Ambulatory Surgery Centers

As a plastic surgeon in Los Angeles, patients frequently ask me if ambulatory surgery centers are safe. After Joan Rivers died this past year, this question has become even more relevant. The answer, unequivocally, is yes. Ambulatory surgery centers (ASCs) have been present in the United States for over 50 years and have a long and outstanding track record for safety. In order to receive a license, ambulatory surgery centers must undergo a rigid accreditation process by organizations such as the Joint Commission, the American Association for Accreditation of Ambulatory Surgery Facilities, the Accreditation Association for Ambulatory Health Care, and the Healthcare Facilities Accreditation Program. In addition, facilities that submit for insurance reimbursement for procedures undergo an additional evaluation by CMS, the Center for Medicare and Medicaid Services. The accreditation process evaluates not only the healthcare facilities and equipment present in the ASC, but other factors as well such as the emergency plan to transport patients to a hospital, should this become necessary.


Ambulatory surgery centers are attractive options for surgeons and Los Angeles plastic surgery patients because of their efficiency and ease of use. Multiple patients have told me that they have had excellent experiences at ambulatory surgery centers and say that they appreciate how smooth their services are.   They have also told me that they appreciated being able to undergo surgery in a facility where they were able to minimize contact with people with colds and coughs. With flu season coming up, I can empathize with their concerns! From a scheduling standpoint, I rarely experience significant delays at ambulatory surgery centers because elective surgical cases can be scheduled without concern for delay or cancellation due to other emergency cases taking priority. Some of my higher profile patients have told me that they appreciate the opportunity for anonymity that surgery centers offer too.


However, not every patient is a good candidate to undergo surgery in an ambulatory surgery center. Patients with multiple medical problems that place them at higher risk for complications in the early perioperative period could be better served by undergoing their procedure in a hospital where a higher level of care is immediately present (if necessary). In addition, Burbank and Encino plastic surgery patients who are undergoing complicated, higher risk procedures might also be better suited to undergo those procedures in hospitals as well. I also often perform skin cancer treatment and other surgeries in hospitals when I work with a surgical pathologist or other specialist.


Ultimately, the final decision about where to perform a surgical procedure comes down to safety. Above all else, we physicians must first “do no harm,” and that extends to the location of our surgical services as well.