Safety in Plastic Surgery
Safety is our highest priority. Surgery to improve your appearance cannot
be justified unless it can be done safely.
While any human endeavor involves some risk, common sense dictates
that we do what we can to minimize the risks we are taking. While surgeons are always thinking
about safety, recent news reports can serve to remind all of us to think about safety when we
are planning to have surgery. So, what can you do to be certain that you are minimizing your risks?
Perhaps the most important thing you can do is to pick your surgeon carefully.
Many Arizonans are surprised to hear that any physician licensed as an MD or DO can
do any surgical procedure he or she wants, without any surgical training whatsoever!
See Picking A Plastic Surgeon for more information on
this most important step.
Surgeons who are members of the American Society of Plastic Surgeons and the American
Society for Aesthetic Plastic Surgery have agreed to include courses in patient safety
in their continuing medical education.
The next most important thing is to consider where your surgery will be done. Some surgeons
will do major surgery in their office. Depending on the office, that might be acceptable, but
I personally do not think that any doctor's office will be as safe a venue for surgery as
a hospital operating room or the operating room of a formal surgery center. Nonetheless,
in some areas of the country, especially the east and west coasts, the use of a hospital operating
room may be cost prohibitive, and there are some very well respected surgeons who do surgery that
way. At a minimum, ensure that such a facility is licensed or accredited. Be aware that
some physicians without adequate training, who would not be permitted to do
plastic surgery in a hospital, will use their office instead. If your surgeon proposes doing surgery
in his office, ensure that he or she has privileges both to do surgery in a hospital, and to
do plastic surgery in a hospital. Call the Medical Staff office of the hospital to check.
For Scottsdale Healthcare, the Medical Staff office is at 480-323-3000.
Third, tell your surgeon about your medical condition, and follow his directions.
A good surgeon
will give you detailed instructions to help you prepare for surgery. Avoid drugs like aspirin,
ibuprofen, Motrin, Aleve, etc., which can cause increased bleeding in surgery. If your doctor
has prescribed those medications, discuss this ahead of time so that the appropriate plans can
Avoid smoking and exposure to cigarette smoke, both before and after your surgery. Smoke
is always bad for you, and increases your risk of pneumonia and other complications, but is
especially problematic for some plastic surgical procedures. Procedures, such as facelift, breast
lift, and abdominoplasty (tummy tuck), which involve raising a flap of tissue, have a much higher
risk of tissue loss (resulting in delayed healing and wide and depressed scars) in patients with
exposure to cigarette smoke.
Finally, ask about any specific safety precautions you may wish to discuss. For longer surgeries,
ask about the use of sequential pneumatic compression stockings, which alternately squeeze
the blood out of your legs during and after surgery to reduce the risk of blood clot.
Dr. Nachbar uses these for surgeries lasting more than two hours. For patients staying
at the surgery center overnight, Dr. Nachbar also uses an injectible blood "thinner" to further reduce
the risk of a blood clot.
While nobody can guarantee a specific result, modern surgical techniques and precautions have
dramatically improved the safety of surgery since the days of our parents. Ensure that you get
the benefit of those advances.