The distinction between medical treatments performed in a doctor’s office and beauty treatments done in a beauty salon has been blurred by the advent of medi-spas. The proliferation of these establishments has been accompanied by an increasing number of surgical and non-surgical or minimally invasive procedures being offered that are well outside the scope of non licensed physicians. Many have moved beyond cosmetic procedures such as Botox injections, facial peels and laser skin resurfacing to plastic surgery including breast augmentation, tummy tucks, chin implants, and face, brow and eyelid lifts. Problems arise because they may not be licensed, or may allow either providers who are not trained in plastic surgery procedures to perform operations or nonmedical personnel to administer some treatments. As discussed recently in The Wall Street Journal,  some states are addressing the issue by implementing stricter regulations, requiring licensing and truth-in-advertising.

Regulations pertaining to the practice of medicine and surgery depend on state legislation, some do not require medispas to be licensed, others even allow nonphysicians to perform liposuction (yes, liposuction!). And although most require a medical doctor to oversee all services provided, the supervising physician is not required to be present for the procedure. Proposed laws in New York would mandate that anyone who treats patients to show their credentials on a nametag, and require doctors advertising themselves as “board certified” to specify which board. The American Board of Medical Specialties recognizes board certification in dermatology and plastic surgery but not cosmetic, aesthetic or anti-aging medicine.

Insofar as scope of practice, the American Society for Dermatologic Surgery Association considers any use of lasers, lights, electrical impulses, chemical peels, injections, insertions or tissue augmentation to be the practice of medicine, which should be performed by a physician or health professional under a doctor’s supervision. An increase in complications, including blisters, burns, nerve damage and scarring may be due to more nonphysicians doing cosmetic procedures. Besides minimally invasive procedures, cosmetic surgery procedures are now being taught to non plastic surgeons. The National Society of Cosmetic Physicians, for instance, provides a 2 day workshop in laser liposuction, breast augmentation and tummy tucks. A board certified plastic surgeon, in contrast, has completed at least 5 years of residency training in general and plastic surgery, in addition to passing comprehensive written and oral examinations.

If you’re considering any aesthetic procedure, be it Botox, fillers, skin resurfacing or plastic surgery operation, spend the time to research your provider’s training, qualifications and board certification, and choose wisely.

Dr. Olivia Hutchinson is a board certified plastic surgeon in NYC whose practice is dedicated to aesthetic plastic surgery. To schedule an appointment with Dr. Hutchinson, please contact us or call us at (212) 452-1400.

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