Are Medspas The Walmarts Of Esthetic Medicine?

Health & FitnessBeauty

  • Author Cynthia Elliott, Md
  • Published February 15, 2024
  • Word count 764

When Should You Choose an Esthetic Physician Practice Instead of a Medspa?

Americans spent more than $14 billion on esthetic services in 2021 and Florida is currently home to over 3,000 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, in most states including Florida, the directors aren’t required to even step foot in the premises. Most don’t have a doctor providing any treatments. Medspas, therefore, aren’t prepared to provide esthetic treatments that produce dramatic results.

In contrast to medspas, esthetic medical practices are owned by at least one physician who directly provides treatments and is on the premises. They usually have other clinicians and medical estheticians who are also comfortable providing physician-level treatments and skincare.

So, when should someone choose a physician-based esthetic practice over a medspa?

According to Cynthia Elliott, MD, who owns Skinspirations and ExpertEsthetics Physician Training in Clearwater, FL, “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?

Here are three reasons why a physician-based office may be the better choice for receiving esthetic medical treatments.

Quality of Results

If someone is interested in a pampering facial or a simple Botox treatment of the frown lines, where the worst possible result are asymmetric brows or simply no results, choosing a medspa for the treatment is a reasonable option.

Dramatic improvement such as that offered with combining 3D facial “youthanasia” volumizing treatments and laser skin resurfacing requires the knowledge and experience that only a physician has. Physicians with extensive experience are comfortable with choosing aggressive laser settings or even combining different devices or treatments to achieve the best possible results, whereas medspa providers are more likely to follow a conservative protocol and use a “cookie cutter” approach with the only devices or treatments they’re allowed to use.


Unlike doctors’ offices that are required to follow strict national and state-specific rules for medical professional qualifications, the regulations for medspas are left up to individual states. In Florida, for example, medspas can be owned by people with no 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 and severe infections as well as permanent discoloration.

Some of the severe complications can be avoided with quick action if there’s a clinician with the right training present, but providers with less training than a physician 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.

MoreTreatment Options Are Usually Available

The most effective treatment options for a person’s 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 medspa personnel may recommend one because they’re more interested in a commission rather than a patient’s safety.

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 had a special or their price was the cheapest? Your face deserves the best and safest results possible, so it’s up to you to do your homework. We are frequently repairing the mistakes made by less experienced esthetic providers”.

About Cynthia Elliott, MD

Cynthia Elliott, M.D., is the owner of Skinspirations, a cosmetic and regenerative medical practice in Clearwater, FL that provides the most advanced nonsurgical treatments available. Having performed over 86,000 cosmetic medical treatments and training hundreds of other physicians, the clinicians at Skinspirations are known for providing the quality of results that most esthetic clinicians are still trying to learn. For more information, visit

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