New study evaluates safety of outpatient plastic surgery, compares patient and facility characteristics

In a new study published in Plastic and Reconstructive Surgery, researchers from the UF Department of Surgery examined the safety of outpatient plastic surgery, providing a more holistic comparative evaluation of outcomes and safety.

“Even as a state, Florida often tends to see some publicity around serious complications or fatalities surrounding plastic surgery,” pointed out Ellen Satteson, M.D., assistant professor of plastic surgery. “Although as professionals we never wish to see that occur, the goal of this study was to look at where instances like these were occurring — typically outside of major surgical centers, which is common with aesthetic plastic surgeries.”

Researchers looked at some of the most common cosmetic plastic surgery cases, trying to determine whether or not there was a difference in terms of mortality or major complications at ambulatory surgery centers (ACS), Satteson explained, which are common at UF, versus those being done in office-based surgery facilities (OBSF).

A commitment to quality patient care is recognized within the American Society of Plastic Surgeons’ database, which draws on voluntarily submitted data from board-certified plastic surgeons who are members of the organization.

“In a way, this database acts as a kind of internal quality control,” Satteson said.

The most common outpatient plastic surgery procedures were identified using the Tracking Operations and Outcomes for Plastic Surgeons (TOPS) Database between 2008 and 2016. The team analyzed outcomes for OBSFs and ASCs, while patient and perioperative information was also analyzed using regression analysis to identify risk factors for complications.

Satteson and co-authors found that there were no significant differences in terms of safety between different practice settings among those who were board-certified and practicing members of the American College of Surgery.

“Many of the issues that there have been, especially in terms of safety, have been non-board-certified plastic surgeons, or people who haven’t even trained as plastic surgeons conducting some of these surgeries that result in bad complications and even death,” Satteson said.

In addition to shedding light on best practices in the field of plastic surgery and understanding the effect of practice settings, study authors hope that data like this will ultimately prove helpful for patients who approach their plastic surgeons with concerns.

“We hope this will encourage patients to make sure that they have somebody who is appropriately trained in plastic surgery and certified to be doing the procedure in question before they sign up for a significant surgery,” Satteson said. “And if they’ve done that, then they can feel comfortable that the level of safety and quality of the care provided is similar, regardless of the practice setting or the surgical site setting where you’re having your surgery done.”