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Archive for the ‘medical spas’ Category

Botox, Injectable Fillers, and Medical Spas

Monday, February 4th, 2008

Who’s Treating You at your Local MedSpa?

In the past 6 months, I have been contacted no less than ten times by nurses and aestheticians for injector training. Some of these folks I have known or interacted with in the past through our local hospitals and operating rooms, others I have had no idea who they were. This represents a disturbing trend that has developed over the past few years, that of the medspa business concept, which has been largely made possible by the number of injectable cosmetic treatments which have become available in the past five years. Since treatments such as Botox, injectable fillers, and laser hair treatment, to name the most prominent, are fairly ‘easy’ to do (compared to real surgery), many medical and allied health personnel as well as day spas and hair salons want to jump on the bandwagon of what they see as easy money, is fun to do, and is part of their beauty business.

While there is much to be said as a plastic surgeon about this concept, our comments are usually viewed as self-serving, territorial, and economically defensive. Personally, I don’t care what others do, inside or outside of medicine. I have enough to worry about in my practice and I prefer to focus on honing my own skills and being the best that I can be. The cosmetic marketplace is not like traditional medicine…it is really let the buyer beware. There are few regulatory agencies or guidelines for a burgeoning field that is not behest to federal and private insurance rules of reimbursement. In this market, only the attorneys and the threat of malpractice and liability issues keep it from spinning completely out of control.

What I find most troubling, however, is the complete disregard or lack of concern about patient safety…..all in the pursuit of cash revenues. Here in Indianapolis, I know of aestheticians who regularly perform Botox in their own home, cosmetologists doing injectable fillers in hair salons, nurse assistants doing lipodissolve injections, and ENT surgeons doing breast augmentations in their own surgery centers. Providers that have little to no training, not to mention being well outside what their licenses and certificates would permit, treating patients essentially as study subjects. (when you are training on someone without supervision by a qualified provider….you are a study subject) And I wouldn’t call visiting someone for a few hours in their office or watching a DVD by a manufacturer bona fide training! I am not sure exactly what these patients think…..is it the allure of a more convenient or cheaper service…..or is it the appeal of a well-crafted advertisement or website?

Equally disturbing….and the genesis of this rant is……stop calling me to provide you with some training! I got my training to do what I do the old-fashioned way….I earned it through the proper channels. And what makes you think I would have any interest in doing it anyway? So you can get a free ride and benefit from my hard-earned experience?…..And no, you can’t pay me for this training either…..a few dollars is not equal compensation for years of effort and time.

Dr Barry Eppley

Indianapolis, Indiana

MedSpas – Dangers Behind The Calm

Wednesday, October 31st, 2007

MedSpas – Assess Carefully Before Entering!

The popularity of Botox, injectable fillers, and other non-surgical treatments has spawned an entire new cosmetic industry, known as the medspa or medical spa. Combining convenience of location, medical treatments, and a spa approach rolled into one facility, large numbers of these facilities have sprung up nearly everywhere. Medspas are the fastest growing segment of the spa or cosmetic world. Like Starbucks, there appears to be one on nearly every corner. While they may look visually appearing on the outside, what lurks inside can be downright scary.

Because they are outside of the traditional medical world, there are no regulations or oversight as to how they are run. They are outside of the jurisdiction of the state’s medical licensing board and a state’s cosmetology board does not really cover it either. (what does hair and nails have to do with sticking you with needles anyway?) As a result, how they run and, more importantly, who is doing the treatments is completely up to the owner.

The birth of the medspa industry, while obviously highly driven by consumer demand for cosmetic treatments, is also highly influenced by the drug, device, and laser manufacturers. They are, for the most part, entirely indiscriminate as to how they sell to. What is most important is the sale, not whether who they are selling to is even qualified to perform the procedure.

As a potential patient, here are the pertinent questions to ask of any spa or medspa that is offering medical treatments before entering the door:

Who is the owner? (physician or private entrepreneur?)

Who is the Medical Director of the facility and what are his/her
qualifications? (If they are not a board-certified plastic surgeon, ENT/facial
plastic surgeon, or a dermatologist………run!) Ask to see credentials.

Is the Medical Director ever on site or supervise any treatments? (if not…be cautious)

Who is actually performing injection or laser treatments? (only a licensed RN with
proper training is really qualified……everyone else (LPN, medical/nurse assistant,
aesthetician) is really doing it beyond their skill and qualifications level) Ask to see
their credentials.

If there are complications, who are they going to send you to for evaluation?
(this is where having a qualified Medical Director is really important)

Ideally, a medical spa is part of a plastic surgeon’s office or affiliated with a plastic surgeon that is close by. This is the ideal union of medical and spa services.

Dr Barry Eppley

Indianapolis, Indiana


Dr. Barry EppleyDr. Barry Eppley

Dr. Barry Eppley is an extensively trained plastic and cosmetic surgeon with more than 20 years of surgical experience. He is both a licensed physician and dentist as well as double board-certified in both Plastic and Reconstructive Surgery and Oral and Maxillofacial Surgery. This training allows him to perform the most complex surgical procedures from cosmetic changes to the face and body to craniofacial surgery. Dr. Eppley has made extensive contributions to plastic surgery starting with the development of several advanced surgical techniques. He is a revered author, lecturer and educator in the field of plastic and cosmetic surgery.

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