Are Canadian Outpatient Ambulatory Surgery Centers Safe? An Assessment of 2596 Consecutive Aesthetic Surgery Patients

Background: Ambulatory surgery centers (ASCs) with same-day discharge criteria are the most common setting for aesthetic surgery in Canada. However, to date, no study has reviewed the safety of outpatient aesthetic surgery performed in the Canadian ASC setting. Objectives: The purpose of this study was to evaluate the overall safety profile of aesthetic surgery in ASCs, to determine how often in-hospital resources were utilized following outpatient aesthetic surgery, and to examine how predictor variables impact adverse outcomes in this setting. Methods: A retrospective chart review of 2596 consecutive patients who underwent aesthetic surgery over a 40-month period at a single Canadian ASC was performed. Data extracted included demographics, operative details, and postoperative complications. Results: A total of 2581 patients met inclusion criteria. The majority of patients were female (91.2%) with a mean age of 37.6 years (range, 18-85 years). Most patients had a BMI in the normal weight range (56.3%), and 70.0% were classified as American Society of Anesthesiologists Class I score. Patients predominantly underwent breast/chest surgery (60.3%) with a procedure duration under 2 h (59.2%). Mean postanesthesia care unit time was 109 min (range, 72-420 min). In total, 10 patients (0.4%) utilized hospital resources in the postoperative period, with 3 (0.1%) direct hospital transfers from the ASC. No patients underwent reoperation in the hospital setting. Overall, 67 (2.4%) patients experienced complications that were managed within the ASC setting. Combined procedures (P = .1367), lipoaspirate volume (P = .53) and procedure duration (P = .92) were not associated with an increased risk of adverse outcomes. Conclusions: Aesthetic surgery in the ASC setting is safe, with a low associated complication rate. Utilization of hospital resources in the postoperative period is rare. Level of Evidence 4 Risk: