What used to be called a health spa is now often referred to as a "med-spa" in several Iowa cities, offering a host of cosmetic procedures to a target audience that’s getting younger. Dr. Steven Hopping, president of the American Academy of Cosmetic Surgery, has concerns about the trend in Iowa and elsewhere, as "spas" used to offer simple beauty treatments and pampering.

"Facials and waxings, massage, wraps, but no more. A medspa also incorporates injections, laser hair removal, chemical peels, various laser treatments for the skin," he says, "so it’s a whole different ballgame from the traditional spa."

Hopping says medspas are doing more invasive cosmetic procedures for walk-in clients. He says there are serious questions to ask before letting the staff treat you.  "Patients have to realize these are procedures and this is not a facial, just like if you were having any procedure, talk to a doctor, find out how many they are doing," he says.  "Is the doctor going to be doing this or is a technician or are you going to be meet the person at all? If you have a complication, who is responsible? Who’s going to take care of it?"

While spas used to cater to women in their 40s and well above, Hopping says younger women tend to visit these new medspas, women as young as 18. "Now, maybe they’re less inclined to call a traditional doctor’s office to have these things," he says. "Maybe they’re caught up in this interest in maintaining youthfulness as long as possible. That is sort of the new philosophy in cosmetic surgery — lesser procedures, lesser invasive things earlier on."

Hopping says people need to be informed before walking into a medspa. For example, a botched botox procedure can cause double vision or cause one eyebrow to droop and the other to be elevated. Hopping says even simple things like laser hair removal can end in tragedy. "There have been deaths from the application of the topical numbing cream that is used before laser hair removal. These are medical treatments. You have to have medical knowledge of how these things work, who is a good candidate, who is a bad candidate and how to treat the potential complications. Physicians should be in charge."

A recent survey shows about one in five women said they might visit a medspa, while one in four said they would -not- go. It’s not cheap. Women with a household income of $100,000 per year or more were nearly two times more likely to have non-invasive cosmetic surgery.