Outpatient Surgery Center vs Hospital: Which Is Safer for Cosmetic Surgery?

If you're having a cosmetic procedure like breast augmentation, you may wonder whether a hospital-based outpatient center or a freestanding ambulatory surgery center (ASC) is the better choice. The answer is clear — and it's evidence-based.

I would choose a freestanding ambulatory surgery center all day, every day. Studies have shown that freestanding centers actually have lower rates of mortality, complications, and hospital admissions compared to hospital-based outpatient centers.

You are not compromising your safety by choosing a freestanding center. In fact, the data shows the opposite.

Not everyone qualifies for outpatient surgery at a freestanding center. You must be a properly chosen candidate — healthy and optimized for the procedure. When patients are appropriately selected, freestanding centers deliver better outcomes.

Beyond the safety data, freestanding surgery centers are 45 to 55% less expensive for the patient compared to hospital-based facilities. Better outcomes and lower cost — it's a win-win.

This can be a loaded question. The honest truth is that no study has properly evaluated true independent CRNA practice versus physician-run anesthesia in a head-to-head comparison of complications. That research simply hasn't been done.

In an outpatient surgery center environment, you don't have the backup of a large hospital staff around you. Because of that, I believe it's critical to have the most skilled people in the room.

At the surgery center where I operate (which is quad AAASF certified), I use board-certified anesthesiologists only. Here's my stance:

• I'm not opposed to CRNAs — they are amazing professionals
• But I require them to work in a care team model supervised by an anesthesiologist
• I believe a physician-led anesthesia team should be the standard of care
• Even in states where CRNAs can practice independently, I require anesthesiologist oversight in my OR

When I say this, someone always assumes I don't like CRNAs. That's not true — I love them. But I want them to have proper physician backup if they need it. An anesthesiologist-led team provides that safety net, and I will not compromise on this for my patients.

• Freestanding ASCs have better outcomes and lower costs than hospital-based centers for cosmetic surgery
• You must be a properly selected candidate for outpatient surgery
• Anesthesiologist-led care teams are the safest model, especially in outpatient settings
• The surgeon chooses the anesthesia team — and I demand physician-led anesthesia in my practice