Liposuction in a Doctor's Office?

Liposuction should be performed in an accredited surgical facility, not an office. Many patients refer to an accredited surgical facility next to a doctor's office as the doctor's office, but there is a difference.
Accreditation of the surgical center means the surgery center is safe to perform surgery. All the necessary emergency equipment is there. All the emergency medications are there. Monitoring of the heart and vital signs is there. The surgery center has cleanliness standards and sterility standards. There are filters in the ceiling to filter the air. Every surgery requires an RN, a surgical technician. Safety procedures are followed. All these things cost money. That is why surgery is more expensive in an accredited surgery center than a doctor's office. If God forbid you have an allergic reaction, develop malignant hyperthermia, have a complication, you do not want to have any of these items missing.
Liposuction is a surgical procedure. You may want to inquire if your surgeon is credentialed in a hospital to perform the surgery. The hospital takes screening of physicians seriously and checks backgrounds, credentials, etc. before they issue operating room privileges.
Is the surgeon performing the anesthesia himself or is there an anesthesiologist present? The anesthesiologist's only job is your safety and your comfort. He is equipped if an airway problem or allergic reaction results, or a complication results.
This is why board certification, accredited facilities, and proper anesthesia support are so important to patient safety.

Dear RealSelf Admin,

Your question about the safety of undergoing liposuction in your doctor's office, as opposed to a hospital setting, is both insightful and important. The safety and efficacy of such procedures depend on several key factors, including the certification of the facility, the complexity of your procedure, and the expertise of the medical team.

When a doctor's office is described as "medi-care certified," it indicates that the facility has met specific standards set by health authorities for providing medical care, including surgical procedures. Here are several aspects to consider when evaluating the safety of undergoing liposuction in such a setting:

1. Facility Certification and Standards: Ensure the office is accredited by a recognized medical body, such as the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), the Joint Commission on Accreditation of Healthcare Organizations (JCAHO), or an equivalent. These accreditations mean the facility adheres to rigorous safety standards, emergency protocols, and quality benchmarks similar to those in hospitals.

2. Surgical Team's Qualifications: The surgeon should be board-certified in plastic surgery or a related field, indicating they have undergone extensive training and examination in surgical procedures, including liposuction. The supporting medical team should also have the necessary qualifications and experience to assist with the procedure and manage post-operative care.

3. Procedure Complexity and Your Health Status: For patients in good health undergoing minor to moderate liposuction, an office setting might be appropriate. However, for more extensive procedures or if there are specific health considerations, a hospital setting might offer additional safety nets.

4. Emergency Preparedness: The facility should have the necessary equipment and protocols in place to handle emergencies should they arise. This includes life support systems, medication to manage adverse reactions, and a clear plan for hospital transfer if needed.

5. Post-Procedure Care: Understand the plan for post-procedure observation and the criteria for discharge. The facility should provide clear instructions for at-home care and have a mechanism for 24/7 patient support in case of questions or complications.

It's important to have a detailed discussion with your surgeon about the proposed setting for your liposuction. Feel free to ask questions about the facility's accreditation, the qualifications of the team, and the specific reasons why the procedure can be safely performed outside of a hospital environment. A trustworthy surgeon will be transparent about these factors and help you make an informed decision.

In conclusion, with the right preparations and qualifications, liposuction can be safely performed in a medi-care certified doctor's office. However, each patient's situation is unique, and it's crucial to weigh all considerations carefully.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS
Plastic and Aesthetic Surgeon

You are going to want to do your homework on this one. Is your doctor a board certified Plastic Surgeon? (Check here asps.org), does he have an accredited facility in his office? Is the anesthesia being administered by a Board Certified Anesthesiologist? Better to find out the answers to these questions before your surgery so you don't have any regrets. 

According to the statistics of the American Society of Aesthetic Plastic Surgery, the vast majority of liposuctions are performed in the office based setting. There are several important factors to consider:


make sure that the facility is certified by a credentialing agency such as the AAAASF orJCAHO

in most states, there is no regulation as to the procedures that a physician can perform in his or her office. Make sure that your physician is credentialed at a local hospital for the same operation. This will reflect that the surgeon is actively trained and experienced in that procedure.

The amount of fat removed should also determine whether or not this is performed as an outpatient or inpatient regardless whether the facility is credentialed or not. It is generally accepted that patients should be monitored overnight with  large volume liposuctions

Trust.
Choosing a plastic surgeon is as much about trust as it is about credentials. Go with your hunch before committing to a particular procedure. A well-qualified and board certified plastic surgeon will not cut corners to acheive results.
Liposuction procedures are generally safe with minimal downtime and postoperative recovery. Anesthesia type, surgical center, and physician technique are absolutely crucial factors in making a decision to pursue the procedure.
If you feel that you are not receiving the absolute best procedure, technique, and amenities, do not proceed with surgery. Meticulous attention to detail defines my personal practice in Santa Monica, CA which is an absolute necessity to obtaining superior results.

The safety of tumescent liposuction in an office setting is well established since its inception two decades ago. Risks exist in the hospital and ambulatory surgical setting as well as the office and thorough discussion of the procedure and its risks must be held with you and your surgeon.

I agree with the comments by the previous doctors. I personally remove only 3 liters in the office at one time if I am combining it with other surgeries on the same patient. Other surgeons may remove up to 5 liters at one time which is probably fine but not more.

The facility in which you have your liposuction should be either AAAHC, AAAASF, JCAHO, or Medicare certified. All these accreditation organizations have strict guidelines to ensure you that the facility is up to the level of standard of care for surgeries. Hospitals have such a high risk of infections now days and often these infections are not suceptible to our common antibiotics.
Have your doc show you the op room and ask how long he has been doing the liposuction procedures and if he is board certified in either Dermatology, facial plastic surgery or general plastic surgery. A dermatologist invented the tumescent technique liposculpture but any physician can be good at a particular procedure with enough experience. This having been said, your rapport with your doc is also very important since he is the one you will be needing to ask all your questions and concerns to before, during and after the procedure. If you like his bedside manners, and his facility is certified and he is board certified and has years of experience then you are probably in good hands.
Good luck on your Liposuction!

For the safety of the patient, liposuction should be performed at an accredited surgical center. Best of luck.

Hello,
Liposuction can be performed in an office when the aspirate (the material to be removed) is small. For larger cases, an accredited surgical facility (SurgiCenter) is best. It is a matter of keeping the surgical sites clean. Small areas can be done in an appropriately-equipped office. For larger cases, an operating facility is better.

P.S. A hospital is not necessary in most cases and is usually much more expensive. Be careful.