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Readers may find it surprising that an anesthesiologist has been invited to give a commentary on the recent analysis on safety of aesthetic surgical procedures in various settings.1 They may find it even more surprising since I was the lead author of a 2003 Archives of Surgery article on office-based surgery safety that found office-based surgical suite (OBSS) surgery 10 times more risky than surgery performed in ambulatory surgery centers (ASC),2 a study that first opened the discussions on safety concerns of office-based surgical procedures. Although Gupta et al1 discuss the contrasting results of my previous study vs their conclusion of OBSS being a safe alternative for cosmetic procedures, I think the readers will be further surprised that their findings actually correlate with my own. I urge you to read on for an explanation.In the article, Gupta et al compared 129,007 patients from the CosmetAssure database who had cosmetic surgeries performed between 2008 and 2013 at hospitals, ASC, or OBSS regarding a limited list of complications and risk factors.1 From multivariate risk analyses, the authors concluded that complication rates were lower in an OBSS vs an ASC or hospital setting. The article has a number of strengths, including the large size of the data set, its prospective design (patients were enrolled in the data set before surgery), and compliance with reporting. Procedures were limited to only plastic surgeries performed by a selected group of surgeons (American Board of Plastic Surgery certified or candidates), with all …

aesthetic surgery journal

Commentary on: Is Office-Based Surgery Safe? Comparing Outcomes of 183,914 Aesthetic Surgical Procedures Across Different Types of Accredited Facilities