Plastic surgery done in surgical center at hospital, or plastic surgeon's own private practice?

Yes, it can be completely legitimate and safe to have breast augmentation (and other cosmetic surgery) performed in a surgery center -- even an office based surgery center.  Ask a few more questions to ensure that everything is truly legitimate.Ask what certifications their surgery center holds and then research (Google) those certifications.  One of the most common legitimate certifications (my own surgery center has this certification) is AAAASF.  Any operating room with valid certification has the same level of sterility and same safety equipment as a hospital operating room.Make sure the surgeon has hospital privileges to perform the surgery you are having even if you are having the surgery in their surgery center.  If your surgeon can't go to a local hospital to perform the surgery that means the hospital doesn't recognize your doctors training to be able to perform that surgery at their hospital.  BIG RED FLAGAsk what their protocols are for intra-operative emergencies that may necessitate transfer to a hospital.  Most surgeons screen patients well enough that this would be extraordinarily rare, but there should be a protocol in place.  I screen my patients so only healthy patients, with minimal anesthetic risk will be operated on in my office operating room (we actually own our own surgery center with four, outpatient operating rooms).  I have performed breast augmentation on kidney transplant patients and patients that have undergone cardiac surgery for congenital heart defects -- but I performed those surgeries at the hospital because those patients are too high risk.Your question about cost is something totally different.  Yes, some doctors that aren't plastic surgeon will perform breast augmentation in their office "operating room" (really just a modified broom closet) and the cost will be lower.  I hope you have done your research enough to completely rule this scenario out of possibility.  Most other reasons for a lower price for breast augmentation are equally sketchy.  Do you really want to go to the discount breast augmentation doctor?  Save money on groceries, not plastic surgery.  I am not trying to say that the highest price is necessarily the best option though either.  Do your research.  Evaluate your surgeon's credentials and those of the operating facility.  Make sure the reviews of other patients helps you feel confident that you will likewise receive similar service.  Remember the lowest price is almost never the right choice or best option.If you want further information about breast augmentation you can download my free breast augmentation planner at aBetterBreast dot com.  There is a TON of information in a very compact and accessible PDF download.Best of luck in your search.

The location is based on surgeon preference.  Make sure that the office-surgery center is a AAAASF Certified Facility.  More importantly, make sure your surgeon is a Double-Board Certified Plastic Surgeon certified by the American Board of Plastic Surgery (ABPS), a member of the American Society of Plastic Surgery (ASPS) and the American Society of Aesthetic Plastic Surgery (ASAPS).Best,Dr. DesaiBeverly Hills Institute for Aesthetic Plastic SurgeryHarvard Educated, Beverly Hills & Miami Beach Trained, Double-Board Certified Plastic Surgeon

Hello,Thank you for your question. Private surgery facilities should be licenced and accredited which means that they are held to the same, strict standards of hospitals. You should have a board certified anesthesiologist and your Plastic Surgeon, board certified with plenty of experience. It is certainly worth paying standard costs and not making decisions based on a deal in these cases. But yes, a private surgical centre can be extremely safe.All the best

Hi xjuliee; Great question; In Washington State, there is a licensing requirement for office based ambulatory surgery centers for procedures done with more than light sedation that is every bit as stringent as the hospital based surgery centers. In our facility, we also have had AAAASF Accreditation prior to the state license requirement. Board Certified Plastic Surgeons who are members or the American Society of Plastic Surgeons and the American Society of Aesthetic Plastic Surgeons must operate in certified facilities to maintain their standing. The exception are procedures done under light sedation practiced by some that is not regulated and may not have the same standards. Ask the office what their track record is. Call your state licensing office at the department of health to check is there have been any complaints against the facility as well as against the local hospital ambulatory center if you are planning to use them. I have also worked in both facilities. I'd say which is better depends. My office based surgery center has had no infection nor severe complications. Compared to hospital based facilities that may be treating people with higher risk of complications as well as carry more community based bacterial risk we are a better choice.  We  have very strict pre-operative protocols for skin preparation and do only clean surgeries so all patients are treated more comprehensively than done at the hospital. Other office facilities may not be as thorough as ours and may have worse complications and infection rates. AS important is who are the personnel and who is giving your anesthesia. We work with a board certified anesthesiologist with decades of experience of safety. In our area, hospital based facilities are significantly more expensive than our surgical center.

Plastic surgery procedures that are small, short in time and under local anesthesia can be done in an office setting, the facility has to be accredited... General or Sedation has to be done in a OR properly. Some plastic surgeons have their facility well equiped, it's own OR, certified anesthesiologist ... Most important make sure your plastic surgeon is board certified...

That's an excellent question and the bottom line is this:
A hospital will have a Board Certified Anesthesiologist in your operating room, a full operating room staff with each person dedicated to a singular aspect of your care and a full complement of medical specialists and diagnostic equipment should the need arise for some type of intervention.
Outpatient centers "should" adhere to the accreditation standards but not all do and not all centers or offices will share that information with you.  The responsibility rests with you to do your research and acquire the necessary knowledge to ask the correct questions.   Many surgeons are owners or partners in these facilities and receive a profit on top of the surgical fees. It can be a slippery slope.
A hospital based surgery may be a couple of hundred dollars more than that offered in the other settings.  Typically the surgeon's fee will be less due to the added cost of the facility.  But quite often, the overall charges are close to an outpatient setting because in that environment, the surgeon will charge more for his or her fee which makes up the difference in the lower cost of the facility.
As for maximum safety, in the event of some type of emergency, a hospital based case has everything on hand within the facility. You will not have to leave the building to be treated- all care and personnel are  immediate and on site.  There is no delay.  That can't be said for an off campus or typical outpatient facility.  As for infection concerns, I have not found there to be any difference and strongly adhere to the need for close follow up care of patients after surgery and meticulous wound care.
I have worked in both settings and make these comments objectively and with considerable experience.  I believe a patient must understand the differences in these setting when making his/her decision and not dwell on the savings of a couple of hundred dollars when it comes down to your health and a the long term investment you are making in yourself.  Understand the differences and make the best decision for yourself.
Hope this helped!
In good health,
Ellen Mahony, MD

it does usually mean total costs are less for the same procedure with someone doing this at the hospital based facility.  As long as the facility is certified by a legitimate agency, its safe to have surgery there.  If there is no certification, you take some chances BUT a surgeon should always want what is best for patients and if so, is probably safe in office facilities.  But why take the chance when those facilities do not have to meet the standards that certified facilities must?

I feel it is best to have any surgery in a full facility hospital, with a board certified anesthesioligist MD attending. Your safety and comfort is the main concern; along with your post op recovery.

The most important issue for you is first to find a reputable board certified plastic surgeon who you are happy and comfortable with. Once you have reached that point you want to make sure that your procedure is going to be performed in a "certified" facility. All hospitals should be certified if they are open but the costs for surgery in most areas are significantly higher than they are either in an outpatient center or a plastic surgeon's office. For these latter two, you just want to make sure that they are accredited typically by the AAAASF which means that they have passed all safety tests and criteria for certification. Personally, I also prefer a board certified anesthesiologist versus a nurse anesthetist.Steven Turkeltaub, MD

Many surgeons have their own office based surgical facility.it is important that the surgeon be Board Certified in Plastic Surgery.The facility must be Aaccredited by an organization such as AAAASF, the gold standard for accreditation of surgical facilities.Such accreditation assures adherence to the highest standards of care and the facility must show they follow strict standards for surgery, cleaning, sterilization, adequate personnel, certified anesthesia provider. quality assurance, handling emergencies, and having all the certifications and drugs for emergencies.Office based surgery with proper choice of doctors, patients can be as safe if not safer than hospitals