THE STANDARDS BEHIND THE CERTIFICATION
In California, outpatient surgical facilities operate under a tiered system of oversight. Where a
facility sits within that hierarchy is not a marketing distinction. It determines the standard of
inspection, the rigor of staffing requirements, the equipment that must be present, and the
emergency protocols that must be in place every day.
At the foundation of the system are office-based surgical suites. These operate under the
lightest regulation, and many cosmetic procedures performed across Beverly Hills take place in
office settings that meet only the minimum legal requirements for the work being offered.
A step above are privately accredited facilities, reviewed by organizations such as AAAASF
(American Association for Accreditation of Ambulatory Surgery Facilities) or AAAHC (Accreditation Association for Ambulatory Health Care). This is the most common credential
for cosmetic surgery centers.
Higher still are facilities licensed directly by the California Department of Public Health as
ambulatory surgical centers.
At the top of the hierarchy is Medicare and Medicaid certification, issued by the federal
Centers for Medicare & Medicaid Services. To earn this designation, a surgery center must
demonstrate sustained compliance with the federal Conditions for Coverage governing
ambulatory surgical centers: the most rigorous standards in the country for sterilization,
anesthesia administration, infection control, emergency preparedness, staff credentialing,
recordkeeping, and surgical outcomes. Recertification is ongoing, and inspection is
unannounced.
The Beverly Hills Rhinoplasty Center holds this top-tier designation. Most rhinoplasty
surgeons, by contrast, operate inside office-based suites that meet far lower standards. Others,
whose office facilities cannot support general anesthesia at this level, are required to perform
their cases inside hospital operating rooms, where the team, the equipment, and the
surrounding environment change with every case.
We do not hold this certification because we are required to. We hold it because it is the
standard at which we have chosen to practice every day. It is the level of care extended to
members of the Royal Family who have entrusted their rhinoplasty to Dr. Dugar, and it is the
level of care every patient at the atelier receives.
