Cosmetic Surgery Risks

Popularity of Plastic Surgery Does Not Diminish Risks American Society of Plastic Surgeons Leads the Specialty with Safety Initiatives

Arlington Heights, Ill. – Plastic surgery is serious and just as with any operation, surgical procedures carry risks. The American Society of Plastic Surgeons (ASPS), the foremost authority on cosmetic and reconstructive plastic surgery, has always led the specialty in safety initiatives and continues to make patient safety the society’s number one priority.

“With the increasing popularity of plastic surgery, combined with the reality show Extreme Makeover, it could be easy for the general public to overlook the serious nature of elective cosmetic surgical procedures,” said Rod Rohrich, MD, president of the American Society of Plastic Surgeons. “But what the public needs to know is that at the highest level of care, every surgery has risks as well as benefits.”

The ASPS has implemented the following initiatives to promote patient safety:

  • The ASPS created its Patient Safety Task Force in 2000, which developed advisories for members on surgery in the office-based setting. Advisories on general patient safety issues and patient selection were published in Plastic and Reconstructive Surgery, the ASPS peer-reviewed medical journal in 2002. Advisories on liposuction as well as pain management and post-operative nausea will be published in 2004 and 2005.
  • As of July, 2002, all ASPS members who perform plastic surgery under anesthesia, other than minor local anesthesia, are required to perform the procedures in accredited facilities.
  • The ASPS has a national database “Tracking Operations and Outcomes for Plastic Surgeons” (TOPS), that collects procedure and outcome data that will provide information to demonstrate the quality of care provided by board-certified plastic surgeons.
  • The ASPS approved a patient safety continuing medical education (CME) requirement for all members.
  • The ASPS will work with accrediting agencies for office-based surgical facilities to develop a definition of reportable adverse incidents as well as minimum quality assurance standards for office-based surgical facilities.
  • The ASPS developed the “Statement of Principle on Informed Consent,” which details the information that should be discussed and understood by the patient, including: details of the surgery, benefits, possible consequences and side effects of the operation, potential risks and adverse outcomes as well as their probability and severity; alternatives to the procedure being considered and their benefits, risks and consequences; and the anticipated outcome. The ASPS recognizes the physician-patient relationship is one of shared decision-making.
  • The ASPS fully supports the Patient Safety and Quality Improvement Act, H.R. 663, which would enable surgeons and other health care providers to learn why medical errors and adverse events occur so that the necessary changes can be made. HR 663 was passed by the House of Representatives last year. The Senate is expected to take up similar legislation in early 2004.

Finally, the ASPS offers the following suggestions to anyone interested in having cosmetic plastic surgery.

  • Check Board Certification: Determine if your physician is certified by a board approved by The American Board of Medical Specialties (ABMS). Members of the ASPS are certified by The American Board of Plastic Surgery, the only board recognized by ABMS that certifies physicians in plastic surgery of the face and all areas of the body. This ensures that the plastic surgeon has graduated from an accredited medical school and completed at least five years of surgical residency, usually three years of general surgery and two years of plastic surgery.
  • Ensure Safe Facilities: Everyone who chooses cosmetic plastic surgery has the right to a safe procedure. Injectables should be administered in a setting with appropriate medical personnel and necessary equipment to observe patients and manage potential complications, as well as provide for the disposal of medical waste as required by Occupational Safety and Health Administration regulations. ASPS requires all members who perform surgery under anesthesia to do so in an accredited, licensed or Medicare-approved facility.
  • Require a Medical Evaluation: When considering a cosmetic plastic surgery procedure, consult with a physician for an evaluation, as well as a full medical history, to determine what is most appropriate.
  • Be Informed: Speak with friends and family about the procedure as well as with a physician. When a treatment decision is made co-operatively between the physician and patient, the physician should explain the risks, benefits, alternatives, and reasoning for the proposed treatment, after which an informed consent document should be signed by the patient.

Look For Specialty Group Affiliation: Membership in the ASPS ensures that not only is the plastic surgeon certified by the American Board of Plastic Surgery, but that the plastic surgeon regularly attends continuing medical education courses and adheres to a strict code of ethics.

Ask Questions:

  • Are you certified by The American Board of Plastic Surgery?
  • What is the best procedure for me?
  • Where and how will you perform my procedure?
  • What are the risks involved with my procedure?
  • Will my procedure need to be repeated?
  • How much downtime should I expect?
  • Do you have hospital privileges to perform cosmetic surgery?
  • How much will my procedure cost?
  • Are financing options available?
  • How are complications handled?

To aid people considering plastic surgery ASPS has developed an informational brochure, “Making the Right Choice”, which offers information on managing expectations and questions to ask before plastic surgery.

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