Surgeons that operate in hospitals

Question

Hi! I'm wanting to get a breast augmentation this year and I have an ICD. I've talked to my cardiologist and he feels comfortable clearing me for his surgery. However, most surgeons I've reached out to in California operate in clinics/surgery centers. Is it uncommon for surgeons across the US to operate in hospitals? I know in Mexico it's way more common but I'd prefer to get my breast augmentation done in the states.

Ted Eisenberg, DO, FACOS, FAACS · Answer

Almost all of my 7500 breast augmentation patients, over 30 years, have had their surgery in a hospital. And, coincidentally,  recently,  one  had an ICD. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Jonathan Landon, MD · Answer

Hello and thank you for your question! Choosing a surgeon for a breast augmentation comes with a variety of factors to consider, and in your case it comes with the consideration of setting safety and protocols. Considering your ICD, I would agree to stay on the safe side and look at getting the procedure done with a surgeon who performs the surgery in a hospital setting. Those of us who do these in a hospital setting are becoming fewer and fewer, but we are still out there! For example, I am located in New York and do all of my breast augmentations/breast surgeries in a hospital setting because they are often better equipped for any scenario that could arise. Hope this helps!

Carlos Marciales, MD · Answer

Hello, I am a certified plastic surgeon, I work in Tijuana, Mexico, and I operate all my cases in a hospital, not in clinics, I have never had complications or fatalities, and a breast augmentation surgery with implants takes me 40 minutes to perform.

Richard A. Bartlett, MD · Answer

Hello fdlt777, many Board Certified Plastic Surgeons in the U.S. perform Cosmetic and Reconstructive Surgeries, including Breast Augmentations, in a hospital setting. When researching a Board Certified Plastic Surgeon for your desired procedure, make sure to inquire whether the surgeon is affiliated with a Hospital in the area. If they are affiliated with a specific hospital, they usually maintain privileges to perform procedures in that facility. It would be best to have your procedure done in a hospital setting as you have an ICD and a representative from the device manufacturer can be made available to adjust the settings of your device to allow for a safe procedure.

Derek Fletcher, MD · Answer

Confirming that your plastic surgeon has hospital privileges is an important method of identifying legitimate surgeons. Gaining privileges at a hospital means that the surgeon in question has been vetted. That means the hospital has confirmed the surgeons training and board certification. The hospital has been made aware of any lawsuits and/or complaints against the surgeon. And they have confirmed the surgical skill of the individual in question as meeting standards of care criteria.

However, not all hospitals will allow cosmetic surgery services in their facilities. So, you should identify a board certified plastic surgeon with hospital privileges at a facility that will allow cosmic surgery.

However, not all hospitals will allow cosmetic surgery services in their facilities.  So, you should identify a board certified plastic surgeon with hospital privileges at a facility that will allow cosmic surgery.

Gerald Minniti, MD, FACS · Answer

There is no reason to have this quick and safe surgery done in an accredited surgery center in a major city. Even if your ICD were activated by an arrhythmia during surgery, you would likely go back into sinus rhythm quickly, and the anesthesiologist would monitor your vital signs throughout the event. In that scenario, you would continue to be monitored for a prolonged period. If you are free of any further defibs, you would be either transferred home or to your cardiologist's office per his/her recommendations.

Warren Schutte, MD · Answer

This is a great question. It is very common for plastic surgeons to operate out of their own OR facilities or out of local day surgery centers. It is statistically safer to operate in day surgery centers and much cheaper for you as the patient. You can always ask your surgeon where his/her hospital privileges are in case of a need for transfer from the surgery center.

Eleonore Zetrenne, MD · Answer

Most plastic surgeons are usually affiliated with a hospital. I operate out of a hospital, but usually for breast cancer cases. It is preferable and more cost-effective to operate in a surgery center for the patient. However, if you desire to be in the hospital, it can be done, but the cost are significantly higher which is why, we do not suggest it. In your case, if you would be more comfortable in a hospital and are willing to pay the hospital fee, then you can be done in a hospital.

Connie Hiers, MD, FACS · Answer

Many surgeons do surgery in hospitals.  For elective cosmetic surgery, there is a much less chance of infections to do surgeries in outpatient surgery centers.

Marcos Lopez, MD · Answer

Thank you for your question. Across the country the decision on where to operate is largely based on the agreements the surgeon has with the surgery centers and hospital. Hospitals tend to charge more which is likely why you are having a hard time finding a surgeon who uses them (most patients don't need that level of care so its advantageous to be able to offer safe surgery at lower prices at a surgery center). In my practice, Amelia San Antonio, we have both hospital and surgery center options available to patients. We also have virtual consults and recommendations for how to make travel surgery safe. If Texas is a bit too far, I am sure there are other places across the country where this is also true. You may have luck with academic institutions (like Standford, UCLA, USC, etc.) because they tend to do more cases in a hospital.