Ambulatory (Outpatient) Surgery: What to Expect

Ambulatory surgery, also called outpatient surgery, means you have your procedure and go home the same day, with no overnight stay. Most oculofacial procedures are done in the Belaray office under local anesthesia. Some cases are scheduled at an ambulatory surgery facility because they need sedation or general anesthesia, a more controlled operating-room setting, or more extensive work. Dr. Rachel Ellis performs these cases most often at Syosset Hospital on Long Island. Dr. Ellis performs the surgery, and the facility provides the operating room, nursing staff, and anesthesia team.

Where Your Surgery Takes Place

When a procedure is scheduled outside the office, it is most often performed by Dr. Ellis at Syosset Hospital in Syosset, NY, a Northwell Health facility on Long Island. Depending on the case and scheduling, another accredited surgical facility may be used. You will be told in advance exactly where to go, when to arrive, and how to prepare.

Before Surgery: Pre-Operative Testing & Clearance

Depending on your age, your health, and the type of anesthesia planned, you may need a pre-operative medical evaluation, sometimes called "surgical clearance," from your primary care doctor. This helps confirm you are ready for anesthesia and surgery.

• Testing can include blood work, an EKG, and a history and physical (H&P), completed within a set window before your surgery date.
• Tell us and the facility about every medication and supplement you take.
• Blood thinners such as aspirin, warfarin, Eliquis, Plavix, and fish oil sometimes need to be paused before surgery, but only with the approval of the doctor who prescribed them. Never stop a prescribed medication on your own.

Anesthesia

The type of anesthesia depends on the procedure. It may be local anesthesia, local with IV sedation (often called twilight or MAC), or general anesthesia. A separate anesthesia provider at the facility reviews your health history beforehand and manages your anesthesia and monitoring during surgery. If you have had a reaction to anesthesia in the past, tell the team in advance.

Eating & Drinking (NPO)

If you are having sedation or general anesthesia, you must be NPO, which means nothing to eat or drink for a set period before surgery, commonly starting at midnight the night before. Take only the medications you are instructed to take, with a small sip of water. The surgery facility gives you exact times based on your scheduled arrival, and following those instructions is important for your safety. If you eat or drink when you were told not to, your surgery may have to be postponed.

The Day of Surgery

• Bring a driver. After sedation or general anesthesia you cannot drive yourself home, and you will need a responsible adult to stay with you afterward.
• Wear loose, comfortable clothing, and leave jewelry and valuables at home.
• Arrive at the time the facility gives you, which allows time for check-in and preparation.
• Plan to rest for the remainder of the day after you get home.

Costs & Insurance

Because a surgical facility is involved, ambulatory surgery usually generates more than one bill:

• The surgeon's fee from Belaray Dermatology.
• A separate facility fee from the surgery center or hospital.
• A separate anesthesia fee from the anesthesia provider.

What you owe depends on your specific procedure and insurance plan, including your deductible, your coinsurance, and whether the facility and the anesthesia group are in your insurance network, which can differ from Belaray's participation. Verifying coverage with your insurer ahead of time is the most reliable way to understand your costs, and the facility can provide an estimate of its portion.

After Surgery

You will recover briefly at the facility until the team is satisfied you are ready, then go home the same day with written post-operative instructions. Belaray patients have direct access to reach the care team with questions or concerns during recovery, and the surgeon who performed your procedure follows your recovery. For background on the procedures themselves, see our oculoplastic and periocular care page and the guides to ptosis repair, tearing and tear-duct surgery, and blepharoplasty.

Frequently Asked Questions

Why is my surgery at a hospital instead of the Belaray office?

Most oculofacial procedures are done in the Belaray office under local anesthesia. Some cases are scheduled at an ambulatory surgery facility because they need sedation or general anesthesia, a more controlled operating-room setting, or more extensive work. Dr. Rachel Ellis performs these cases most often at Syosset Hospital on Long Island. It is still same-day surgery, so you go home the same day.

Will I be put to sleep, or what kind of anesthesia is used?

It depends on the procedure. Anesthesia may be local, local with IV sedation (often called twilight or MAC), or general anesthesia. A separate anesthesia provider at the facility reviews your health history and manages your anesthesia and monitoring during surgery.

Can I eat or drink before surgery?

If you are having sedation or general anesthesia, you must be NPO, meaning nothing to eat or drink for a set period before surgery, commonly starting at midnight the night before. Take only the medications you are told to take, with a small sip of water. The surgery facility gives you exact times, and you should follow those instructions.

Can I drive myself home after surgery?

No. If you receive sedation or general anesthesia, you cannot drive yourself home. Arrange for a responsible adult to drive you and to stay with you afterward. Plan to rest for the remainder of the day.

Why did I get a separate bill from the hospital or anesthesia group?

Ambulatory surgery usually generates more than one bill: the surgeon's fee from Belaray, a separate facility fee from the surgery center or hospital, and a separate anesthesia fee. What you owe depends on your specific procedure and insurance plan, including your deductible, coinsurance, and whether the facility and anesthesia group are in your network. Verifying coverage with your insurer ahead of time is the best way to avoid surprises.

Which medications should I stop before surgery?

Tell us and the facility about all your medications and supplements, especially blood thinners such as aspirin, warfarin, Eliquis, Plavix, and fish oil. Some may need to be paused before surgery, but only with the approval of the doctor who prescribed them. Do not stop a prescribed medication on your own.