Plastic Surgery 101

Doctors have killed people during cosmetic procedures. Make sure you know your doctor.

Q. There’s a med spa near my house that advertises Botox fillers and many other cosmetic things. They claim to have a medical director. Can you tell me if that’s legal and what I should look for?

A. Miami is the wild west of cosmetic treatments and procedures. It’s why we have killed more people in cosmetic surgery than any other city.

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A physician must supervise PAs (physician assistants) and nurse practitioners. For a physician assistant to perform cosmetic procedures, he or she must be supervised by either a dermatologist or plastic surgeon. If your med spa is not manned by a physician in those specialties and they are practicing cosmetic procedures, they are doing something illegal.

While cosmetic procedures are safe, in general, there are many situations where a patient will need to see an experienced facial plastic, plastic surgeon or dermatologist to correct a defect or adverse reaction that has occurred. South Florida is notorious for being lax on these laws.

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So here’s my take on what you should do. If you’re going to have injections or treatments of any aesthetic services outside of a traditional physician’s office, you should ask to see the medical director, and ask questions about his or her area of specialty.

Many doctors, experiencing income reduction from curtailed reimbursement from health insurance companies, are creating a business of supervising and overseeing cosmetic injectors with little or no experience. Over the last several years, I have had multiple physician extenders contact me to see if I would be their medical director.

My only qualification was that I would not disturb them and they would just pay me money for my services. Doing this leaves them room to practice without a supervising physician and to make money.

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Dr. Carlos Wolf is a partner in Miami Plastic Surgery and is board certified. Email questions to him at Cwolf@miamiplasticsurgery.com. For more information, videos, and before-and-after photos, follow @carloswolfmd and @mpsmedspa on Instagram.

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