Table of Contents
Survey Recommends Better Reporting
on Safety
of Cosmetic Surgery
Rajesh Balkrishnan, Ph.D.
A new study led by a University of Texas School of Public Health at Houston researcher finds that cosmetic surgeries performed in doctors’ offices could be safer if state governments required doctors to report adverse incidents involving serious injury or death. The study was published in November in Dermatologic Surgery, the journal of the American Society of Dermatologic Surgery.
“Although there have been studies addressing the safety of office-based cosmetic surgery, few have concentrated on the reason for the adverse incidents – such as whether the procedures themselves were inappropriate, the overall health of the patient or what type of anesthesia was used,” said Rajesh Balkrishnan, Ph.D., lead author of the study and associate professor of management policy studies at the UT School of Public Health.
According to Balkrishnan, the study was designed to assess the safety of office-based cosmetic surgery through a national survey of state medical boards, the state board of medical examiners and other authorities responsible for collecting information on adverse incidents.
Researchers reviewed records on adverse incidents from 48 states from Jan. 1999 through Dec. 2001. Five states were able to provide complete information regarding 13 cases of adverse outcomes from office-based cosmetic surgery. Nine of the 13 adverse cases involved board-certified plastic surgeons
Thirteen states had incomplete information and were unable to provide data. The remaining states, including Texas, reported no adverse outcomes.
According to the study, improvements in surgical techniques and lower levels of anesthesia have led to the increasing popularity of outpatient cosmetic surgery.
In fact, the study cites 2001 statistics from the American Society of Plastic Surgeons that indicate 51 percent of cosmetic surgeries were performed in doctors’ offices.
Twenty-four percent of cosmetic procedures were done in freestanding ambulatory surgical facilities, and another 25 percent were performed in acutecare hospitals. Liposuction was the most commonly performed cosmetic surgery procedure in the United States.
However, the study notes office-based cosmetic surgery has come under scrutiny due to recent press reports of adverse outcomes including a number of high profile cases of deaths involving liposuction procedures.
The study also found that, while many states are drafting regulations for office-based cosmetic surgery, only a few states require doctors to report adverse incidents. Those states include Florida, California, New Jersey and Georgia. Only some of these states have outlined specific consequences for doctors who do not report adverse events.
“Before we move toward uniform state regulations on this issue, all states should first put in place standardized, mandatory reporting of adverse surgical procedures,” said Balkrishnan, who also holds an appointment in the UT Graduate School of Biomedical Sciences at Houston. “This will allow us to formulate effective, evidence-based policy and regulations.”
The study was done in conjunction with the American Academy of Dermatology.
— Pamela Cathion, Public Affairs