BASICS: CHOOSING SAME DAY SURGERY FACILITIES
An increasing number of plastic surgery procedures are being performed on an
ambulatory, or same day basis. This means you will arrive and leave the facility
in which the surgery is being performed on the same day as the operation.
An ambulatory facility can be a part of a surgeon's office, a surgical suite
adjacent to the office, a separate or free-standing surgical facility, or it can
be part of a hospital. Any facility in which you have surgery as an outpatient
is an ambulatory facility.
If you are considering plastic surgery at an ambulatory facility, this
brochure will give you a basic understanding of what to look for in a facility,
how to find out if the facility is accredited, and why accreditation is
important. It can't answer all of your questions. Please ask your doctor about
anything you don't understand.
Choosing a Same Day Facility
Your choice of an ambulatory or same day facility for plastic surgery is an
important decision. For your own well-being, you should make every effort to
make it an informed decision. You should also be comfortable with the facility,
your surgeon and your surgeon's staff. Some patients choose, and surgeons
recommend, ambulatory surgery because of the possible cost savings and
convenience as well as the greater privacy and personalized care it affords.
Many patients find the pleasant setting an ambulatory facility provides them and
their families to be an attractive feature. Others choose ambulatory surgery
because it eliminates an overnight hospital stay.
When planning surgery at an ambulatory facility, you should ask if the
facility is accredited. Accreditation can be an indication of the quality of the
facility operation. It requires that the facility has passed strict guidelines
for equipment, staff, hospital access and anesthesia administration. It also
requires that the doctors performing surgery at the facility have privileges to
perform the same procedures at an accredited hospital.
You can find out if a facility is accredited by asking your surgeon. The
doctor will welcome questions about the facility and will be pleased that you
are concerned enough to ask.
An accreditation certificate will usually be prominently displayed in the
facility. The following are some of the groups that accredit facilities:
· The American Association for Accreditation of
Ambulatory Plastic Surgery Facilities (AAAAPSF)
Mundelein, Illinois 60060
· The Joint Commission on Accreditation of Healthcare
One Renaissance Boulevard
Oakbrook Terrace, Illinois
· The Accreditation Association for Ambulatory Health
9933 Lawler Avenue
Skokie, Illinois 60077
All of these groups have programs to provide accreditation and inspection of
outpatient surgical facilities.
A patient can also check if a plastic surgeon's facility is accredited by
calling the American Society of Plastic Surgeons (ASPS) at 1-800-635-0635. ASPS
is a national medical specialty society in which certification by the American
Board of Plastic Surgery is a membership requirement.
Inspection and Classification
The American Association for Accreditation of Ambulatory Plastic Surgery
Facilities (AAAAPSF) is a not-for-profit association devoted to a voluntary
inspection and accreditation program for qualifying ambulatory plastic surgery
facilities. Accreditation by the AAAAPSF certifies a facility has met the
rigorous standards developed by the AAAAPSF for patient care, quality and
The AAAAPSF inspects only ambulatory plastic surgery facilities owned or
directed by surgeons certified by the American Board of Plastic Surgery (ABPS).
Certification by the ABPS means that the surgeon has graduated from an
accredited medical school and completed at least five years of additional
residency training - usually three years of general surgery (or its equivalent)
and two years of plastic surgery. To be certified by the ABPS, a doctor must
also practice plastic surgery for two years and pass comprehensive written and
AAAPSF classifies ambulatory surgery facilities as A, B or C facilities.
Re-certification of facilities occurs every three years. Plastic surgery
procedures are performed under local anesthesia in class A facilities.
Medication to relieve tension may be given before local anesthesia is
administered. A sedative and local anesthetic allow you to be comfortable during
Most plastic surgery procedures are performed in class B or C facilities. The
standards vary just slightly between B and C facilities. Both have life-support
equipment just as a hospital operating room.
· In the class B facility intravenous sedation may be
· General anesthesia, which will allow you to sleep
through the entire operation, may be administered only in class C
An ambulatory facility usually charges set amounts based on the procedure(s)
performed at the facility. Therefore, you will have a good estimate of what
costs will be for your surgery in an ambulatory facility. Generally, costs for
ambulatory facilities are less than similar services provided in a hospital.
While most insurance plans do not cover facility fees for elective surgery,
facility fees for reconstructive procedures may be covered. Your doctor or your
doctor's office staff may be able to help you with questions about your
insurance coverage. Reimbursement of facility fees may be expedited when the
facility carries recognized accreditation, as accreditation assures that the
facility meets generally recognized standards of quality. The cost-saving
benefits of ambulatory facilities have also been favorably viewed by state and
federal health agencies, including Medicare.
Ambulatory surgery is not appropriate for everyone. Each case must be
evaluated individually. Your medical history must be reviewed and only your
doctor and you can best decide if you are a good candidate for surgery in an
As an additional precaution, after surgery in an ambulatory facility, a
responsible adult must be available to drive you home and remain with you for 24
to 48 hours post-operatively - or as your doctor recommends. If this is not
possible, your physician may transfer you to a post-operative recovery facility
until you are able to safely care for yourself.
Because of the need to control health care costs while preserving quality of
care, ambulatory surgical care will likely continue to grow. Accreditation
programs and physician commitment to excellence ensure that ambulatory
facilities will continue to set high standards for quality and safety as well as
provide cost savings and convenience to you.
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