A Florida woman's quest for more youthful skin turned deadly this past July when her face became dangerously swollen after she received vitamin injections at a day spa.
Isabel Gonzalez paid nearly $900 for "facial rejuvenation" injections at Viviana's Body Secrets Spa in Doral, Fla. After receiving the treatments, her face started to swell and became infected, and she soon landed in the hospital, where she spent more than two months. Doctors fear her face may be permanently deformed.
The spa owner, Viviana Ayala, was arrested this week on charges that included aggravated battery and practicing medicine without a license, according to a report from the Doral Police Department. Ayala wasn't trained or certified to deliver facial injections. She wasn't even a licensed massage therapist as she advertised on her website. Ayala, according to the Miami Herald and other news sources, has denied all charges against her. Neither Ayala nor her lawyer, Milena Abreu, could be reached for comment.
Experts are alarmed at the increasing number of people seeking such cosmetic procedures. According to the organization Cosmetic Plastic Surgery Research, more than 8 million people underwent cosmetic treatments to freshen up their appearance last year. Treatments included Botox, chemical peels and laser skin resurfacing, and consumers migtht not be aware of the risks.
"Cosmetic procedures are now so mainstream there's a misperception that it's like getting your hair done," said Dr. Leo R. McCafferty, a board certified plastic surgeon who is president of the American Society for Aesthetic Plastic Surgery. "They are inherently safe, but this is predicated on [their] being delivered by properly trained professionals in a properly equipped facility."
ASAPS recommends that cosmetic procedures be performed only by board certified plastic surgeons or dermatologists in an accredited facility, although some states also allow registered nurses and physician's assistants to deliver therapies under doctors' supervision. Members of the ASAPS, and similar professional organizations, are required to operate only in certified centers or hospitals.
Some spas meet these criteria, but even if a facility brands itself a "medispa," that's no guarantee of proper oversight. A clinic may claim it's affiliated with a board certified plastic surgeon, but a surgeon might only show up to check charts once a month. Or a spa may try to pass off a practitioner who has no medical training as a cosmetic surgeon. Although this is illegal in some states, McCafferty said, no one's really checking.
Dr. Nima Patel, a plastic surgeon at Maimonides Medical Center in Brooklyn, N.Y., said spas can mislead consumers in other ways, too.
"Most people know they probably shouldn't get an injection from the same person who gives them a massage but don't think twice about letting a dentist or a physician who doesn't have intensive training in a cosmetic specialty give them an injection," she said. "In some spa settings, this is who is delivering the services."
Patel also emphasized the importance of making sure the attending professional maintains privileges at a nearby hospital and remains on the premises when cosmetic procedures are done. If there are side effects or complications, a patient can be transferred to the emergency room.
Dr. Felmont Eaves, a Charlotte, N.C., board certified plastic surgeon in private practice, advised any consumer considering any type of cosmetic touch-up to do their homework. "Check out the credentials of anyone performing or overseeing your treatment and know the risks of the product you are considering," Eaves said.
As for bargain hunting, Eaves warned against it.
"Price is where illegitimate practitioners entice people to throw legality and caution and safety to the wind, but cosmetic procedures are expensive because of the extensive training and education board certified surgeons and dermatologists go through -- these are not areas where consumers should be looking to skimp," said Eaves.
And ironically, the cost to fix a botched cosmetic procedure is usually much higher than having it done right to begin with by a qualified professional.
Eaves called the Gonzalez case "especially heartbreaking" in light of the fact that the vitamin injections she received weren't approved by the Federal Drug Administration and were probably worthless.
"Even with no complications, it was likely she was being defrauded. Many legitimate procedures would have cost her considerably less," he said.
Sometimes those complications can be irreversible or life-threatening. Gonzolez's lawyer, Diana Santa Maria, said Gonzalez seems in for a very long recovery and is about to file a civil suit against Ayala.
To find more information about where to go and how to choose a cosmetic treatment provider, check surgery.org. The average cost of many common procedures can be found on infoplasticsurgery.com. A list of the pros, cons and risks of many cosmetic products can be found at injectablesafety.org.