Choosing between the office and the surgery center

Published on November 18, 2013

When it comes to the advancements made in cosmetic surgery, more and more people are having aesthetic procedures with less and less downtime. Plastic surgery is safer, more effective, and more affordable than ever before. But the fact that plastic surgery and cosmetic in-office procedures have become so accessible does not discount the fact that these are still medical procedures being performed, and that there continue to be risks and benefits that must be discussed with you prior to undergoing one of these procedures.

While many patients are accustomed to visiting their facial plastic surgeon to have Botox and fillers (such as Juvederm and Radiesse), many are also having surgery in the office. How is this possible? Is it safe? 

Improved techniques and better trained facial plastic surgeons who have honed their skills have made such in-office surgeries feasible. I regularly perform eyelid surgery in the office, and for select, otherwise healthy patients, may elect to also perform facelifts, ear pinning surgery, and even reconstruction after skin cancer surgery. This can be done safely only after I have fully evaluated the patient and had any necessary laboratory work and/or other check-ups done prior to performing the procedure. I always personally fully review the medical history of anyone in my office who would like to have any procedure done, including surgery. This is the only way I can assure each patient that I have carefully vetted them to safely achieve the aesthetic results they desire.

There is no standard formula regarding who can or cannot have surgery done in an office setting. But there are some general guidelines. First of all, ask yourself if you are comfortable being awake during the procedure. If you feel you will be slightly anxious, but are overall comfortable with the idea, taking an oral medication such as Valium before having your procedure in the office may be an ideal situation. On the other hand, if you feel you will be very nervous and uncomfortable with your procedure if you are awake and aware of what is happening, then you will most likely benefit from a higher level of sedation and anesthesia while being attended to by a board certified anesthesiologist. 

Next, you should seek a facial plastic surgeon who is comfortable with performing procedures both in the office setting as well as in surgery centers and, when necessary, the hospital. Since I commonly perform surgery in each of these settings, I am able to choose between these options based on the needs of my patients. If your surgeon only performs procedures in the surgery center, then he or she may not want to provide you with additional options regarding the location of your surgery. 

Of course, you must also realize that the fact that a surgery can be performed safely in the office does not necessarily mean that you can safely have the same surgery done in the office. Your medical history, level of calm, and a host of other factors can affect your suitability for such a procedure. I believe the two most important factors are safety and success. You want the best results possible through the safest means possible. If something about your medical history or physical examination suggests that a surgery will be safer or more successful when performed in an operating room under IV sedation or general anesthesia, then I will make that recommendation.

That said, as we continue to make improvements in facial aesthetic surgery, more and more excellent outcomes will be achieved in the office rather than the operating room. And that is good for everyone.

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