there are two issues which every patient needs to understand with respect to surgery. first there is always the potential for problems and the best insurance against having a catastrophic outcome is to have the procedure performed in a fully equipped surgical facility. a medical spa is not a bona fide surgical facility. the facility should be either licensed by the state accredited by the u. s. department of health and human services (accredits facilities to qualify for medicare payments) or by one of three well-known private accrediting organizations: accreditation association for ambulatory health care (aaahc) the american association for accreditation of ambulatory surgical facilities (aaaasf) and the joint commission on accreditation of health care organizations (jcaho) which accredits hospitals. fully accredited licensed facilities must have the same resuscitative equipment emergency drugs and supplies and infection control standards as a hospital. they have passed the test. finally i would never have any type of significant surgical procedure whether done under local anesthesia or with local anesthesia with sedation or general anesthesia without the services of a board-certified physician anesthesiologist. certified registered nurse anesthetists (crnas) may be appropriate in some situations. in any event you want an anesthesia specialist at the controls. such specialists are another "insurance policy" for you because they will not work in a substandard facility.
is a medical spa the right place for invasive surgery?