Safety of Outpatient Plastic Surgery: A Comparative Analysis Using the TOPS Registry with 286,826 Procedures

Area of Science:

• Plastic Surgery
• Ambulatory Surgery
• Patient Safety

Background:

• Outpatient plastic surgery in office-based surgery facilities (OBSFs) and ambulatory surgery centers (ASCs) has risen significantly.
• Historical data on the safety of these settings is conflicting.
• This study aims to compare outcomes and safety between OBSFs and ASCs.

Purpose of the Study:

• To provide a definitive comparative evaluation of outcomes and safety for outpatient plastic surgery.
• To analyze risk factors associated with complications in these settings.

Main Methods:

• Analysis of 286,826 procedures from the Tracking Operations and Outcomes for Plastic Surgeons database (2008-2016).
• Comparison of outcomes between OBSFs and ASCs.
• Regression analysis to identify risk factors for adverse events.

Main Results:

• No significant difference in adverse events (5.7% overall) between ASCs and OBSFs.
• Common complications included antibiotic requirement (1.4%), dehiscence (1.3%), and seroma (1.1%).
• Factors like age, ASA class, BMI, diabetes, smoking, anesthesia type, and procedure details were linked to adverse events.

Conclusions:

• Outpatient plastic surgery is safe in both ASCs and OBSFs when patients are appropriately selected.
• Board-certified plastic surgeons can perform common procedures safely in these ambulatory settings.
• The low incidence of complications supports the safety of both environments.