 A
merging of Medicine & Spas
At a free evening reception at the Vita Spa in Roslyn, Helen Proimus
nibbled finger sandwiches and chatted
with other guests about the pleasure of pampering themselves. The
sound system lulled them with the soothing music of a typical spa:
“Reflections of Nature,” Kenny G. and “Zen: The Art of Relaxation.”
When Proimus settled in a private room in the back, though, she
wasn’t receiving a typical spa service - no
facial or pedicure or massage. Instead, Dr. Karina Bibicheff, an
internist who runs the business, projected a digital scan of Proimus’s
face onto a screen, throwing into high relief every imperfection
that might go unnoticed in softer light.
Then Bibicheff recommended treatments usually available in doctors’
offices: Botox injections to ease wrinkles around the eyes, filler
injections to plump up the lips and laser treatments to reduce the
redness of broken capillaries in the cheeks.
Proimus headed home to consider her options. But she didn’t give
much thought to the novelty of getting those procedures in a spa
environment instead of a medical office. “I like the decor,” Proimus
said. “There is a doctor
here. They aren’t doing anything so severe that I’d have to be worried
about it.” Increasingly, clients like her
seem comfortable at hybrid enterprises like the Vita Spa. Known
as medspas or medispas, such businesses
combine standard beauty treatments with medical interventions.
It all takes place under the supervision of a physician, but in
the setting of a spa.
Medspas satisfy the public’s growing desire to do what it takes
to look younger, preferably in posh surroundings. They also fulfill
the desires of doctors who want to enhance their incomes with high-profit
cosmetic procedures that don’t involve dealings with insurance companies.
The idea emerged around 2002, when there were 25 medspas nationwide,
according to Hannelore Levy, executive director of the International
Medical Spa Association. Now she estimates that there are more than
2,000.“The growth has been tremendous,” she said. Singing a familiar refrain,
she added: “It’s the baby boomers. They don’t want to get old.”
Twelve on LI
On Long Island, at least 12 medspas have opened since 2002. Their
clients lounge on satin pillows in candle-lit treatment rooms painted
in restful shades of beige and taupe, receiving just about any cosmetic
procedure short of surgery. Although prices vary, they pay fees
in the neighborhood of $800 for 10 minutes of a variety of injections,
$300 for 15 minutes of laser treatments like hair removal or $175
for an hour of microdermabrasion of the skin, according to Dana
Caruso, founder and president of the Long Island Nail and Skin Care
Institute, a school for aestheticians that also houses a medspa
in Levittown.
“The day of the major facelift is kind of over and done with,” said
Caruso. “Now it’s about doing sections or areas of the face in subtle
ways, so that you don’t get that blowing-in-thewind, 75-mile-per-hour
look.”
Medspa operators say an outpatient setting is appropriate for these
increasingly popular treatments. And popular
they are. The number of nonsurgical cosmetic procedures in the United
States increased from 1.1 million in 1997 to 9.5 million last year,
according to the American Society for Aesthetic Plastic Surgery,
while surgical procedures
merely doubled, to 1.9 million. Botox injections led the way at
3.2 million, followed by filler injections, laser hair removal,
microdermabrasion and laser skin resurfacing.
Scrutinize Before Choosing
But the businesses are prompting debate over where and how clients
receive such services. Caruso warned, “Buyer beware. You see places
popping up along major thoroughfares that have signs in the windows
— laser
hair removal. What does that mean? Is there a doctor supervising
it?”
Dr. Alan Gold, a plastic surgeon who performs outpatient procedures
in his Great Neck office, said that medspas may lead patients to
take procedures too lightly. “I know people who will travel 30 miles
to get their hair done,” said Gold. “But they don’t investigate
these services in the same way, because they’re being pushed as
spa services and they appear very benign.”
And Gold warned patients against unrealistic expectations. Perfectly
airbrushed, wrinkle-free skin is rarely possible. “Some treatments
are very effective,” he said. “But it shouldn’t be like the emperor’s
new clothes,
when you’re convinced that you look better, but everyone else is
laughing behind your back.”
Dr. Stephen Greenberg, a Woodbury plastic surgeon who serves as
the medical director of Caruso’s facility,
expressed reservations as well. “The business of medspas is booming
because everyone wants a piece of the cosmetic pie,” he said.
Some such facilities encourage patients to try treatments that may
not be appropriate, he said. For example, Greenberg said he would
not use the digital facial scan offered at the Vita Spa and others,
because he views it as a marketing tool, designed to show clients
at their worst and convince them that they need intervention. “The
companies that make this equipment emphasize how much money doctors
can make from using it,” he said.
Hope springs eternal in beauty and in business, so physicians and
investors are jumping into the medspa
market. Bibicheff opened the Vita Spa two years ago. Board-certified
as an internist, she spent a year working and studying for a fellowship
in geriatrics. She switched to cosmetic medicine, she said, because
she realized “people who like the way they look live better.”
Bibicheff said she uses the digital facial scan in her medspa because
she shows clients a new one after treatment, so they can see the
improvement. “It’s more for later,” she said, “not to scare them
in the beginning.”
Over 40 and Ready
Helen Proimus, an actress who lives in Dix Hills, seemed to be typical
of the spa’s customers: Female, over 40 and worried about the effects
of sun damage on her skin. “I just want to make sure I don’t look
older than 30,” she joked.
After looking at the digital scan of her face, her humor got darker.
“My God, I’m almost suicidal,” she said. “I’m going to need to win
Lotto.” The doctor wasn’t specific about the cost, but it was clear
it would run more than a
thousand dollars.
A businessman rather than a doctor opened the Bella Mi MedSpa in
Plainview in September. Charles
Guerriero, the managing director, worked on Wall Street for 30 years
before deciding to start a business. “I looked at many things, but
the thought of owning a Carvel franchise, or one of the many franchises
that are out there, didn’t seem mentally stimulating enough to me,”
he said. Guerriero had noticed that the stocks of laser
manufacturers were doing well, thanks to the rising interest in
cosmetic procedures. He linked up with a company called Solana MedSpas,
which advises medspa owners and takes a percentage of their revenues.
A family
practitioner joined him as medical director, mostly performing injections
while physician’s assistants perform other tasks.
The Long Island Nail and Skin Care Institute, the school that trains
licensed aestheticians, has long operated a standard day spa on
the premises. Three years ago, Greenberg, who practices plastic
surgery in Woodbury, started providing medical services there. A
client, Juliana Carambia of Dix Hills, said she hoped they would
help her fend off the effects of age.
Only 22 years old, with pale, flawless porcelain skin, she nevertheless
lay back on a gold chenille throw recently
for a microdermabrasion treatment. An aesthetician rubbed a wand
over Carambia’s face, pummeling it with tiny crystals with the goal
of exfoliating and preventing fine lines.
“I’m trying to slow down the aging process now,” said Carambia.
“Just keeping up a regimen is important.”
The treatment wasn’t painful, she added. It gave her a sensation
of slight scratching, like a baby drawing its fine nails across
her face. Someday, Carambia said, she might consider Botox injections.
In the next treatment room, Greenberg inserted a needle right between
the eyes of Deanna Thomas, 40,
of North Massapequa. The skin swelled up briefly as the Botox liquid
pooled, then slowly smoothed as it dispersed. Greenberg placed additional
shots in her forehead and the crow’s feet area next to her eyes.
“I don’t really care what anyone else’s opinion is,” Thomas said
as the doctor worked. “I do it for me.”
Greenberg mopped up a tiny trickle of blood from above an eyebrow,
but Thomas smiled and said she didn’t view the procedure as particularly
medical. “If you look in the mirror and you appear younger, it makes
you feel younger,” said the patient. “That, and a new pair of shoes.”
Originally appeared in Newsday.
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