FAQs: Breast Augmentation & Breast Implants Surgery Location

Accreditation & the Surgical Facility: Office Surgery, Surgicenter, or Hospital - Does It Matter Where Breast Augmentation Surgery Is Performed?

Plastic surgery can be performed in any of several different types of facilities. The actual location used depends largely on the individual surgeon. It is important to realize that, from the standpoint of safety and results, no surgical facility is inherently superior to any other.

Some surgeons operate exclusively (or nearly so) in an office-based or other free-standing surgical facility, some operate exclusively in hospitals, and many operate in either environment. Sometimes it depends on the procedure (with larger, longer, or more complicated procedures being done in a hospital) and sometimes it depends on the patient (the patient's preference, or if there are certain medical conditions that are best monitored in a hospital setting). Also, advances in anesthesia have facilitated outpatient procedures. The newer medications are stronger but shorter-acting, which allow for tighter control of the patient during the procedure and a faster "wake-up" afterwards. Financial considerations may be a factor, since plastic surgery procedures can often be performed more cost-effectively in an office or outpatient setting. For these and many other reasons, there has been a dramatic shift towards office and outpatient surgery over the past decade or so.

One question raised by this shift is whether it is safe to have procedures performed in an office or outpatient setting. The answer is "Yes" - even though precise statistics are hard to come by for any type of facility, including hospitals.

There are several organizations that have established standards for office and outpatient facilities in an ongoing effort to maintain and improve safety. One of these is the American Association for the Accreditation of Ambulatory Surgical Facilities (www.aaaasf.org). Offices and outpatient facilities that have received accreditation from this or a similar organization have established and/or adopted standardized protocols and routines - similar to those used in hospitals - and have been subjected to rigorous inspections that examine a wide range of issues, from safety equipment and procedures (like backup power and emergency medications) to office layout, staffing, and record-keeping. Already mandatory in some states, such accreditation may eventually become so everywhere.

In planning your surgery, therefore, you may want to add "Accreditation" as something to consider.  As always, there are few simple answers. What matters most is that the surgeon and team are capable, caring, and vigilant. Wherever the surgery is.

This FAQ and answer contributed by Dr. Alan M. Engler, of New York, NY.

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