Largest review of office-based plastic surgery confirms safety in accredited facilities

Mortality rate less than 1% in over 1.1 million procedures

July 16, 2008
American Society of Plastic Surgeons (ASPS)

A study examining plastic surgery procedures performed in accredited outpatient facilities found that office-based surgery is as safe as surgery performed in hospitals. The study published in July's Plastic and Reconstructive Surgery® (PRS), the official medical journal of the American Society of Plastic Surgeons (ASPS), reviewed more than 1.1 million procedures and found the mortality rate to be significantly less than 1% or 0.002%.

"The study shows that plastic surgery in accredited facilities is safe and deaths are rare," said ASPS Member Surgeon Geoffrey Keyes, M.D., study co-author. "However, 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 study reviewed data collected from January 2001 through June 2006 by The American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF), which mandates biannual reporting of all complications and fatalities. The data was obtained from facilities accredited by the AAAASF, which requires that surgeons be board-certified and have credentials at a hospital to perform any procedure being contemplated at an office-based facility. The ASPS requires all of its Member Surgeons to operate only in accredited or licensed facilities.

The study found deaths occurring at office-based surgery facilities are rare. More than 1.1 million operative procedures in AAAASF-accredited office-based outpatient surgery centers were studied from 2001-2006. Deaths were infrequent, occurring 2.02 in 100,000 procedures or 0.002%, which is comparable to the overall risk of such procedures performed in hospital surgery facilities. The vast majority of deaths were due to pulmonary embolism (a blood clot that travels to the lungs, blocking major blood vessels). Pulmonary embolism is an uncommon cause of death associated with any type of surgery whether elective or medically necessary.

These new findings contribute to a growing safety record for office-based surgery procedures. A 2004 PRS journal study examined 400,000 operative procedures in AAAASF-accredited office-based outpatient surgery centers from 2001-2002 and found that death occurred in 1 in 59,000 procedures or 0.0017%.

"While all surgery carries risks, the bottom line is that this study illustrates patients can and should feel safe when they go to an ASPS Member Surgeon who performs their procedures in an accredited facility," said ASPS President Richard D'Amico, M.D. "Amazingly, only 14 states mandate accreditation of facilities, so it's up to the patient to be knowledgeable. A patient's safety and life is everything."

Nearly 11.8 million cosmetic surgery procedures were performed in 2007, up 59% since 2000, according to ASPS statistics. 95% of cosmetic surgery procedures were performed in an office-based facility, 21% in a free-standing ambulatory surgical facility, and 20% in a hospital.