How to choose a med spa: a 10-point checklist

No federal law defines "med spa": whether one is regulated as a medical practice, and who may own it, is determined by each state's medical-practice, nursing and corporate-practice rules.

AmSpa, the medical spa trade association, says med spas "are medical practices," and that a medical director is responsible for all the medical decisions in the practice.

Those decisions are often delegated, but, as AmSpa puts it, "the buck stops with the medical director."

In AmSpa's 2024 industry survey, 74% of medical directors came from outside the "core" specialties of plastic surgery, facial plastic surgery, oculoplastic surgery and dermatology, and 48% of med spas had hired a medical director in the past year.

Ownership varies too: the same survey found 67% of single-owner practices were owned by non-physicians, including nurse practitioners, RNs, physician assistants, entrepreneurs and aestheticians.

AmSpa explains the corporate practice of medicine doctrine behind those ownership rules: many states bar non-physicians from owning a medical practice directly or through a business entity, out of concern that lay control interferes with physician judgment — states range from permissive (AmSpa cites Alabama, Idaho and North Carolina's med spa rules) to strict (California), and management services organization (MSO) arrangements are commonly used where lay ownership is restricted.

On who may treat, AmSpa's position is that injecting a prescription drug such as botulinum toxin is the practice of medicine, so it must be done by a physician, an independent-practice nurse practitioner or another licensed professional acting within their scope, under rules that vary by state.

That gives you the first checklist questions: who is the medical director, what is their specialty, and who will perform your treatment under whose order?

FDA's advice to anyone considering a filler is to choose a licensed provider experienced in dermatology or plastic surgery and trained to inject them.

Whether that describes the person in front of you is partly checkable.

Nurse licenses — RN, APRN, LPN/VN — can be looked up in Nursys, the National Council of State Boards of Nursing's national nurse licensure and disciplinary database, through its QuickConfirm search.

For physicians, a "board-certified" claim should name the board: ABMS member boards certify doctors in 38 specialties, and you can look up a specific doctor's ABMS board certification at CertificationMatters.org.

The core specialties train for years: the American Board of Dermatology requires four years of postgraduate training after medical school — a 12-month clinical year plus three years of ACGME-accredited dermatology residency — and the American Board of Plastic Surgery requires at least 6 years for integrated plastic surgery programs, or 3 years of plastic surgery training after general surgery residency (5 years, or an approved alternate pathway).

Ask how much of the provider's practice is the treatment you are coming for, and what documented training they hold in it.

Marketing titles are not licenses: our research found no state that issues a "master injector" or "certified injector" license, and AmSpa's guidance is that the ability to legally inject comes down to the regulations imposed by the licensing board in your state.

Titles like these, along with weekend-course certificates, are private or marketing credentials that do not change who may legally inject.

A star average compresses everything into one number, and the themes in the text tell you more — whether consultations felt thorough, whether the person treating explained the product and the price, and how the practice handled it when something went wrong.

There is also a federal floor under what a business may do to shape its reviews.

The FTC's Consumer Reviews and Testimonials rule (16 CFR Part 465) bans fake reviews, paying for or conditioning incentives on reviews that express a particular sentiment, undisclosed insider reviews, company-controlled "independent" review sites, and suppressing negative reviews through threats or by hiding reviews based on rating.

The FTC announced the final rule on August 14, 2024, and it took effect on October 21, 2024; the agency can seek civil penalties against knowing violators.

The rule cannot tell you whether any individual review is true, so read for specifics: a review that names the provider, the treatment and the follow-up tells you more than a page of interchangeable praise.

Ask which exact product would be used for your treatment, and where the practice buys it.

The question is not paranoia: on April 16, 2024, FDA warned that counterfeit Botox had been found in multiple states and given for cosmetic purposes, causing adverse events including hospitalizations.

FDA said the incidents involved injections by licensed and unlicensed individuals and/or in non-medical or unlicensed settings, with products that appear to have been bought from unlicensed sources — and federal law requires providers to buy prescription drugs only from authorized sources.

Manufacturer programs can confirm part of this: Allē, Allergan Aesthetics' consumer loyalty program, says its provider directory lists providers that buy Allergan Aesthetics products (the company behind Botox Cosmetic and the Juvéderm fillers) from authorized, legitimate sources.

Read the directory the way Allergan's own terms describe it: except for verifying authorized purchasing, all other information on a provider's listing, including credentials, is entered by the provider and is not verified by Allergan.

Galderma runs ASPIRE Rewards, which covers the Restylane fillers and Sculptra; we could not confirm whether ASPIRE checks where a provider buys its product, so for Restylane or Sculptra, ask the practice about sourcing directly.

For fillers, FDA says the provider should use properly labeled, sealed vials or pre-filled syringes of FDA-approved filler, and it advises against buying fillers sold directly to the public, self-injecting, and needle-free filler "pens," which are not FDA-approved.

For devices, ask for the brand and model, and what the device is cleared for.

Chain pages show what a named answer looks like: Milan Laser says it uses the Candela GentleMax Pro with Candela-certified providers, and Sev Skin says its treatments are performed by nurse practitioners, registered nurses, licensed estheticians and laser specialists using FDA-cleared devices.

Cleared is the operative word: the chains' own words are "FDA-cleared," and that clearance is different from FDA approval — so a device advertised as "approved" deserves the follow-up question of which approval, exactly.

AmSpa's description of the "good faith exam" sets a baseline for what a real intake looks like: before a first treatment, a physician, physician assistant (PA) or advanced practice nurse (APN) takes a medical history and performs an appropriate physical exam, and creates the treatment order.

An RN may assist, but cannot generate the order.

AmSpa suggests repeating the exam when treatments change, when your health changes, or at least annually — the association's rule of thumb, with details varying by state.

Use your consultation to watch the intake itself: the history and exam should come before the first treatment, and a treatment plan you can take home should name the product, the units or syringes, the sessions involved, the total price and who will treat you.

If the history and exam never happen, that is information too — it is one of the med spa red flags.

Med spa price lists follow a few structures: injectables priced per unit or per syringe, laser and light treatments per session or per area, and packages that bundle a series.

LaserAway's published pricing page, read October 16, 2026, shows all three: laser hair removal listed at $99 to $649 per treatment by area, as single sessions or packages of 3, 8 or 10; Botox at $15 per unit, or $10 per unit in a 300-unit bank; and Juvéderm lip filler at $450 per full syringe.

LaserAway says prices may vary by location, so read any chain's published price as that chain's price — at the locations it names, on the date published — not as a quote for your city.

For a national anchor, ASPS's cost page says the average cost of botulinum toxin injections is $435 "according to the latest statistics."

Scope matters when comparing: ASPS describes that figure as the average fee reported by its member plastic surgeons — not a med spa price, and not a per-unit number.

To compare locally, ask each practice you are considering for the total for your treatment plan — product, units or syringes, sessions, aftercare — and put the quotes side by side.

A quote that cannot name the product or the unit count is hard to compare with anything.

Our med spa listings are not published yet, so for now the shortlist is yours to build from the checks on this page: provider credentials, review themes, the products and devices a practice names, and its published prices.

Shortlist the practices near you that pass the first points, then send each one a request that asks the remaining questions in writing — who will treat you, what license they hold, which product and device, where it is sourced, and the total for your treatment plan.

A practice that answers those questions plainly has already done half the work; a practice that will not may be telling you something.