Blog — Notes of a Plastic Surgeon

Welcome to my blog. I am a plastic surgeon in Seattle and have been in private practice since 1991. I've seen more than a few interesting faces and cases through my years spent in the exam room, the operating room and the emergency room. And I have an opinion on just about everything relating to plastic surgery (and a lot of unrelated stuff). If you like my blog, let me know. Thanks for reading! Lisa

Trust me, I’m a “cosmetic surgeon” and I have this nice operating room in my office.

Seattle Plastic asps egoSurgeon discusses  fake cosmetic surgeons.

Just because she says says she’s a “cosmetic surgeon” and has an office operating room doesn’t mean that she is qualified to do cosmetic or any other type of surgery.

I want to thank O Magazine for the article “The OR Down the Hall” in September’s issue. You will have to buy the magazine to read the article but here are the main points.

1. Office operating rooms are less regulated than hospitals and free standing ambulatory surgery centers. In some states (Washington, for example), if patients do not have general anesthesia, office operating rooms are not regulated at all. YIKES!

2. Most states (Wahington, for example) issue a license to practice medicine but do not regulate scope of practice at all. A doctor who has not spent one day in an accredited surgical training program may perform surgery in their own office operating room as long as the patient does not have a general anesthetic. YIKES!!

3. “Board Certification” could mean a “board” other than the American Board of Plastic Surgery (ABPS). It can even mean a “self designated” board which exists only to give a facade of training or expertise to those who have not met the requirements for certification by the ABPS. The “cosmetic” surgeon who does liposuction may be “board certified” but that board is the American Board of Radiology. I’m not making this up. One of those “cosmetic surgeons” practices a stone’s throw from my office. YIKES!!! To check on a physician’s board certification, go to the American Board of Medical Specialties’ web site (

4. Your “cosmetic surgeon” may not even have hospital privleges. If you were to develop a problem after surgery, he could not even admit you to the hospital or treat you in an emergency room. I’m not making this up either. There’s one of those about 15 miles down the road from me. YIKES!!!! Always ask you surgeon, “Do you have privleges in a local hospital to do this procedure?” Check out this story.

5. Unless you are having just minimal sedation, you should have a board certified anesthesiologist or certified registered nurse anesthetist administer anesthesia. Some office operating rooms “fly under the radar” of state authorities by sticking with only sedation and/or local anesthesia. OUCH and YIKES!!!!!

6. “Only local anesthesia” does not imply “minor surgery”. Local anesthetic agents, like all drugs, can be toxic. This is often used as a selling point for some of these Yahoos. “It’s just a local anesthetic, so it’s not really surgery.” YIKES!!!!!! Check out this tragic story I was asked to comment on.

 Be careful out there. Do your homework and ask questions. A fully trained and ABPS certified plastic surgeon will not be offended but be very pleased that you are an informed patient. And if the issue of poor oversite of some office operating rooms and physician scope of practice is something you think our state authorities should address, let them know. Washington State DOH. It’s their job to keep you safe.

 Thanks for reading!  Lisa Lynn Sowder, M.D.


Category: Body Contouring, New Technology, Non-invasive, Patient Beware, Plastic Surgery | Tags: , , , , , , ,

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