A Connecticut plastic surgeon has had her clinic closed for violations which cite mouse droppings on surgical equipment and resealed one-use instruments with blood on them.
The state suspended the license for the Connecticut Plastic Surgery Center, run by plastic surgeon Dr. Teresita Mascardo, on Dec. 4.
According to a report from ABC News affiliate WTNH in New Haven, the state found nine violations, including the animal droppings, resealed instruments with human fluids on them, dust and blood on the floor and machines, and an unlicensed anesthesiologist.
"This facility is one in which there is imminent and immediate danger to public health," Connecticut attorney general Richard Blumenthal told WTNH.
Mascardo surrendered her license voluntarily on Dec. 11, according to a sworn statement sent to ABCNews.com by the Connecticut Department of Public Health.
A message left by ABCNews.com with a receptionist at Mascardo's Connecticut office was not returned. A number listed on her Web site for a New York office was not in operation.
With 17 million plastic or reconstructive procedures performed in 2008, according to the American Society for Plastic Surgery, many may be wondering what they need to look for to avoid having their operation performed at a clinic like Mascardo's, where risks for infection can run high.
Visible problems, obviously, are a red flag.
"If you see contamination and soiled items that are visible to the naked eye, you can pretty much guarantee there are microscopic things that are harmful as well," said Dr. Mark Abdelmalek, chief of the division of laser and dermatologic surgery at Drexel University and an ABC News contributor. "A lot of the things that are harmful, you can't even see, unfortunately."
There are some things patients can do -- though the possibility of infection, however minor a risk, will be present with any cosmetic surgery.
Asking the right questions "doesn't guarantee everything will be perfect," said Dr. Michael McGuire, president of the American Society of Plastic Surgeons. But, "It's the best precautionary approach."
Given varying standards by state, there are a number of steps patients can take to minimize risks when undergoing a cosmetic or reconstructive operation.
McGuire said patients can take steps before entering the operating room to ensure that the place they are having the surgery. He called it the ABCs -- for accreditation, board certification and credentials.
First, he said, the facility itself needs to be accredited by a national agency, the state it is operating in or Medicare.
"You can have the world's best surgeon, and if he or she is operating in a garage, you're not going to have a safe surgery," he said.
Next, he said, the doctor should be board certified in the specialty you are having treatment in. For plastic surgery, he said, that means "it's board certification by the American Board of Plastic Surgery."
Finally, he said, doctors should be credentialed by a hospital, meaning that the hospital would grant the doctor credentials to perform the operation there.
"At an acute care hospital, you have the peer-review process," McGuire said.
After ensuring that the big things are in place, McGuire, like Abdelmalek, recommended taking a look at the surgery site itself, adding that it often they can be well-judged on appearances.