Irvine, Calif. — A new service based here promises to bring Botox Cosmetic (botulinum toxin type A, Allergan) and injectable facial fillers to patients' workplaces.
For sources contacted by Cosmetic Surgery Times, however, the service raises concerns about the treatments' quality, efficacy and safety, while highlighting the issue of nonphysician medical practice.
Like any new service, Mr. Fisher says, "It will take a little time. But I'm sure it will catch on."
Red flags raised
Already, the service is raising red flags among dermatologists and plastic surgeons.
"It has a lot of potential problems," says Bruce E. Katz, M.D., director of Juva Skin & Laser Center in New York and clinical professor of dermatology at Mount Sinai School of Medicine.
Dr. Katz raises two concerns.
Botox must be kept cold but not frozen, he notes, because temperature extremes impair its potency, as does shaking.
"A patient might not be in a comfortable chair, and can move when they're being injected," resulting in a needle in the eye, he adds.
Mr. Fisher counters that to prevent problems, MobileBotox uses the same procedures as its brick-and-mortar counterpart, on the advice of NYLM's medical director, Neil Neimark, M.D.
He adds, "The PA has ultimate authority" to deny treatment if a workplace fails to meet sanitary or other requirements.
"I'm quite surprised that this is taking place, because none of the consultations or treatments are done by a physician," says Vic A. Narurkar, M.D., a San Francisco-based dermatologist in private practice, assistant clinical professor of dermatology at University of California, Davis, Medical Center and president of the American Society of Cosmetic Dermatology and Aesthetic Surgery (ASCDAS).
Dr. Narurkar also expresses concern that Dr. Neimark is a general practitioner, not a dermatologist, plastic surgeon or other core specialist. Dr. Narurkar says he and some colleagues are conducting an ongoing multicenter study cross-referencing complications resulting from nonphysician treatment with medspa medical directors' specialties.
According to preliminary findings, he says, "The majority of complications occur in situations where there isn't a dermatologist or plastic surgeon who is the physician of record."
"We don't have that concern," Mr. Fisher says. "Dr. Neimark is getting hands-on training for all the injectables from the manufacturers," he says.