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The zen of spas: Do we need them?: The path to patient awareness may very well mean that the answer is a resounding "yes"


Dr. Carraway
In my practice, not a day goes by that I don't receive a magazine about the spa business, a flyer about a skin care meeting, and at least several advertisements on body and skin care products to improve appearance and aging of the skin.

Several years ago, most of our colleagues decided that they needed to offer some type of skin care program in their offices. Some did this as a way to inform their patients about better options for aging skin and some did it as a way to enhance profit margins, particularly if they did not have a busy cosmetic surgery practice.

I've talked to a lot of people, read a lot of articles, and heard discussions about skin care center location at meetings on many occasions. In our clinical practice, we have the office which includes clinic, administrative and operating suites, but no skin care center contained within. However, across the hall is the medical skin care center, which also has a "day spa" menu.

DEFINING TERMS So what's the difference between a spa, a day spa, a medical spa, a medical skin care center and a complete spa?

The answer lies in definition of the range of services. Most cosmetic surgeons have a medical skin care center because the products are doctor prescribed and are also sold to medical skin care clinics. Any of these centers may provide aesthetic procedures including facials, peels, massages and so on, but the differentiating services provided by medical skin care centers include Botox, Restylane, TCA peels and other medical procedures. A day spa, on the other hand, may have a menu of services including all of the aesthetic nonmedical procedures plus yoga, exercise and even diet. These services may be offered by the day only (hence the name "day" spa), but some facilities may also provide longer-term services where you can stay for several days or weeks to "get your body back in the best shape."

WIN-WIN I believe that medical skin care centers with day spa facilities have been one of the best things that have happened for patients as well as for plastic surgeons. These offer awareness of skin aging, advice on how to take care of the skin and prevent damage and aging, and a plan of treatment for most people that ranges from minimally invasive to more complex treatments. I believe that it has al so improved the economic positions of some practices, but I think that the important aspect of the rising interest in skin care treatment is getting the message and the treatment to patients. We do our best work as plastic surgeons structurally improving the appearance of the face or body, but these are enhanced by skin treatments.

In our aging patient population, when the "glow" begins to fade and the skin begins to relax, something more than just plastic surgery is needed. Surgical procedures can tighten the skin and improve contours with fat grafting and fillers as well as Botox and other modalities. However, as a woman ages, the glow can be replaced with glamour, which includes better skin, better use of makeup, and an awareness of keeping skin aging to a minimum.

It is not uncommon in our practice to see someone with moderately severe aging of the skin, wrinkles, and other age-related skin changes almost completely reverse all of these changes over a period of time with good skin care and good plastic surgery. People seem to "grow younger" now with the availability of skin care treatment options and spas to help them as they get older. Also, emphasis on the nutritional pathway, as well as other lifestyle changes such as exercise, has made a huge difference in patients' long-term results.

In my opinion, any spa that offers services heightens patient awareness of the need to take better care of themselves. Day spas combined with medical skin care centers are an excellent option. Longer term spas — with or without an associated medical doctor or plastic surgeon — are also great offerings for patients. It's time we all got on the bandwagon to offer the best skin care and body care as well as anti-aging techniques and nutritional pathways for our patients.


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