Esthetic Physician Practice vs. Medspa: Opting for Quality, Safety, and Options

Americans spent more than $6 billion on non-invasive esthetic services in 2023, and Florida is currently home to over 5,400 medical spas (commonly known as medspas). The number of medspas has multiplied so fast that they now outnumber physician-based esthetic practices in 73% of US cities. Many people who visit medspas, however, are unaware that there’s not much “med” about most medspas.

Medspas provide simple, non-invasive cosmetic treatments that provide minimal to moderate results. Even though medspas are required to have a medical director, however in Florida, the directors aren’t required to ever be on-site. Most don’t have a doctor providing any treatments therefore can't produce dramatic results.

In contrast to medspas, esthetic medical practices are owned by at least one physician who directly provides treatments and is on premises. Their clinicians and medical estheticians are experienced and provide physician-level opinions, treatments, and skincare.

When should you choose a physician-based esthetic practice over a medspa

Medspas are like Walmart. People are happy to shop at Walmart for basics, like socks, but when it’s a more important purchase, they shop at higher-end stores. And what’s more important than your face?

Three reasons why a physician-based office may be the better choice for esthetic medical treatments

1. Quality of Results

If someone is interested in a pampering facial or a simple Botox treatment of the frown lines, for example, where the worst possible results are asymmetric brows or simply no results, a medspa is a reasonable option. Medspa providers are more likely to follow a conservative protocol and use a “cookie cutter” approach, with only devices or treatments that don’t require a physician.

More complicated treatments, such as 3D facial contouring or laser skin resurfacing, require the knowledge and experience of a physician. Physicians with extensive experience are comfortable choosing aggressive laser settings or even combining different devices or treatments to achieve the best possible results.

2. Safety

Unlike doctors’ offices, required to follow strict national and state-specific rules for medical professional qualifications, the regulations for medspas are left to individual states. In Florida, for example, medspas can be owned by people with non-medical background.

Even though many esthetic medical treatments are touted as minimally invasive, some can cause severe complications. Blindness, strokes, and even deaths have been recorded when wrinkle-filling substances were accidentally injected into facial arteries. Burns from lasers can cause scarring, severe infections, and permanent discoloration.

Some of the severe complications can be avoided with quick action when there’s a physician present, but providers with less training may not have the knowledge or resources to manage problems in time to prevent permanent damage.

For cosmetic treatments that don’t penetrate the skin, like basic facials or massages, a medspa may be the perfect choice, but the more potential complications that are associated with a procedure, the more important it is to choose a physician for the treatment or at least know there’s one immediately accessible.

3. More Effective Treatment Options Are Usually Available at Physician Practices

The most effective treatment options for a person’s appearance goals aren’t always available in a medspa. For example, a patient who would benefit more from a fat transfer than an injectable filler won’t be given that choice in a medspa.

Because esthetic lasers and devices are extremely expensive, it’s not uncommon for a medspa to only own one or two and promote them to treat concerns for which a different device would have been safer and/or more effective. For example, using the wrong laser for hair removal on dark skin can cause blistering and permanent scarring, but if a medspa only has a laser that's safe on light skin, the medspa personnel may take a chance and use it on dark skin so that they can get the commission.

If that patient is burned, who at the medspa has the knowledge to treat them? There will probably be a delay while they try to contact the off-site medical director. There's no delay in treatment when the physician is on-site.

Conclusion

Dr. Elliott advises anyone seeking more than simple esthetic treatments or skincare to go to a physician-based practice, even if it’s sometimes more expensive. She says, “Would you go to a facility for your heart surgery because they were the cheapest? Your face deserves the best and safest results possible, so it’s important to do your homework."