The American Society for Aesthetic Plastic Surgery and the American Society of Plastic Surgeons Issue Patient Safety Advisory on Medi-spas
How to get the most from your Medi-spa experience: New York, NY (January 19, 2007) — Medi-spas, locations that can offer everything from facials and hair removal to pharmaceutical injections and other medical procedures, are proliferating across the country. Medi-spas may be located in a physician’s office, or in non-traditional locations such as shopping malls, store fronts and beauty salons.There are many excellent and convenient Medi-spas that offer safe, physician supervised treatments. However, for those providing treatments outside of the physician’s office, there are no national standards for medi-spas, no recognized definition of what constitutes a medi-spa, and no oversight organizations that provide the information you need to make an informed, safe choice for your medi-spa experience.As advocates for patient safety and healthy outcomes, The American Society for Aesthetic Plastic Surgery (ASAPS) and The American Society of Plastic Surgeons (ASPS) have created the following questions you should ask before committing to any procedure or medical treatment in a spa or non-traditional facility. It is important that you do your homework as you should on anything that can affect not only your appearance but your health and safety as well. We suggest obtaining the following information:
About the facility:
- Is the Medi-spa located within a physician’s office? While problems are infrequent, physician’s offices generally have medical personnel available if a problem develops.
- Is the Medi-spa located outside of a doctor’s office in, for example, a mall or salon? If so, ask the name of the physician responsible for oversight and when they are available for consultation or questions before having any injectable, deep peel or laser treatment. Also ask about the training of any other medical personnel. This is vital to protect your health and insure an optimal outcome. These are generally safe procedures with minimal recovery, but do have real risks.
About medical supervision and personnel training:
- Does your medi-spa have a physician who can help in determining your goals, provide a treatment plan and direct your care?
- What are the credentials of the physician supervising your treatment in the medi-spa? Injectables (such as Botox and tissue fillers), skin treatments (such as laser, intense pulsed light, and radiofrequency) and deep peels should be under the supervision of board-certified plastic surgeons or dermatologists. Ask to see these credentials. Doctors in other specialties, designating themselves as “cosmetic medicine physicians” may lack the comprehensive training that is needed for administering drugs and treatments to the deeper levels of the skin and lack the experience necessary to achieve optimal aesthetic results or to manage potential complications. Just as you wouldn’t see an allergist if you were having a baby, it’s in your best interest to see a physician who specializes in plastic surgery and dermatologic care when seeking cosmetic medical procedures.
- Who is performing the injection?
Depending on the State you’re in, injections and deep peels may be performed by a nurse, physician’s assistant or nurse practitioner. However, never allow a non-medical, unlicensed person to perform a medical procedure and be sure that the procedure is supervised by a physician board-certified in plastic surgery or dermatology. Your health and safety depend on it.
About efficacy and risk of procedures and realistic expectations:
- How effective are facial injectables and what is the right product for me?
Injectables are generally very safe and effective treatments. There are a wide range of products on the market that are FDA approved and provide good outcomes. However, be sure to ask your provider the following questions:
- Is the product FDA approved? Is it approved for this use?
If your provider is reluctant or does not directly answer this question, don’t proceed with the treatment. Don’t be afraid to ask to see the manufacturer’s label for any injectable product.
- Can a medication, filler, or a device be used for a purpose different from which the FDA originally approved it?
In the United States, FDA regulations do not prohibit physicians from prescribing approved medications, fillers and devices for other than their original intended indications.Good medical practice and the best interests of the patient require that physicians use legally available drugs, biologics and devices according to their best knowledge and judgment.If physicians use a product for an indication not in the approved labeling, they have the responsibility to be well informed about the product, to base its use on firm scientific rationale and on sound medical evidence, to fully inform the patient that it is being used “off-label” and to maintain records of the product’s use and effects.
- Will injections last and prevent the need for a facelift in the future? In most cases injectables are temporary solutions and will not give the long-lasting outcome of a surgical procedure.
- Have you been fully informed of the possible benefits and side effects of the proposed treatment and have you been apprised of possible options?
- Have all of your questions been answered and are you are fully aware of the risk and rewards of the procedure?
All medical procedures, whether they are injections or surgery carry some risk. If you are not fully informed of all risks and requirements for after care, find another provider.These procedures should never be performed in someone’s home, hotel room, or at a party. This is not only unethical and legally risky for the injector but unsafe and potentially dangerous for you.
About taking control of your own treatment options:
- What do I expect from my medical procedure? Discuss your expectations with your provider. If you are promised unqualified, 100 percent success it is probably best not to proceed.If it sounds too good to be true, it probably is!
- Am I taking the procedure seriously? Surgical deep peels and injectables like soft fillers and Botox are not the same as getting facials or other superficial beauty regimens. Make sure you have done your homework on the treatment you seek and be aware that these are medical procedures.
- Am I basing my decision on the best treatment option and not on price?
Medical care of any kind is not a commodity. Be sure you have based your decision on the credentials and experience of the practitioner, not on price.
- Have you asked to see before and after pictures? They can be very helpful in determining with your provider the right treatment for you.
- What if I’m unhappy with the result? A qualified practitioner can provide you with appropriate revisional or after-care. Make sure you ask this question before the injection or treatment.
- Have you been told who holds financial responsibility for any revisions or if complications arise? You don’t want any surprises later!
The American Society for Aesthetic Plastic Surgery (ASAPS) is the leading organization of board-certified plastic surgeons specializing in cosmetic plastic surgery. ASAPS active-member plastic surgeons are certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada. www.surgery.org .
The American Society of Plastic Surgeons is the largest organization of board-certified plastic surgeons in the world. With more than 6,000 members, the society is recognized as a leading authority and information source on cosmetic and reconstructive plastic surgery. ASPS comprises 94 percent of all board-certified plastic surgeons in the United States. Founded in 1931, the society represents physicians certified by The American Board of Plastic Surgery or The Royal College of Physicians and Surgeons of Canada.
Q & A with Dr. N. Eugene Morrow on Medical Spas
This week’s expert: Dr. N. Eugene Morrow has been a dermatologist since 1982. He has been the owner and medical director of Seasons Medical Spa in Springfield since 2003. He is a fellow of the American Society of Cosmetic Dermatology and Aesthetic Surgery. He researched some of his answers through the American Academy of Dermatology, medicalspaassociation.org and spafinder.com.
Q. What is the difference between a medical spa and a regular spa? Is there a difference in the types of treatments offered?
A. A medical spa is a facility that operates under the full-time, on-site supervision of a licensed health-care professional, according to The International Medical Spa Association, but there are no definitive regulations governing the use of the term “medical spa.”
Medical spas focus on intense treatments that make a significant improvement to the individual’s appearance, without the down-time associated with more invasive procedures. Medical spas may use lasers and intense pulsed light technology, as well as medical microdermabrasion, photofacials, Botox and Juvéderm injections, medical peels and other medical-aesthetic procedures. These are procedures that may be used for skin tightening, permanent hair removal, wrinkle reduction, acne treatment and the fading of brown spots, freckles, pigment irregularities, rosacea and redness.
Medical spas may incorporate other services found in regular spas, such as waxing, massage, make-up, manicures, pedicures, body wraps, soaks and hair-salon services.
Q. Should clients see a difference between the two types of spas?
A. The first thing a client should notice about a medical spa is the supervision of a licensed health-care professional. Both medical spas and regular spas may employ licensed aestheticians, massage therapists or cosmetologist, but regular spas do not typically have supervision from a licensed health-care professional.
In Missouri, the laws that regulate the use of laser and other intense pulse light technology are rather vague. The consumer must take the initiative and examine the credentials of the health-care professional who supervises the medical spa. Is the supervising health-care professional a medical doctor? How long has the supervising professional studied skin and skin care? Is he or she actively involved on-site on a full-time basis or just an absentee supervisor? What type of assistance is available if you experience unwanted side effects from your treatment?
Another difference should be in the professional atmosphere of the spa. Although medical spas strive to offer a relaxing and comfortable “spa-like” ambiance, they do so in a more clinical environment. Client confidentiality should be a foremost concern. Medical spa personnel should be highly trained and put the client at ease.
Also, because of the intense nature of treatments, the medical spa should provide an in-depth skin analysis and consultation before the treatments. They should use a more thorough intake form and initial interview than a regular spa. Usually the client will sign consents before receiving laser treatments, chemical peels or Botox or Juvéderm injections. Most medical spas offer a free consultation before major treatments. A physician should be available for pre-treatment consultation, if necessary. read more