W h en it comes to cosmetic surgery, being a good consumer can be as tough as negotiating your way through a minefield. Of course, the ultimate goal of all those who seek these procedures is to achieve an excellent result. Never forget, however, that a huge part of achieving that result resolves around safety. Unfortunately, when it comes to making the best choice of where to have cosmetic surgery performed, there is no foolproof “Consumer Guide” to aid the prospective patient. Yet the choice of surgical facility for your cosmetic surgical procedure is a critically important decision.

It is estimated that 10 million surgical procedures are performed in doctors’ offices annually. In fact, 65% of all surgical procedures do not involve a hospital stay. The growth in such surgery has been explosive, with some 41,000 office-based surgical facilities being utilized. Indeed, a large percentage of cosmetic surgical procedures are performed in such facilities, for reasons that include privacy, confidentiality, cost, ease of scheduling, patient comfort and convenience for the surgeon.

Why should this be of concern to the potential cosmetic surgery patient? Unlike licensed ambulatory surgical centers and hospitals, office-based surgical facilities are often not regulated by local, state or federal laws. An unsuspecting patient could easily submit to a procedure in a facility poorly equipped for that procedure or for emergencies which might arise. In some cases, that could be a deadly oversight.

For this reason, there is increasing media scrutiny of cosmetic surgery performed in offices because of surgical complications, anesthesia and medication errors.

To ensure the safe delivery of cosmetic surgical care, procedures involving intravenous (IV) sedation or general anesthesia should only be performed in a facility that has been inspected by a national accrediting organization, to ensure that facility has met established standards related to the safe delivery of surgical care.

Achieving accreditation can be a long, time consuming and expensive process, and some surgeons resist becoming accredited for precisely these reasons. To achieve accreditation, a surgery center must meet hundreds of standards of quality. Examples include standards related to the rights and responsibilities of patients, adequacy of the surgical facility for the surgical procedure(s) to be performed, safety and emergency equipment, quality improvement programs, risk management, peer review, laser safety, anesthesia care, surgical care, and the privileging and credentialing of providers, to name just some. All of the required standards are designed to ensure the safe delivery of care to patients. And, once a surgery center achieves accreditation, it must undergo on-site inspections every three years to ensure adherence to standards and to demonstrate improvement in quality of care.

As you work through the decision processes in deciding on cosmetic surgery, you should consider many factors, including the importance of having your surgery in a fully accredited office-based surgery center. The three best known, nationally recognized accreditation organizations for surgery centers include the Accreditation Association for Ambulatory Health Care (AAAHC), which accredits 3,215 surgery centers, the Joint Commission, which accredits 1,600 surgery centers, and the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), which accredits 1,100 surgery centers.

The American Academy of Cosmetic Surgery requires its members to perform cosmetic surgery in accredited surgery centers when those procedures involve IV sedation or general anesthesia. Other organizations have similar requirements.

Cosmetic surgery is, by definition, elective surgery. As a good consumer of cosmetic surgery, you should not only check the credentials and reputation of the surgeon, but the accreditation status of the surgery center where your surgery might be performed.