If you think that 'medical' and 'spa' do not go together like coffee and donuts, you're not alone. Many national medical societies (plastic surgery and dermatology alike) consider any use of lasers, lights, electrical impulses, chemical peels, injections, insertions or tissue augmentation to fall under the practice of medicine and, as such, be performed by a physician or midlevel health professional, such as a physician assistant, under a doctor's supervision.
Some medical spas offer excellent care. But for those that are not up to snuff, here are some of the problems to be aware of:
• Doctors trained in unrelated specialties may supplement their incomes performing cosmetic procedures they are not trained to do.
• Medical spas typically offer Botox, facial peels, laser skin treatments and other minimally invasive cosmetic procedures. But some facilities also offer procedures that require a rigorous medical setting and emergency equipment, such as breast implants, tummy tucks and liposuction.
• Only a few states require medical spas to be licensed. In some states, procedures, from laser hair removal to liposuction, can be performed by nonmedical personnel. Most facilities require a medical doctor to oversee the services—though not necessarily to be on site or even in the same state.
The June 4, 2013, the Wall Street Journal reports: "States are tightening regulations on medical spas—and wading into some ugly disputes over where beauty treatments stop and the practice of medicine begins." Here is some new legislation designed to improve medical spa safety:
• A month ago, Maryland Gov. Martin O'Malley signed a new law directing the state health department to oversee cosmetic surgery facilities after one woman died and two others became seriously ill with infections following liposuction.
• Florida now requires that liposuction, removing more than two pounds of fat, be performed in a state-licensed surgical center with emergency equipment on hand.
• In California, it is now a felony, punishable by up to five years in prison and a $50,000 fine, for a corporate entity to own a medical spa; the majority owners must be M.D.s.
• Fourteen states are considering "truth in advertising" laws, many of which would require medical spas to list personnel's training and credentials in all marketing.
• The proposed medical-spa law in New York would require doctors advertising themselves as "board certified" to specify which board. The American Board of Medical Specialties recognizes dermatology and plastic surgery but not cosmetic, aesthetic or anti-aging medicine.
For the most part, you still cannot rely on your state to oversee cosmetic procedures. For the best results, make sure your provider is board-certified in an appropriate specialty and performs the procedure in a licensed hospital or outpatient facility.
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