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American Academy of Facial Plastic and Reconstructive Surgery Study Finds Anesthesia Not an Indicator of Patient Morbidity and Mortality

World's Largest Facial Plastic Surgery Organization Provides Patient Safety Guidelines as In-Office Procedures Are on the Rise

(press release from AAFPRS)

NEW YORK, Oct. 19 -- As cosmetic surgical procedures continue to increase in office-based settings, and there is an on-going demand for patient safety measures, the American Academy of Facial Plastic and Reconstructive Surgery and Dr. Neil Gordon of Yale University School of Medicine conducted a study to analyze the use of anesthesia in facial plastic surgical procedures in non-hospital environments, and the effects longer duration aesthetic procedure has on patient morbidity and mortality. The study findings illustrate that anesthesia-time is not an indicator of patient morbidity and mortality. In 2004, there was a 22 percent increase in facial cosmetic-surgical procedures compared to 2003, and AAFPRS members report that more than half (55 percent) of those procedures took place in private office- based settings.

In the study, 1200 patients who underwent facial plastic surgery by a board-certified surgeon in an accredited office-based surgical facility from July 1995 to February 2005 were analyzed by Greenwich, Connecticut-based facial plastic surgeon Dr. Gordon. Patients who underwent anesthesia for less than 240 minutes (four hours) were compared to patients who underwent anesthesia for more than 240 minutes. Of the 1200 cases analyzed, 1032 (86 percent) were greater than 240 minutes. There were no deaths in the study group. There was one case of respiratory failure, one case of central nervous system deficit, one case of medication reaction, and one case requiring hospital transfer. The less than 240 minutes case group indicated the same findings. Eighty-six percent of the case patients were female while 13 percent were male and the average age was 55 years old. Outcomes or the incident of patient morbidity would not have been altered by shorter duration procedures or a hospital environment. The study will be featured in an upcoming issue of Archives of Facial Plastic Surgery, one of the JAMA/Archives journals.

"This study, the largest of its kind to specifically evaluate the effects of anesthesia in patient cases of four hours or more, shows minimal morbidity and no mortality. This is a result of the careful combination of facial plastic surgery procedures and the safe delivery of general anesthesia, as well as strict patient screening and the accreditation of the office-based facility," says Dr. Ira Papel, AAFPRS president. "These findings will help regulatory bodies and state medical boards better understand the surgical risks associated with facial plastic surgical procedures, and also will help create surgical guidelines and safety standards for surgeons."

Dr. Gordon, author of this study, realized that no data existed concerning the use of anesthesia during surgery in an office-based setting and, until now, no such study was ever performed to directly address and quantify the risks of anesthesia-use in surgeries of four hours or more in an office environment. Office-based surgeries are performed at a significantly higher rate compared to the 18 percent of procedures done in hospitals, 26 percent in free-standing surgical centers and two percent in medical spas.

"States are currently considering regulations for non-hospital surgical environments and a criterion which they are basing their guidelines on is the duration of surgery. The data from this study shows that medical issues during facial surgery are not duration-based, as a patient's risks do not increase if the patient is under anesthesia for four hours or more," added Dr. Gordon.

There are many advantages to office-based surgical procedures including patient privacy, personalized care, convenience, and significant cost reduction. In addition, a patient's familiarity of the surgical staff to the surgeon, their procedures and routines allow for efficient and consistent patient care.

Last month at the AAFPRS Annual Meeting, the board of directors voted in favor of making all outpatient and office-based surgery accreditation mandatory, thereby requiring all AAFPRS members who use Level II anesthesia or above to comply with this new regulation. Office accreditation will assure patients that all AAFPRS members are operating in a safe environment with a high standard of care.

"This new bylaw, requiring all members to have their office-based facilities accredited, is a step that further demonstrates a commitment to the safety of all facial plastic surgery patients," continued Dr. Papel. "The AAFPRS deems patient safety as the number one priority and urges patients to be fully educated about their surgery and surgeon." Below are some safety tips from the AAFPRS for making an educated choice BEFORE undergoing facial plastic surgery:


* Make sure the surgeon is a board-certified facial plastic surgeon: Look for a surgeon board-certified by boards affiliated with the American Board of Medical Specialists (ABMS). Most AAFPRS members are certified by the American Board of Otolaryngology -- a board recognized by the ABMS. However, in addition to specialized training in facial plastic surgery, many Academy members undertake another year of fellowship in facial plastic surgery, which is in addition to their six years of residency training to gain further certification by the American Board of Facial Plastic and Reconstructive Surgery.
* Verify Credentials: While referrals may be helpful, it's still important to validate the training, skills and experience of the surgeon. Make sure the surgeon is a reputable member of an organization of surgeons who specialize in facial plastic surgery, the facility is accredited by a nationally or state recognized accrediting agency, the surgeon has privileges to perform procedures at an accredited local hospital or ambulatory center and has appropriate anesthesia providers.
* Ask for Referrals: When choosing a surgeon, start with word-of-mouth referrals. Ask friends who have undergone facial plastic surgery, consult a trusted family physician or call a respected hospital in the community and ask for the names of board-certified facial plastic surgeons.

For more information about this study, please contact Patty Mathews at Euro RSCG Magnet at 212-367-6923 or patricia.mathews@eurorscg.com.

About the AAFPRS:
The AAFPRS is the world's largest association of facial plastic and reconstructive surgeons with more than 2,600 members -- whose cosmetic and reconstructive surgery focuses on the face, head and neck. Academy fellows are board-certified and subscribe to a code of ethics. In addition, the AAFPRS provides consumers with free information and brochures and a list of qualified facial plastic surgeons in their area by calling 1-800-332-FACE or by visiting the AAFPRS Web site, www.AAFPRS.org.

American Academy of Facial Plastic and Reconstructive
Surgery (AAFPRS)


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