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Chatelaine.com, September 2012, 10 things you need to know before getting cosmetic procedures

A recent visit to Toronto's Glow medi-spa, run by Dr. Diane Wong, MD, not only opened my eyes to the incredible advances being made in the cosmetic world, but also worried me when I learned about the lack of regulations surrounding some of these procedures.

by Robyn Shanks, Wednesday September 26th, 2012
 

A recent visit to Toronto's Glow medi-spa, run by Dr. Diane Wong, MD, not only opened my eyes to the incredible advances being made in the cosmetic world, but also worried me when I learned about the lack of regulations surrounding some of these procedures.

While chatting with Dr. Wong I learned that a lot of the patients she treats are there to have botched procedures — think Botox gone bad — fixed by her, a trained doctor. I chatted with her about how patients can take safety into their own hands when it comes to cosmetic surgery and what they need to look for when choosing the best location for their treatment. Here, Dr. Wong lets us in on the truth behind this booming industry:

1. What's in a name? "The term 'medi-spa' is used to refer to a medical clinic that provides medical skin treatments and that is owned, operated and supervised by a qualified medical physician. Unfortunately, that description now rarely holds true. Without any restrictions on the use of the word 'medi-spa', it has now become open to interpretation."

2. Ensure there’s a physician on-site. "At the very least, a medical physician should be available in a medi-spa to establish a patient-physician relationship, assess the patient, and make recommendations, discuss risks and benefits, and obtain informed consent. Furthermore, should complications arise, that medical physician should be readily available and versed in possible treatment options."

3. Just because they have it, doesn’t mean they’re qualified to use it. "Botox and Latisse (for eye lashes) are prescription drugs and can be obtained only through a physician. Dermal fillers are usually sold to physicians solely and are considered medical devices, however, often the physicians purchasing these prescription drugs and dermal fillers turn a profit by selling the product to medi-spas (which is of course not allowed)."

4. Check their credentials. "These 'medi-spas' can provide medical services, such as Botox injections and advanced laser treatments, never having a physician involved. Furthermore, they will use the physician’s name, secured as a medical director to the medi-spa, to imply the presence of proper supervision, when it may be the case that the physician is only remotely involved."

5. Money does not equal credibility. "It is fairly simple in Canada to purchase cosmetic injectable products and lasers. All you need is the money to make the purchase and a willing physician to give you their physician number (this of course comes at a fee). This should not be the case, but does occur frequently. Many laser companies don’t even require a physician anymore and will sell the machinery to any spa, hair salon or nail shop in Canada."

6. Use lasers with caution. "In Canada, there are currently no regulations for laser use. Anyone can own and/or operate these machines. Lasers should be viewed as weapons and are potentially very dangerous. In poorly or untrained hands, they can cause serious and permanent damage. Laser skill requires not just intellectual comprehension of laser physics; it also requires a great deal of common sense, judgement and manual dexterity. Safe use of lasers cannot be taught by a laser company in 1-2 hours, as is the common practice nowadays. To be adequately trained in the use of lasers, it requires many hours of study and supervised clinical practice."

7. Know the risks. "Burns resulting from laser hair removal can lead to both temporary and permanent problems. Temporary problems include discomfort or pain that lasts longer than the treatment session, swelling, redness, blisters, infection, and discolouration. Permanent problems can include scarring, or hyper or hypopigmentation (darker or lighter patches of skin). Ineffectively trying to treat hair with low-powered lasers or treatment using the wrong settings can actually distort the hair and cause it to grow back abnormally (think coiled or wiry) and can result in even more difficulty when treating with subsequent laser treatments.

Mistreating veins with laser vein treatments can lead to serious complications such as vascular impairment, which leads to poor circulation in the foot, wounds, infections, ulcers and scarring. Lasers are often used to treat other skin conditions such as sun spots or pigmentation but if a suspicious skin lesion is not recognized, and a medical doctor has not been consulted, a potentially harmful medical condition, such as skin cancer, can go undiagnosed."

8. Do your research. "I would recommend that you research that doctor and that clinic. At the minimum, use Google to find out as much about that doctor and clinic as you can before going for your assessment with the doctor. If you are having Botox, dermal fillers, sclerotherapy, or other injectables, you are required to see a qualified registered doctor for consultation. To determine whether or not they are a registered physician in Ontario, check the CPSO website. If the clinic does not have a qualified doctor that will be seeing you personally, don’t go there."

9. Ask the right questions. "Start by asking how they were trained, how many procedures they have done, how long have they been doing the treatments, how many complications they have had, as well as ask to see before and after photos of some of their own clients who have given permission to use their photos. You cannot ask for testimonials since that is against the CPSO guidelines."
Click here for more info from Health Canada on the matter.

10. Don’t look for a bargain. "Now is not the time to be cheap and look for a discount. Avoid buying group discount deals on-line. You need a full assessment by a qualified physician prior to making your decision about injectable treatments. To get quality service, you often have to pay for it. Remember that you are not just paying for the product that is being injected into your face. You are also paying for the skill and expertise of the person assessing you and doing the treatment."