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6 things to know before a procedure at a medical spa

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By Donna Tepper, M.D., FACS
In many cases, medi-spas offer lower-cost cosmetic procedures for a reason.

The medi-spa market has exploded in recent years, and it’s not hard to see why. Advertised as a mix between a medical clinic and a spa, today’s medi-spas offer traditional spa services (mani/pedis, facials and massage) alongside promises of younger-looking skin, fewer age spots and hair-free bikini lines. Add to that easy access to procedures like Botox and laser hair removal – treatments once only performed by doctors – and it’s certainly tempting to believe these facilities can offer the best of both worlds.

The truth: Most medi-spa staffs have limited medical experience. So while you may be tempted by the latest Groupon to try your local spa for a cosmetic procedure, consider these six secrets spa directors may not want you to know:

1. There may not be a physician on site.

Even though a doctor must serve as medical director, he or she may “supervise” from a medical office miles away. Unlike physician offices where clinicians oversee treatments and maintain medical records, medi-spas have limited or no medical staff. So there may not be a doctor around when problems arise.

Also, keep in mind that the supervising doctor may not have the experience or training needed. With lower reimbursement rates from medical insurance, some physicians are serving as medi-spa directors to boost their bottom line. So while your spa’s director may hold a medical license, if they don’t specialize in the field of practice in which they are performing procedures, odds are they aren’t adequately trained to address problems that arise from spa treatments. Your best bet: Seek cosmetic treatments from board-certified physicians that specialize in skin care, cosmetic, plastic or facial plastic surgery.

2. Consider the training level of a “medical aesthetician.”

Many spas say their procedures are performed by medical aestheticians, or skin care specialists. Aestheticians require only 400 hours of training, which can include previous job experience. After completing cosmetology school for training in hair, nails and makeup, aestheticians receive training in facials, massage and waxing. Then, after completing additional course training in laser and injections, they’re able to call themselves “advanced aestheticians.” Consider that this means medi-spa staff may be performing potentially dangerous treatments with limited medical experience.

Not all medi-spas are danger zones, but Donna Tepper, M.D., FACS, advises getting a doctor’s recommendation and doing research before setting up an appointment.

How dangerous? If injected incorrectly, Botox or dermal fillers such as Juvederm Voluma, Restylane and Radiesse have serious risks. If filler is injected around the eyes or between the eyes, there is a higher risk for injection into a blood vessel, causing blindness. Botox, when injected too close to the eyebrow, can cause drooping brows that will last four months. There is no correction for this latter issue but time.

Lasers treatments have risks too. They are high-powered devices with the ability to damage your eyes and permanently scar your skin. And while you cannot purchase a laser without a medical license, some technicians who perform laser treatments may have limited training. In the wrong hands, the powerful light pulses from lasers can cause burns, scarring and pain.

3. Equipment is expensive.

Nonsurgical technology has evolved dramatically over the years with devices designed for liposuction, skin tightening, fat removal with heat or cold, hair removal, skin resurfacing and laser spot removal. But with a machine that uses a handheld device costing more than $100,000, a spa needs to have clients to pay for it. Be sure that you are not the first to “try out” the newest services. Request to see pictures of the spa’s own patients that have undergone the treatment, not just brochures from the machine’s manufacturer.

4. Medi-spa staffs aren’t trained to spot cancer.

A pesky pimple or unsightly mole may be more than just a cosmetic concern. Board-certified dermatologists, plastic and facial plastic surgeons are trained to identify and remove potentially cancerous lesions—and send the tissue to an appropriate lab for diagnosis. An aesthetician with limited knowledge of skin lesions may miss this.

5. Spas don’t have the same safety regulations.

Medi-spas are not held to the same standard as a free standing accredited medical or surgical facility. For spas offering treatments outside of a physician’s office, there are different safety standards that do not measure up to those needed in a more credentialed medical facility.

Even a simple manicure or facial can have health consequences if a technician isn’t properly trained or a facility follows unsafe or unsanitary practices. Do your homework before you sign up for a service, and make sure the spa you’re visiting has the appropriate licensing.

6. Counterfeit Botox is real.

Think you’re getting a steal on Botox treatments? A super low price may be a sign that you are getting swindled. Botox and other injectables, such as dermal fillers, have been sold as counterfeit products. Reputable spas and physician offices will not be lured into these tampered products.

Not all medi-spas are danger zones, of course, especially for typical spa-type treatments. But if you’re seeking “medical treatments,” including fillers, Botox, laser treatments or deeper peels, make sure an experienced physician oversees the procedure. And before you make an appointment for your next day of primping, be sure to get a recommendation from your doctor, read online reviews and ask questions about the staff’s education and experience.

Dr. Donna Tepper is a senior staff plastic and reconstructive surgeon with Henry Ford Health System, who sees patients at Henry Ford Hospital in Detroit and at Henry Ford Medical Centers in Dearborn, Grosse Pointe Farms and Novi.

Learn more aboutplastic surgery anddermatology and skin care at Henry Ford. To make an appointment with a plastic surgeon or skin care professional, call 1-800-HENRYFORD (436-7936) or visithenryford.com.

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This story is provided and presented by our sponsor Henry Ford Health System.

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