Can non-plastic surgeons (who are nevertheless doctors and do things like liposuction) legally use general anesthesia?

Question

Because I have been looking into some full body procedures that would have to be done in two sessions to not cause lidocaine toxicity and am being told it is best to do it like this. Is that true or can they just not legally use general anesthesia?

Kenneth Hughes, MD · Answer

These individuals would have to get privileges to do this at a surgery center or hospital that is accredited.

Gerald Minniti, MD, FACS · Answer

Hello,There are no city, state, or federal laws preventing an 'MD' from performing any procedure, however hospitals and ambulatory surgery centers interested in keeping their accreditation do have credentialing in place which prevents any other doctor from performing liposuction other than plastic surgeons. The reason you'll find all sorts of doctors doing liposuction is because it is not as technically difficult as, say brain surgery, and it is a 'cash case'.  This doesn't mean outcomes are good, or that these various doctors have any real deep understanding of what they are doing.  As I always say, 'liposuction is easy to perform, very hard to perform well'.  You would be fool hardy to not go to an ABPS certified/ASAPS member surgeon for liposuction, especially if it is high volume. Safety first. Best of luck!

John L. Burns Jr., MD · Answer

To receive and maintain hospital privileges or privileges at a fully accredited surgery center, the surgeon will have to be board certified in their respective speciality, in this case Plastic Surgery,  The only legitimate certifying board is the American Board of Medical Specialities by which the American Board of Plastic Surgery is recognized.

Jason Emer, MD · Answer

With general anesthesia, only a licensed anesthesiologist can administer it, but most Doctors who perform body shaping procedures will have an anesthesiologist they work with out of their office. You'll want to see a board certified doctor with skill, expertise, and the best techniques with hi definition procedures like VASER HI DEF. Look at doctors who do live filmings, teachings, and have good before and after photos on social media sites!  Best, Dr. Emer

Tim Sayed, MD, MBA, FACS · Answer

Good question.Legally, any MD/DO with an unrestricted medical license can perform any procedure that a facility lets the doctor do. Since many physicians who are not trained as surgeons or specifically as plastic surgeons can operate in their own office-based OR's or other environments that grant them privileges, you may see these doctors trying to promote "local anesthesia" liposuction as an alternative. This often includes dermatologists who may have some training in liposuction techniques but are not surgeons. Because there is no legal restraint on people calling themselves "cosmetic surgeons" (to the chagrin of the plastic surgery profession and to the detriment of patients), anyone can offer this procedure in a setting that does not necessary allow for general anesthesia.Most accredited surgery centers and hospitals will not grant privileges for these operations (whether done under local or general anesthesia) to these kinds of practitioners because they are not fully and properly trained in the surgery and management of complications. Most plastic surgeons prefer general anesthesia for all but the smallest of treatment areas because of concerns about lidocaine toxicity. Many "corporate" practices try to promote lipo under local as "safer" when in fact, it is less safe than properly performed lipo in an appropriately accredited facility with a credentialed anesthesia provider (MD/DO or CRNA) providing general anesthesia with full control of the airway, IV access, and all other supportive equipment and meds required for accreditation of the facility. I caution patients not to think they can get the same result for a large volume or more comprehensive lipo/fat transfer under true local anesthesia due to limits on lidocaine volumes from a safety standpoint.

John S. Alspaugh, MD, FACS · Answer

We use board certified anesthesiologists to provide the best comfort and more importantly, the best safety for our patients. Lidocaine can be used instead of general anesthetics but it has limits. I personally would not be comfortable doing body contouring procedures without the support of an anesthesiologist unless the procedure was limited in scope.

Nick Masri, MD, FACS · Answer

Thanks for your question, muoldbidy.
If you are looking at full body procedures like a body lift or a mommy makeover, the best anesthesia to use is general anesthesia. And the only one who can administer it is a licensed anesthesiologist.
Most reputable plastic surgeons have licensed anesthesiologists in their clinics. I suggest you look for a board-certified and experienced plastic surgeon to get yourself evaluated. Your plastic surgeon will also let you speak with the anesthesiologist assigned to you so that he can evaluate your airway for anesthesia administration.
Good luck!

Can non-plastic surgeons (who are nevertheless doctors and do things like liposuction) legally use general anesthesia?

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