As more spas and salons offer cosmetic procedures, experts warn potential patients to beware. “Something as simple as an injectable, a patient can have an allergic reaction, and if a med spa isn’t equipped to handle that, a simple trip to a med spa can be disastrous,” said plastic surgeon Leo McCafferty, president of the American Society of Aesthetic Plastic Surgery. The Miami Herald Cosmetic procedures are on the rise, resulting in an ever-growing onslaught of youth- and beauty-enhancing practitioners.
A list of cosmetic procedures are posted on the door as wine is serve to those attending Dr. April Patterson’s dental spa, featuring retail fashion, food, music and cosmetic procedures. CARL JUSTE / MIAMI HERALD STAFF.
It’s hard to escape the lure.
South Florida radio ads for Venus Mini Med Spa tout the beauty benefits of getting facial fillers at the mall.
A Fort Lauderdale dental spa invites women to a cocktail soiree to sip champagne, taste hors d’oeurves, sample Botox and try eyelash extensions.
And just last week, Miami Beach Plastic Surgery and Medspa offered discounted treatments at its Back to School Injectable Day and Tweet Up.
They are all cashing in on the desire to turn back the clock.
Across South Florida, medical spas are proliferating, offering nonsurgical — and sometimes even surgical — cosmetic procedures for women and men.
Once strictly the purview of plastic surgeons and dermatologists, medical professionals of nearly every ilk — from ophthalmologists to dentists to gynecologists, as well as physician assistants and nurse practitioners — are now jumping on the youth-enhancing bandwagon.
“It is a bit of a Wild West out there,” said Dr. Leo McCafferty, a Pittsburgh plastic surgeon and president of the American Society of Aesthetic Plastic Surgery. “It doesn’t mean that all med spas are bad, but it certainly behooves the consumer to do due diligence.”
Without question, cosmetic procedures are soaring, rising 197 percent since 1997, according to the ASAPS. Surgical procedures have increased 73 percent, while nonsurgical procedures, like Botox, facial fillers and laser hair removal, have surged by 356 percent.
In all, Americans spent more than $10 billion on cosmetic procedures in 2011, according to the organization’s tally.
Blame it on the baby boomers: As they are getting up in years, they are leading the charge toward cosmetic enhancements.
In fact, people age 35 to 50 had the most procedures last year, nearly four million, and 43 percent of the total. Those 51 to 64 had an additional 28 percent, the ASAPS said.
“It’s a large target market, and it’s a market that is sensitive to aging, that doesn’t like aging, and that wants to fight it,” said Dr. Stephan Baker, a Coral Gables-based plastic surgeon and a local spokesman for the American Society of Plastic Surgeons. “That creates, obviously, a demand, and you see that reflected in the economic world. When demand increases, supply increases.”
Couple that, Baker said, with the evolution of nonsurgical procedures, such as injectables, and the decline in reimbursements for insurance-based, or non-cosmetic medicine.
The result is an ever-growing onslaught of youth- and beauty-enhancing practitioners.
But buyer beware, warns Dr. Carlos Wolf, a facial plastic surgeon at Miami Plastic Surgery, who also practices in St. Helena, Calif., and writes the column Plastic Surgery 101 for The Miami Herald.
“Any Bozo can inject this stuff,” he said. “However, to do it well and do it safely requires an art and training.”
The ASAPS says that medical spas “should be supervised by a physician, who should be on-site, and who should be properly trained and board-certified within their scope of practice, because problems can happen,” said McCafferty, who trained at Jackson Memorial Hospital and who has a vacation home in Key Biscayne.
“Something as simple as an injectable, a patient can have an allergic reaction, and if a med spa isn’t equipped to handle that, a simple trip to a med spa can be disastrous,” he said.
“They are not going to get their hair done,” MdCafferty added. “They are having a medical procedure, and they need a medical evaluation pertinent to what they are going to have done.”
Dr. Amaryllis Pascual, an internist, decided to open her first weight-loss and cosmetic medical spa after she became disillusioned with the direction medicine was taking, with ever shorter time slots allotted to patients.
Pascual now operates four Pascual M.D. Cosmetic Surgery and Weight Loss Centers in South Florida, with a staff of four doctors, two physician assistants and one nurse practitioner. The med spas offer everything from weight-loss programs to breast augmentation, facial lasers and injectables.
“We came from a med spa environment but grew into serving all aspects of health and beauty,” said Pascual, 45. “So if someone comes in for weight loss and loses weight, then they may be interested in liposuction or a tummy tuck.”
She estimates that 50 percent of the med spas’ patients come in for weight loss, 30 percent for cosmetic surgery, and the remaining 20 percent for such procedures as lasers and injectables.
And a growing portion of her patients are men, as much as 30 percent.
“When I first started, men really didn’t do Botox, maybe one a month — now it’s a lot more coming, especially older men in their 50s,” she said. “They are competing with younger guys and they want to look good.”
Indeed, treatments that were once done in secrecy, whispered about in hushed tones among girlfriends, are now out in the open. And they are advertised nearly everywhere you look. Deals from med spas like Pascual’s seem to arrive in email boxes daily, promising discounts on everything from Botox to laser hair removal.
But don’t let the name “med spa” fool you, Baker warns.
“The terminology works a little on the fear factor — you’re not really going to a doctor’s office, you’re going to a spa, with aromatherapy, nice music. You’re going to be treated like a queen,” he said. “Do your homework, be aware, ask questions before you buy. Before you sign up for treatments, understand what you are doing and who is doing what to you, and be a smart consumer.”
Laws differ from state to state, but in Florida, anyone with a medical license can practice in any medical field. And physician assistants and nurse practitioners can perform injections.
“The Board of Medicine has stated that lasers, laser for hair removal, Botox injections, collagen injections, and any other noninvasive injections of materials used as procedures to treat patients must be performed by a Physician, a Physician Assistant under supervision, or an Advanced Registered Nurse Practitioner working under a protocol signed by a Physician,” Florida Department of Health spokeswoman Ashley Carr said via email.
Bill Clarke and his wife, Rita Clarke, a physician assistant, have created a growing chain of med spas in shopping malls, offering Botox, Dysport and fillers.
Venus Mini Med Spa, headquartered in Sarasota, operates nine med spas in malls, including Aventura Mall and The Galleria mall in Fort Lauderdale.
The mall, Bill Clarke said, is the perfect environment, because it’s convenient, it’s where women go for fun, and clients don’t have to make appointments.
“Our competition is Coach purses, Ann Taylor dresses and Nordstrom shoes,” he said.
At a Venus Mini Med Spa, physician assistants or nurse practitioners do the injecting after they undergo intensive training. A group of plastic surgeons is available on call in case anything goes wrong, Clarke said.
“Eighty percent [of clients] are walk-in, and we will spend as much time as they want educating them and showing them how it works,” Clarke said, adding that 75 percent of clients are getting facial injections for the first time.
“All we’re trying to do,” he said, “is wind back the clock and make people look refreshed.”
Denise Fontaine of Coral Springs had a chemical peel a couple of weeks ago, and got Botox for her 51st birthday at the Venus Mini Med Spa at the Town Center at Boca Raton.
A sales representative for the cosmetics company Trish McEvoy, she often works at the Saks Fifth Avenue at the mall, and the med spa is just outside the door.
“It’s so convenient,” said Fontaine, who has referred her sisters and plenty of clients. “I work a lot of hours and when I want something done right after work, it just takes a couple of minutes.”
Venus Mini Med Spa frequently advertises on the radio. And in this age of social media, some med spas send emails and post on Twitter and Facebook to help spread the word.
Parties and events are also becoming en vogue.
Dr. Leonard Tachmes’ Miami Beach Plastic Surgery Center and Medspa teamed up with Sean Donaldson Hair Salon, Ryce Fitness and Sobe Tan by Fabiola recently to host a Beauty Block Party, complete with music, drinks and a raffle for Botox treatments, blow dries, personal training and tanning sessions.
“It was our idea to put something together where it’s a collaboration with other businesses in South Beach in the health and beauty industry, to put our energies together and have the opportunity to meet new clients,” Tachmes, a plastic surgeon, said at the event.
Just last Tuesday, his practice, which offers various cosmetic procedures, held a Back to School Injectable Day and Tweet Up, and about 20 people made appointments for discounted treatments.
“This is a perfect time because it’s a little slow in August and it gets people in here,” said Tachmes, who came up with the event’s name.
Lynn Ponder, founder of WebCityGirls, filled out paperwork while waiting for Tachmes to inject Dysport into her forehead. The event, spread through social media, lured her in — and made her stray from her usual doctor of four years.
“I think we all need a little refresh,” said Ponder, who declined to provide her age. “We work hard, we are stressed out, and I feel injectables just refresh my face, giving me kind of a glow.”
With med spa fever reaching new heights, even dentists are taking part.
“Most people don’t like the dentist, and I wanted to change that outlook,” said Dr. April Patterson, who opened her Dr. Patty’s Dental Boutique in Fort Lauderdale in February, offering everything from conventional dentistry to injections to massages, facials and chemical peels. She held a Bubbles, Botox and Trunk Show in her Fort Lauderdale office earlier this month, offering neck massages, eyelash extensions, eyebrow threading, Botox and more.
For Patterson, adding cosmetic services to enhance beauty seemed like a no-brainer.
“If you think about it, we study the face, the muscles, the nerves, we use needles all the time,” said Patterson, 30. “It actually makes a lot of sense for a dentist, especially if you have an eye for cosmetic symmetry.”
To enhance the smile, for example, she administers fillers in nasolabial folds, in lips and for the lines above the lips.
And she injects Botox to relax the upper lip for those who have gummy smiles — as an alternative to surgery.
“Botox and fillers have allowed dentists to do amazing things,” Patterson said. “It really makes a difference for the client.”
For the doctor, too. Spa services now represent about 15 percent of her revenue.
“It creates another stream of cash coming into the business,” she said. “And women will tell their friends they got Botox today, versus they got a cleaning today.”
Dr. Alejandro Espaillat, an ophthalmologist, still performs eye surgery in his Brickell Key office, but he is aiming his practice on wellness, including aesthetic procedures.
“I believe ophthalmologists are uniquely trained to treat any area of the eyes and face, because of our knowledge of facial anatomy and movement,” he said.
So when his patients receive refractive surgery, they can also now get Botox, fillers, laser treatments and more.
“They realize that now that they can see better, they not only want to see better, but they want to look better,” said Espaillat, 47, medical director of the Espaillat Eye and Laser Institute.
About half of his practice’s revenue comes from aesthetics, and half from ophthalmology, he said.
Aesthetic procedures include laser hair removal, resurfacing of the skin, skin tightening and cellulite treatments, as well as facials, said Gabriela Oviedo, aesthetics director of the Brickell Key Medical Center, which is a division of the Espaillat Eye and Laser Institute.
Just last week, the center added a new weight-loss program, and more expansion is in the plans.
“Having a comprehensive approach to the wellness of the person is important,” Espaillat said, “from the psychological aspects to the physical aspects.”
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