Q: Who is the Doctor in charge and where is he?
A: Medical Spas are supposed to have a Physician present to provide medical-grade products and procedures. Unfortunately, the Doctor is often nowhere to be found. All too often, a Doctor whose primary area of interest and income may be something other than Medical Aesthetics signs a contract to be the “Medical Director” of a Medical Spa. He makes some extra income; the Spa staff gets to use prescription-only products and perform complex medical procedures but the Doctor isn’t even present. He could be performing surgery or seeing patients in his own office or even hitting golf balls.

If you are contemplating receiving a Medical Procedure at a Medical Spa, find out if the Doctor will actually be there during your visit.

Q: Will my Medical Procedures be performed by the Doctor?
A: Too often, Medical Spas are revenue “add-ons” to a busy medical practice. The Doctor may be busy seeing medical patients on the medical side of the office while an Aesthetician, Physician Assistant, Nurse Practitioner, or even a Nurse wields potent syringes of Botox and complicated lasers on the Spa side. Even Plastic Surgeons and Dermatologists commonly hire Nurse Practitioners to perform Medical Procedures in their spa.
Before you walk in the door, ask if the Doctor will actually be the injecting the drugs or performing the Medical Procedures. If the answer is something like “No, our Nurse does that, but she’s very good,” do yourself a favor and look elsewhere.

Q: How experienced is the Doctor?
A: Commonly, a Doctor will simply add on a few nicely-appointed rooms to his busy office, buy some lasers, hire an Aesthetician and call it a Medical Spa. These Doctors often have no real interest in Medical Aesthetics and rarely perform any of the procedures themselves. They may be physically nearby but they are generally not well-versed in what works well and what doesn’t.
You should only trust your face to a Physician who practices Medical Aesthetics day in and day out. If the Doctor spends the vast majority of his time practicing day-to-day medicine or performing complex surgery in the O.R., can you really expect him to be up on the latest techniques and equipment used in Medical Aesthetics?

It’s perfectly all right to ask, “How many times per week does the Doctor actually perform this procedure?”

Q: What kind of Aesthetic Training has the Doctor had?
A: Many people assume that Board Certified Dermatologists or Plastic Surgeons make the best Aesthetic Physicians but that isn’t always the case.
Dermatologists spend a majority of their training learning how to treat diseases of the skin and how to recognize when a particular skin condition means that something serious is going on elsewhere in the body. If you have a suspicious or bothersome lesion or rash, you should visit a Dermatologist. If you want to soften a few wrinkles and look more refreshed, a Dermatologist may not always be your best choice.
Plastic Surgeons acquire many complex skills during their extensive training period including hand surgery, breast implants, facial reconstruction, scar revision and complex skin grafting techniques. Plastic Surgeons can work wonders for patients with those sorts of major problems. They may not be the best choice, however, for someone with facial sun damage or pigment irregularities.

Actual training in Medical Aesthetics is absent or only a very small part of many Dermatology and Plastic Surgery training programs. Most physicians who wish to become proficient in the appropriate use of Botox, Facial Fillers, Lasers, and prescription grade cosmeceuticals usually must take multiple courses from national experts on the various aspects of Medical Aesthetics. These courses are expensive and inconvenient but remain the major means for most Doctors to become proficient in these techniques.

Do not be afraid to ask about the training of the Doctor who will be doing your procedure. Do not accept “Dermatologist” or “Plastic Surgeon” as the only meaningful credentials. Ask if the Doctor has taken advanced courses specifically focused on Botox or Fillers or Facial Lasers.

Q: What Medical services are available?
A: A true Medical Spa should be able to design a specific treatment plan that will address all of your aesthetic concerns. Botox and Facial Fillers are just the beginning. Does the Spa have Intense Pulsed Light to erase brown and red spots? What about a Laser to promote new collagen formation and tighten skin? Can they remove unwanted hair? Can you receive expert advice about prescription-strength cosmeceuticals to repair ultra-violet damage and improve texture? Are medical-grade peels available?

Some Medical Spas are even able to offer body sculpting using a laser like the SmartLipo Laser. They are able to tighten skin and melt away fat from the waistline, thighs, hips, arms and even the neckline.

Make a list of what services you might be interested in and ask about them when you call. A true Medical Spa should be able to offer you a comprehensive program to assess your needs and address your concerns.

Q: What Aesthetic services are available?
A: Besides the medical-grade Aesthetic services like microdermabrasion and advanced chemical peels, a full-service Medical Spa should offer a selection of anti-aging and revitalizing facial treatments as well as a full menu of cosmetic and aesthetic services like waxing, paraffin treatments, permanent make-up and even detailed instruction on make-up application.

Ask what is available and check the web site for details.

Q: What will the Aesthetician do for me and what is her experience?
A: The key component of a professional Medical Spa experience is the consultation with the Aesthetician. It is the Aesthetician who will delve into the details of your skin care history, investigate the products you are presently using, analyze the condition of your skin and tailor a treatment program to address your concerns. If you need Medical procedures, it is the Aesthetician who involves the Physician at the appropriate times to get you the optimal results. If this consultation step is skipped, you are getting an inferior service and will have inferior results.

It takes years of experience for an Aesthetician to obtain the level of knowledge and understanding to perform a detailed and accurate consultation. Don’t be afraid to ask how long your Aesthetician has been practicing and whether a detailed consultation is a part of the service.

Q: How will my care be documented?
A: Before-and-after photo documentation is a must. Most advanced Medical Spas use a sophisticated camera system like the Canfield Visia to guide and document your treatment program. The Visia takes multiple photographs using various filters and then it applies complex software algorithms to your photos to highlight specific areas of skin damage. There should be no charge for this service. Ask how your Medical Spa plans to document your treatment program.

Q: What other Spa services are available?
A: Generally, most Medical Spa clients want to look more youthful and refreshed, but that is simply not enough. Spa clients want to feel better as well. Stress reduction is a major part of the modern spa experience. How this is accomplished varies greatly from spa to spa.

Most spas offer massage. Ask about what type of massages are available. Deep neuromuscular may work well for the active athlete but the stressed-out executive may prefer Japanese Hot Stones or Lomi Lomi. Is the therapist experienced in Pregnancy Massage? What about Reflexology? Or Aromatherapy?
If you need a few hours or relaxation, will your spa get you a cappuccino and some lunch? Do they have a concierge service? Can they get your car washed, pick up your dry cleaning, or make your dinner reservations while you unwind? Will they provide limo service for your spa day?

You may not be looking for this level of service every time you visit a Medical Spa, but you should ask about it anyway. If your Spa is willing to provide concierge-level service, you can be confident that their dedication to all aspects of customer service is unparalleled.

Q: What will my Spa experience be like?
A: This is easy. When you walk in, you should immediately experience an overwhelming sensation of tranquility and relaxation. Every one of your senses should be involved. The surroundings should be visually beautiful. The sounds should be light and airy. There should be a subtle scent that calms the mind and soothes the spirit. You should be offered a beverage that reduces stress and pleases the palate. The robes should be plush. The touch of your therapists should be confident and gentle.

In short, you should be ushered into a sanctuary of calm where the stresses of the world can be left behind and you can become refreshed, revitalized and feel more beautiful inside and out.
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