Face Value

The Beauty Boom

Nationally, women are the biggest users of both cosmetic surgery and nonsurgical cosmetic procedures, accounting for 92 percent of the total last year, according to the New York-based American Society for Aesthetic Plastic Surgery. At Skin Speaks SPA MD, women are also by far the primary clients.

Since 1997, the total number of cosmetic procedures has increased by 446 percent, with surgical procedures rising 98 percent and nonsurgical treatments soaring 747 percent.

"The women in this state, this culture, the Scandinavian-German mentality, probably segues from 'Minnesota nice' to 'I am relatively content with who I am as is.' And yet I think there is a movement to break out of that," Carney says. "Minnesota men are not as metrosexual as men on the coasts. They are a little more content with their appearance as is."

Growth in the nonsurgical cosmetic treatments in which medical spas specialize is far outstripping that of surgical counterparts. According to the American Society of Aesthetic Plastic Surgery, nearly 9.6 million nonsurgical cosmetic procedures were performed last year in the United States, compared with only about 1.9 million surgical cosmetic procedures. Since 1997, the total number of cosmetic procedures has increased by 446 percent, with surgical procedures rising 98 percent and nonsurgical treatments soaring 747 percent.

According to the Illinois-headquartered American Society of Plastic Surgeons, the Midwest accounts for 15 percent of all minimally invasive cosmetic procedures given in the United States. That compares with the New England-Middle Atlantic region with 21 percent, the South Atlantic with 21 percent, the South Central region, also with 15 percent, and the West with 28 percent. The treatment that has gained the widest acceptance in the Midwest is laser skin resurfacing. The Midwest accounted for 29 percent of all such treatments performed in the United States last year, higher than any other region—except the West, with 30 percent.
 
Medical spas originated (may-be not surprisingly) on the West Coast about a decade ago; in the past five years, they've rapidly spread across the country. Several factors have fueled their growth. "First, doctors are looking for sources of income to replace income lost to insurance companies," says Eric Light, president of the New Jersey-based International Medical Spa Association, who asserts that, on average, doctors collect 65 cents for every dollar they bill an insurance company. "Second, consumers are looking for new ways to manage aging. And third, manufacturers of lasers recognized a potential market with the cost of lasers coming down and with new uses for lasers, including hair removal and skin resurfacing."

But the factors driving the development of medical spas go back even further. In the 1980s, Carney says, "things started moving fairly quickly in the world of plastic and cosmetic surgery. It started interfacing more with dermatology. For example, new procedures—chemical peeling, microdermabrasion, fillers like collagen—were being offered for treating imperfections [and] for enhancing beauty. And they were directly related, for the most part, to someone's skin. As a dermatologist, it was a natural extension for me to be interested in enhancing someone's beauty through [his or her] skin."

It was patient demand, Carney says, that drove him to open his medical spa: "It occurred to me that there was one too many people coming into my office saying, 'I'm interested in these procedures. Do you offer them?' And I'd say, 'No, that can be done by your aesthetician or maybe by someone who is working with a plastic surgeon.'

"Yet I realized that an aesthetician or even a plastic surgeon [did] not have the expertise that I had as a specialist in skin or dermatology," he adds. "So I felt it was necessary to provide these services to patients or clients in a medically supervised facility."