The “medical spa” or “medispa” is a rapidly growing phenomenon in the United States and internationally. As opposed to the local day spa, medical spas provide non-surgical medical care for a variety of conditions. The day spa is geared toward a relaxing Zen-like experience for massage, meditation, and superficial skin care.
The medical spa experience includes injectable medication to fill lines (Juvederm, Restylane), freeze muscles (Botox, Dysport), add facial volume (Voluma, Resylane Lift), and dissolve fat (Kybella). Medical Spas may offer a variety of energy sources including lasers for hair removal, ultrasound to tighten skin or dissolve fat, radio frequency to tighten skin or improve symptoms of vaginal aging or hormone changes. Microwave energy can kill sweat and odor glands. Cellulite can be attacked with a variety of devices that are mciroinvasive (small needles) and non-invasive.
The point of all this information is that the medical spa is not a day spa in your local strip-mall or hotel. These forementioned treatments are medical treatments that have many benefits but also carry risks that are of greater concern when performed by unqualified personnel in unsafe and unsupervised environments. The laws governing medical spas vary from state to state and the facilities themselves are often poorly monitored.
California—where I practice—has fairly strict guidelines, however the sheer number of new medical spas popping up is astounding. Frequently, there is no physician present or one is loosely affiliated as “the medical director”. This in itself is illegal as a non-physician cannot employ a doctor in this state; the physician must be the owner. A medical spa by definition is in the business of providing medical services and therefore falls under the jurisdiction of the Medical Board of California.
Furthermore, California State law specifies the “scope of practice” for health care providers as well as the amount of physician supervision required for various procedures. A simple example is the recent increase in the number of facilities offering microneedling and dermaplaning by aestheticians. This is illegal and the Board of Cosmetology and Barbering has been investigating and cancelling licenses for these providers.
All of the injectables and energy devices noted above can only be used by doctors, nurses, and physician assistants who are properly trained and supervised by their employing physicians. There must be a good faith exam and oversight by the doctor or Nurse Practitioner (NP) and Physician Assistant (PA) of the office. The NP or PA are also working under the strict guidelines of their doctor who must be supervising their work and patient charts on a regular basis.
To further complicate issues for patients seeking medical spa services, many of the physicians who own or direct the spa, are not experienced in cosmetic or aesthetic surgery or medicine. This aspect is not regulated in California. The doctor may actually specialize in family medicine, anesthesia, or dermatology.
At the BioSpa, Newport Beach, all procedures are overseen by board-certified plastic surgeons Dr. Jed Horowitz and Dr. Larry Nichter and their medical staff. We go above and beyond the regulations to provide our medical spa patients with consistently outstanding results and an unsurpassed patient experience.