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Key Points
- Plastic-surgery procedures performed in accredited outpatient facilities are just as safe as those performed in hospitals.
ARLINGTON HEIGHTS, ILL. — Plastic-surgery procedures performed in accredited outpatient facilities are just as safe as those performed in hospitals.
That's one of the findings of a study co-authored by Los Angeles plastic surgeon Geoffrey R. Keyes, M.D., and published in Plastic and Reconstructive Surgery, the journal of the Arlington Heights-based American Society of Plastic Surgeons (ASPS).
The study — the largest ever on office-based procedures — reviewed more than 1.1 million office-based surgeries and found the mortality rate to be 0.002 percent, or two deaths in every 100,000 procedures — a figure comparable to that of hospital-based plastic surgeries. The reviewed data were collected from January 2001 through June 2006 by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) from AAAASF-accredited outpatient facilities. The AAAASF mandates biannual reporting of all complications and fatalities resulting from surgical procedures and, further, requires that surgeons be board-certified and have credentials at a hospital in order to perform any procedure being contemplated at an office-based facility.
In a statement issued by the ASPS, Dr. Keyes notes that while procedures done in accredited facilities are safe and deaths are rare, "People should consider plastic surgery with the same seriousness as medically necessary surgery. Most importantly, patients should have their procedure performed by an ASPS Member Surgeon in an accredited facility." The ASPS requires all of its member surgeons to operate only in accredited or licensed facilities.
In an interview with
Cosmetic Surgery Times
, Dr. Keyes notes another of the study's key findings: The vast majority of surgery-related deaths were due to pulmonary embolism.
"We think it's a significant finding that pulmonary embolism plays a big role in surgery in general as well as in our surgery, particularly in abdominoplasty procedures," says Dr. Keyes, an ASPS member surgeon who serves as vice president of the California Society of Plastic Surgeons and president of the Los Angeles Society of Plastic Surgeons.
The study made no mention of mortality rates associated with procedures done in non-accredited facilities — according to Dr. Keyes, that's because no regulations exist requiring such facilities to track that information.
"While we cannot say what the mortality rate is for non-accredited facilities, one could make the assumption that having standards through accreditation significantly improves patient safety and quality of care," Dr. Keyes tells
Cosmetic Surgery Times
.
Dr. Keyes says only 14 states mandate accreditation of health-care facilities and adds that efforts are ongoing to increase that number.
"The AAAASF has been instrumental in meeting with state-government leaders to discuss the issue," he says.
According to the ASPS, the new study's findings contribute to a growing safety record for office-based plastic-surgery procedures. A 2004 Plastic and Reconstructive Surgery study reviewed 400,000 procedures done in AAAASF-accredited outpatient facilities in 2001 and 2002 and found that death occurred in 1 in 59,000 procedures, or 0.0017 percent.
ASPS statistics show that nearly 11.8 million cosmetic-surgery procedures were performed in 2007, up 59 percent since 2000. Fifty-nine percent were performed in an office-based facility, 21 percent in a free-standing ambulatory surgical facility and 20 percent in a hospital.
