines and regulations.  In addition, the facilities go through annual inspection.  The benefits of AAAASF certified operating room are that they tend to be more private, confidential, convenient, and have a better continuity of care.  The surgeon has his/her  nurses, anesthesiologist,and scrub tech who are very familiar with the surgeon's needs and protocols.

Please discuss your apprehension with your plastic surgeon.  He should be able to allay your fear.  However, after talking with your plastic surgeon, you still want to proceed your surgery at the hospital, he will be able to accommodate your wishes.

Good luck with your surgery and recovery.

Sugene Kim, MD, FACS
Houston Plastic Surgeon
4.7 out of 5 stars 76 reviews

Surgery Suite Accreditation

It is very difficult to obtain AAAASF accreditation, there are very strict guidelines that must be met to obtain this status.  That would include a board certified surgeon, board certified anesthesia personnel and ACLS/BLS trained nurses.  Plus, the doctor is using his own hand picked staff that perform the same procedures over and over again.

In a hospital setting, you might get nursing/anesthesia personnel who have never seen a breast implant surgery, or worse, students still in training.  Hospitals have sick people in them, the doctor's ambulatory surgery suite doesn't and won't have any sick people in it.  The infection rate in the hospital is much higher.

Don't kid yourself, you are much better off in your doctor's office than the hospital.

Good Luck!

David Finkle, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 75 reviews

Opinions on breast augmntation in an office operating room?

I have always operated in a hospital OR because of the ready availability of support if you have a complication. I share your mothers concern and it sounds as though you are concerned as well. For your psychological comfort the hospital may be a better choice.

AAAASF accredited office for breast augmentation is BETTER than a hospital

AAAASF requires the use of doctors for anesthesia and there is literally a phone book thick set of regulations that must be 100% complied with to obtain this top certification. In this setting, the doctor has all their own staff (not true in a hospital) and they all know exactly what to do to make the experience best, also not true in a hospital. They control the pricing and the scheduling is also much tighter. Unless you have a medical condition that increases the risk of surgery, most would agree that a breast augmentation is better done in a AAAASF facility than a hospital.

Richard P. Rand, MD, FACS
Seattle Plastic Surgeon
4.8 out of 5 stars 67 reviews

Breast augmentation

Hello and thank you for your question. Patients that are otherwise healthy and fit may be candidates for having surgery in a facility that is properly accredited. If you have concerns I would make sure the facility is properly accredited first. If you prefer you may still be able to request having your procedure performed at the hospital. This often times comes with a higher price depending on the hospitals fees

Best Wishes 

Theodore Nyame, MD
Charlotte Physician
4.9 out of 5 stars 41 reviews

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.