Reviewed by Varnada Karriem-Norwood on May 27, 2012


Robert Kotler, MD, FACS Cosmetic and Plastic Surgeon of the Face and Neck Clinical instructor, Division of Head & Neck Surgery, UCLA Medical School.

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Video Transcript

Narrator: Why are neighborhood medical spas buyer beware?

Robert Kotler, MD: Medical spas, buyer beware, because a medical spa implies that there's some medical treatments. Often, there's a staff physician, or a nurse as opposed to just a traditional day spa. And so, yes, there are procedures that are offered. The question is whether that's the best environment for that.

Narrator : Why would it not be?

Robert Kotler, MD : Well, it depends on how much on site supervision there is by a physician and what is the physician's specialty. Because by routine, typically there is a dermatologist or a cosmetic surgeon available and sometimes on site, but for some spas, the so called medical director could be a pediatrician. It could be a heart surgeon participating in a business enterprise. You just need to know that you have to have a license to be a medical director, but the question is what specialty is that licensed doctor carry?

Narrator : How can a pediatrician or a heart surgeon actually do cosmetic procedures? That doesn't make sense.

Robert Kotler, MD: Well, they are really not doing the procedures in some of the spas, and I'm not saying that this is the rule, but there are some that we know about. They don't do them. They are really done by often very experienced and sophisticated nurse practitioners who specialize in that type of work. But there are some medical issues that can come up, particularly suitability. Should one have such and such a procedure? A given skin peel or the injections, because not everyone is a candidate for these things. It's not like shopping at a supermarket where you just take something off the shelf. There has to be some consideration for the right substance, the right treatment and for the right skin, and the right type of person in respect to their health. So that's where the system breaks down if in fact the supervising doctor hasn't been raised in the world of cosmetic surgery. Most are raised in the cosmetic surgery world, but not all. And we do hear stories about physicians kind of migrating in to the medical spa because it's um, it's a business, an investment opportunity. Or often, the spa may be owned by business men and they've appointed Dr. X to be the quote medical director. But it's good to have a sense of who's at the controls, who's responsible, and who will be there if there's a problem. All medical treatments have some potential for, you know, delayed healing, some minor complications. Who is going to be the backup?