 [ Symptoms ] is a medical spa the right place for invasive surgery [ Disease ] 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