10 Things That Med Spas Won’t Tell You

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Medical spas have grown into a multi-billion dollar industry during the last 10 years. But are they safe? Who is regulating them? San Francisco plastic surgeon Dr. Roy Kim discusses 10 things that patients should know about med spa safety.

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“A few states require that a doctor be on site to perform or directly supervise treatments. But the majority of states, including California, only require that the doctor be ‘reasonably accessible.’"

A California boy was injured recently by a laser used to treat toenail fungus, resulting in the arrest of a spa owner who was charged with practicing medicine without a license.

This most recent case sheds light on a medical spa industry that continues to outpace state regulations aimed at protecting patients. Dr. Roy Kim, a board-certified San Francisco plastic surgeon with 13 years of private practice experience, says he is concerned by the lack of oversight and shares the 10 things that patients need to know about medical spas.

# 1 - Oversight regulations are lax or non-existent.
Medical spas offer cosmetic medical treatments such as Botox injections, laser hair removal and chemical peels. Some facilities even offer more invasive treatments such as liposuction and fat grafting. But who is watching over these medical spas to make sure that the staff is properly trained and that patients are safe? Too often, it’s nobody.

“A few states require that a doctor be on site to perform or directly supervise treatments,” says Dr. Kim. “But the majority of states, including California, only require that the doctor be ‘reasonably accessible.’ This could be interpreted to mean anything from a short drive away to reachable by phone at his beach house in Tahiti. The laws don’t often specify.“

#2 – Facilities are rarely, or never, inspected.
Unlike surgical centers and hospitals that must be inspected and licensed by the state, there is no state agency assigned to inspect the cleanliness of the facility, the safety of the equipment or the training of the staff at medical spas.

#3 – There may be a doctor’s name on the door, but he might not work there.
The majority of states only require that med spas operate under a medical director. But the laws are vague when it comes to defining the role of the medical director. It could be that the doctor simply loans his name to the medical spa in exchange for a cut of the profits or that the doctor stops by a few times per month.

#4 – The medical director might not be a plastic surgeon or a dermatologist.
Just as patients wouldn’t want a podiatrist to treat asthma or a gynecologist to perform knee surgery, patients shouldn’t want just any doctor to perform cosmetic procedures.

Dr. Kim says, “There is what’s known as the Core Four specialties that are recognized as uniquely trained and qualified to deliver cosmetic treatments. They are Plastic Surgery, Dermatology, Facial Plastic Surgery and Oculoplastic Surgery.”

#5 – Medical spas often buy used equipment that is often slower and more painful.
Lasers for hair removal and skin resurfacing are expensive. Brand new, one of these units can easily cost $100,000 or more. The used market is where most medical spas do their shopping.

#6 – If patients have dark skin, a laser could seriously injure them.
Laser energy is attracted to pigment, and brown skin is more prone to burns, scarring and dark marks when the wrong laser is used or when a laser is used in the wrong way by an inexperienced provider.

#7 – Medical spas may not be properly insured.
Medical spas and some procedures are under the malpractice insurance umbrella of the doctor responsible for the treatments. Yet while most doctors have malpractice insurance, it might not cover the specific procedure, injectable or cosmetic laser treatment being offered.

#8 – Medical spas are often financially struggling.
Medical spas are a tough business. There is fierce competition, and if a med spa is unwilling to spend huge amounts of money on advertising or to discount prices, or both, they’re likely struggling to survive.

#9 – Medical spas sell prescription products like Latisse and Retin-A without a doctor’s consultation.
Only a doctor, or a nurse under the supervision of a doctor, can legally talk to patients about prescription products and how to use them. The front office staff is not allowed to dispense prescription medications such as Latisse or Retin-A. Yet, at many medical spas, this is a routine practice.

#10 - Complications may not be discussed beforehand, and might not be reversible.
Dr. Kim says, “An excellent plastic surgeon or dermatologist will not only discuss possible complications prior to your treatment but will also be able to perform complication reversals for things like Botox, dermal fillers, too much skin exfoliation or laser skin damage should they occur. A doctor or nurse who completed a weekend course in cosmetic procedures will likely not be able to fix your problem.”

Dr. Roy Kim is a plastic surgeon with 13 years of private practice experience in San Francisco’s financial district. He is a Diplomate of the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons, The American Society for Aesthetic Plastic Surgery, and the California Society of Plastic Surgeons. He regularly writes about plastic surgery and the issues surrounding it on his blog at http://www.drkim.com/blog .

Contact Info:
Dr. Roy Kim
220 Montgomery Street, Suite 348
San Francisco, CA 94104
415-354-8148

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Roy Kim
Roy Kim, MD
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