Private, fully equipped office surgical facilities have been established in many large Canadian metropolitan areas. Often these units are situated in or near fashionable shopping complexes where patients or their relatives can browse while waiting for the doctor.

Although more and more people - both men and women - are opting for cosmetic surgery to improve the way they look, public attitudes toward plastic surgery have always been somewhat ambivalent. The subject fascinates most everybody, but one was never supposed to appear too interested. Those attitudes are changing.

Cosmetic surgery patients are becoming less and less self-conscious about their decision to change what Mother Nature gave them - or to restore what time has taken away. Society increasingly accepts cosmetic surgery as an honest investment in self-improvement.

Surgicentres are ideally suited to the majority of cosmetic procedures. However, proximity to public transportation, or rapid access to large hospitals in case of an emergency, was always a concern. The positive and more open social attitude has provided the solution. Instead of being hidden away, surgicentres specializing in cosmetic surgery are being located in highly visible and readily accessible downtown cores.

In contrast to most financially plagued hospitals, surgicentres are cost effective. They are managed by the doctor-owner and not the government. This saving is passed on to the patient. Whereas in the public hospital system, where cosmetic surgery is not an insured benefit, the patient must contribute to the high global expense.

Cosmetic surgery is elective. There are few other medical fields in which a relaxed patient and a good doctor-patient rapport is so essential to ensuring an optimum result. A surgicentre allows the surgeon to replace the sterile foreboding environment of a general hospital with a more caring and calm setting. The doctor and his personally selected staff are with the patient before, during and after surgery. The same group provides follow-up care.

Whether surgery is performed in a large public hospital or a small office unit, it must be done safely and in accordance with the accepted local standard of care. Patients contemplating surgery in an office facility must be healthy. High risk individuals such as those with heart, lung or blood pressure disease are best treated in hospitals where expensive support care, such as an intensive care unit is available if needed.

Escalating health-care costs and the desire for more personalized treatment have created a trend back to the doctor's office. Technological advances in both surgery and patient monitoring have combined with these factors to produce the modern surgicentre.

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