Medspas Are Moving To Malls

By Rhonda L. Rundle
Wall Street Journal
NEW YORK – The fast-growing field of cosmetic medicine is spreading out of the doctor’s office – and into the mall. Around the country a new breed of spa is popping up, offering dermatology services such as injectable wrinkle treatments, peels and laser procedures, along with the usual facials and massages.
Though slower to catch on in the Midwest, industry insiders say it’s gaining ground. In Fort Wayne, a conservative version of the medical spa – which includes more medical offerings and an on-site doctor to administer procedures and injections – is expected to open next month.
Nationally, stand-alone stores, and chains with names such as Radiance Medspa, Solana MedSpas and Sona MedSpa, have opened in a number of states in the past few years – often in swank shopping districts. And their numbers are growing fast. There are 1,250 to 1,500 medical spas in the U.S., up from a dozen or fewer five years ago, estimates Hannelore Leavy, executive director of the International Medical Spa Association, a trade group.
The trend is setting off alarms in the medical world, with some doctors expressing concern that medical treatments may be performed at spas without adequate physician supervision. Most states require a doctor or licensed medical professional to oversee dermatology services – including prescription injections like Botox or Restylane, certain chemical peels and intense-pulsed-light skin treatments. But many, including Indiana, don’t require the doctor to be on the premises when the services are rendered. Though those rules apply to doctors’ offices and other facilities, physicians are more likely to be on hand in their own practices, say doctors who are critical of the spas.
Dr. Alan Gilbert, president of the Indiana Dermatological Society, said he hadn’t personally encountered medical spas. The Fort Wayne dermatologist said it’s common practice to offer some spa services in a clinical setting. But he is wary of offering medical services in a retail setting without direct, on-site medical supervision.
“It’s kind of a risky thing,” Gilbert said.
Dr. Jeffrey Sassmannhausen, owner of Three Rivers Dermatology, concurred. He, too, offers spa services and doesn’t have a stand-alone spa.
Without on-site supervision, “I think that you can run into a lot of problems,” Sassmannhausen said. Lasers alone could prove volatile without proper training and supervision, he said.
Ultimately, much depends on the qualifications of the spa’s medical director and the company’s management style, Sassmannhausen and other doctors said.
The spas say that they contract with physicians to oversee the services, and procedures are usually administered by a nurse or licensed technician. Some spa owners say that nurses and technicians are often more experienced and skilled at nonsurgical procedures than physicians. And they say that a physician is reachable on short notice if complications arise. Andrew Rudnick, chief executive officer of Sleek MedSpas Inc., based in Boca Raton, Fla., says the chain has a medical director who floats among the four Boston stores and performs some treatments herself.
But Dr. Robert Severinac, owner of Rejuva MedSpa, which is expected to open in mid-February in Fort Wayne, wanted to be even closer to the facility. It will be in the same building as his plastic surgery practice in a separate suite. The plastic surgeon was lauded by Sassmannhausen and Gilbert for his expertise and his hands-on approach to his new med spa.
“We thought about doing the retail thing,” Severinac said. But ultimately he chose to locate Rejuva in the Dupont Medical Arts Building at 10020 Dupont Circle Court. In a separate suite, the building houses Indiana Plastic Surgery Center, which Severinac owns.
The set-up allows Severinac to be more hands-on with aggressive treatment to complement spa services such as aroma therapy. All that will be offered in a cozy, warm spa setting, with a focus on comfort, he said.
In addition to usual med spa offerings like Botox and Restylane injections, Severinac’s med spa will offer procedures such as dermabrasions – which can smooth skin on the face through controlled surgical scraping – and suture suspension designed to raise tissues in the face. Oral sedatives will also be offered to reduce pain.
“That sort of thing is done by the physician,” said Severinac, who thinks properly trained personnel can handle Botox injections and the like, leaving more involved surgical procedures to doctors.
Conceding some professional bias, Severinac thinks it important that plastic surgeons and dermatologists serve as medical directors for med spas. He said many spas are run by non-specialized family physicians. Whoever’s at the helm, he expects the med spa industry to continue its rapid rate of expansion, given their present popularity.
Convenience and pampering are among the main lures of these spas, which typically feature posh surroundings and flexible appointments. Prices are generally competitive with physicians’ fees, though they can vary greatly around the country and from facility to facility. Unlike most physicians’ offices, spas are open on weekends and weekday nights. Some will take drop-ins. Sleek MedSpas in Boston hand pagers to walk-ins without an appointment so they can shop at nearby stores until a consultant is ready to see them. Plasma TV sets in the waiting rooms show programs describing the available procedures.
The cosmetic-medicine spas differ from resort-style spas such as Canyon Ranch in Arizona, which offer health remedies and diagnostic services like stress tests along with massages and nutrition counseling. Whereas the resorts involve overnight accommodations, the cosmetic spas offer a salon-like setting for quick procedures.
Michelle Sanchez, a 35-year-old wholesale office supplies saleswoman, said she plunked down $500 on Restylane, a treatment for lines and wrinkles, earlier this year. She had never had such a procedure before, but a friend told her about Blue Medical Beauty Spa in Sherman Oaks, Calif. She said the store was “really cute,” and she had a consultation with a nurse before her treatment. When she left, her face was “a little swollen, but it wasn’t red or bruised or anything.” She was pleased with the results and is already thinking about doing it again.
Pricing of cosmetic medical services can range widely by provider and region. But the crowded field in some cities is leading to price competition – something common in retailing but rare in medicine. In a West Los Angeles mall, Lumity MedSpa last month was offering a holiday special: 40 percent off all laser hair removal. Botox was bargain-priced at $9 a unit, with a 20-unit treatment running $180. The Web site for Kalologie Skincare, which has shops on elegant Robertson Boulevard in Los Angeles, and an outdoor retail complex in Thousand Oaks, Calif., listed sample prices of $300 and up for Restylane, and $12 a unit for Botox.
Sleek in Boston charges $300 per treatment area for Botox, which is 25 units at $12 a unit. For laser hair removal, Sleek charges $150 per 15-minute session.
Michael Schroeder of The Journal Gazette contributed to this story.
