Archive for April, 2010

Who Is Qualified to Perform Liposuction?

You would not select an auto mechanic to perform root canal. Similarly, you should not jeopardize the outcome of your procedure, or your well being, by choosing anyone less than the most qualified plastic surgeon.

While many states allow any licensed physician to perform cosmetic surgery, that does not mean all physicians are competent to do so. In some states, even dentists are lobbying to perform cosmetic procedures. Because liposuction is major surgery, you should place your life in the hands of the most qualified and skilled plastic surgeon. You should also choose a surgeon who will show you solid “Before and After” examples of his or her work, and whose artistic sense is in sync with the results that you are seeking.

In choosing a surgeon to perform liposuction, you should first choose one who has been certified by the American Board of Plastic Surgery (ABPS): This assures that surgeon has endured the most rigorous training possible, including three to five years of training in general surgery and two years of training in plastic surgery. Beware of those physicians who claim to be “board certified” cosmetic surgeons. This may mean that they have taken a brief weekend course in a procedure, but does not guarantee the competence that the American Board of Plastic Surgery ensures. Ideally, you will choose a surgeon who has extensive surgery experience, not only experience in plastic surgery in general. Liposuction, like sculpturing, is an art that is learned through experience, but can only be perfected by the plastic surgeon who has an eye and feel for body proportions and contour. This ultimate expert in liposuction can perceive your body contours and the thickness of fat just by feel. In essence, you should choose a physician who is also a sculptor.

In a “Practice Advisory on Liposuction- Executive Summary” published on March 15, 2003, The American Society of Plastic Surgery states the following regarding Training and Qualifications for liposuction:

Physicians performing liposuction must be trained as surgeons. A surgeon’s scope of practice is defined by one of the 10 surgical boards recognized by the American Board of Medical Specialties (ABMS);

Surgeons performing procedures outside of his/her area of training, defined by the surgeon’s specialty, must obtain additional education, certification and experience. The ABMS surgeon must have body contouring training as well as operate in his/her area of anatomic expertise. The physician who performs liposuction in any surgical setting must meet all of the following minimal formal training requirements:

Basic Education: M. D. or D. O.

Be qualified for examination or be certified by a surgical board recognized by the ABMS: and

i. Complete training in body contouring during an accredited residency or fellowship; or

ii. Complete an eight-hour liposuction/body contouring training course approved for Category I CME credit with at least three hours of hands-on bio-skills cadaver training and a comprehensive instructional program on fluid replacement. Observation by a proctor with liposuction privileges for the first three clinical procedures is recommended.

Operate within his/her area of training and area of anatomic expertise, which is defined by his/her ABMS Surgical Specialty Board.

A physician should have the primary responsibility for providing and/or supervising anesthesia. A physician should order all anesthesias. Anesthetics may be administered by a qualified physician, a CRNA under physician supervision, or by another qualified health care provider under the supervision of a qualified physician as required by law. The responsible physician must be physically present in the operating room throughout the conduct of the anesthetic.

In Addition to Education, Training, and Experience, What Should You Seek in a Plastic Surgeon?

A plastic surgeon should be nonjudgmental – accepting the patient “as is” and with sensitivity toward the patient’s concerns. At the same time, you should seek a surgeon who will project realistic results, and not make false promises. Your expectations, and what the surgeon can achieve for you, should mesh.

What Are the Preferred Facilities?

There been incidents when liposuction deaths or mishaps occurred when patients had liposuction performed in garages, dentist chairs, or even in doctor’s examination rooms. You should pay special attention to the facility where the plastic surgeon operates. To be safe, the surgery must be performed at an accredited ambulatory surgery center, or at a hospital, and the surgeon should have privileges to perform liposuction at that hospital, wherever the surgery takes place. If it takes place at a freestanding ambulatory facility, consider the following:

It is certified by the American Association for Accreditation of Ambulatory Surgery Facilities (AAAASF) or;

It is certified by the Accreditation Association for Ambulatory Health Care (AAAHC) or;

It is certified by Medicare or;

It is certified by the Joint Commission on the Accreditation of Healthcare Organizations (JCAHO) and;

The facility has a transfer agreement with a local hospital.

To investigate the status of local physicians, visit www. medbd. ca. gov/lookup. htm

You should also discuss who the plastic surgeon employs to administer anesthesia during this procedure, as your life depends on his or her skills, as well as those of your surgeon. While many surgeons use nurse-trained anesthetists, you should choose one who employs a physician who is trained in the specialty of anesthesiology. A physician is the most skilled and qualified to administer anesthesia safely, and to address any complications that may arise.