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Office-based surgical suites safe alternative to hospitals for cosmetic surgical procedures

Accredited office-based surgical suites were a safe alternative to ambulatory surgery centers and hospitals for patients undergoing cosmetic surgical procedures, according to study results recently published in Aesthetic Surgery Journal.

Researchers used the CosmetAssure insurance program database to conduct a prospective study of 129,007 patients (93.5% women; mean age, 40.9 years) undergoing cosmetic surgery between 2008 and 2013. The type of accredited facility where the procedure was performed — office-based surgical suites (OBSSs), ambulatory surgical centers (ASCs) or hospitals — was used to group patients.

Incidence of major postoperative complications that required an ED visit, hospital admission or reoperation within 30 days, was used as primary outcome.

There were 183,914 cosmetic procedures performed, including 57.4% at ASCs, 26.7% at hospitals and 15.9% at OBSSs. The number of procedures performed in OBSSs between 2008 and 2013 remained stable (16.6% vs. 15.9%). However, there was a significant increase in the number of procedures performed in ASCs (53.9% vs. 58.7%) and a decrease in the procedures performed at hospitals (29.5% vs. 25.3%).

Patients in the OBSS group were older (mean age, 42.2 years) compared with those in the hospital (mean age, 41.6 years) and ASCs (mean age, 40.2 years; P < .01). The OBSS group also contained more men (7%) compared with hospital (6.4%) and ASCs (6.3%; P < .01).

Patients undergoing combined procedures were less likely in the OBBS cohort (30.3%), compared with ASCs (31.8%) and hospital (35.3%; P < .01).

The most common procedure performed at each facility was breast augmentation, followed by liposuction at OBSSs and ASCs, while abdominoplasty was the second most common procedure at hospitals.

Face procedures were conducted on 21.3% of patients at OBSSs, 15.5% at ASCs and 14.1% at hospitals.

There were complication rates of 1.3% for OBSSs, 1.9% for ASCs and 2.4% for hospitals.

The researchers used multivariate analysis and found a lower risk for complications in an OBSS compared with an ASC (RR = 0.67; 95% CI, 0.59-0.77) or hospital (RR = 0.59; 95% CI, 0.52-0.68) procedure.

“OBSSs are a reasonable alternative to ASCs and hospitals for cosmetic procedures,” the researchers concluded. “Accredited OBSSs are a safe environment for board-certified plastic surgeons to conduct single, combined, or complex cosmetic surgical procedures. This may translate to reduced costs and better patient satisfaction without compromising safety.

“However, plastic surgeons should continue to triage their patients carefully for candidacy based on variable such as ASA class and pother significant comorbidities that were not measured in this present study.” – by Bruce Thiel

Disclosure: Gupta reports no relevant financial disclosures. Please see the full study for other researchers’ relevant financial disclosures.