While decades ago, plastic surgery was performed only in private and public hospitals, today there are outpatient facilities and doctors’ offices that are fully equipped. According to the laws, rules, and regulations, plastic surgeons can only perform their surgeries in certified locations. It was not that many decades ago that plastic surgery was performed only in public and private hospitals. Oftentimes the patient was admitted to the hospital on the previous night before their surgery, and spent the evening being fully prepared for the next day’s surgery. Their vital signs would be checked, including their blood pressure, and written orders for routine blood work would be performed. The nurse might take an electrocardiogram and pre-surgery medications would be given the evening before. There might also have been a discussion with the anesthesiologist in the last 24 hours before the surgery. With advancements in medical care, there was a move away from performing all surgeries in a hospital, where physicians could do their work at outpatient facilities. While one might consider that the surgeons performed in less than ideal conditions, rules and regulations were strictly maintained and allowed plastic surgeons to only operate in certified facilities. Outpatient Surgery Center Many plastic surgeries are performed under local anesthesia with sedation (also known as twilight anesthesia) where the patient is sedated to a point where they are less aware of their surroundings. The anesthesia is strong enough to avert pain but mild enough to allow the patient to respond to spoken orders. At some facilities, no anesthesiology is present during the surgery, with the sedation being provided by the nurse under the surgeon’s direction. Patients that require general anesthesia typically have their procedures performed at an outpatient surgery center or in a hospital. Depending on the surgeon, and the type of surgery being performed, the doctor might elect to have the procedure done at a surgery location based on scheduling issues, geography, and comfort. At-Home Recovery Nearly every type of plastic surgery is performed as an outpatient procedure, allowing the patient to go home once they have retained cognitive function from the cessation of the anesthesia. Depending on the type of procedure they have had done, they can typically recover at home over the next 6 to 14 days. Some extensive surgeries including abdominoplasty and intensive liposuction procedures may require a more extended level of convalescence, at a facility. To keep risks at a minimum, including bleeding and the potential for infection, the patient must follow strict guidelines from the competent plastic surgeon to maintain their health through recovery. The surgeon will provide a list of procedures to follow including when to bathe, how to bathe, along with an appointment to have the sutures removed within the first 3 to 6 days.