What to Look for When Choosing a Med Spa

Dr. Houssock (00:01):
You are listening to another episode of Perfectly Imperfect. Hi, Lindsey.

Lindsey (00:06):
Hey, Dr. Houssock.

Dr. Houssock (00:07):
It's been a while.

Lindsey (00:09):
It has. I was thinking about that this morning.

Dr. Houssock (00:11):
Welcome to the Perfectly Imperfect Podcast.

Lindsey (00:13):
Thank you so much.

Dr. Houssock (00:14):
I'm also glad to be here. Like I said, it's been a bit, we took a little hiatus, not for any particular reason, just we got busy. We had the holidays, and so we're really excited to start 2026.

Lindsey (00:26):
Yes.

Dr. Houssock (00:27):
We're really passionate about the topic we're going to talk about today.

Lindsey (00:30):
Yep.

Dr. Houssock (00:31):
So Lindsey and I are going to dive into the world of spas, medical spas, and you might at first glance say, why is a plastic surgeon talking about medi spas? And that might be a reasonable question in the modern world of medi spas and what you see out there. But I will tell you, if we take it back a bit historically, it will make perfect sense very quickly.

Lindsey (00:57):
Yeah. So follow along with our journey.

Dr. Houssock (00:59):
Yeah, here we go. So generally speaking, let's just talk nonsurgical treatments, which for most people who are going to be listening will understand. That's what MediSpa does most nonsurgical aesthetic treatments, A lot of medis spas are diving into all other types of avenues. But we're going to just for the sake of this conversation, talk about medis spas as being the non-surgical side of medical aesthetics. Let's just start with that. Right.

Lindsey (01:23):
Okay.

Dr. Houssock (01:23):
Reasonable.

Lindsey (01:23):
So we're talking Botox fillers, lasers.

Dr. Houssock (01:25):
Right.

Lindsey (01:26):
The basics.

Dr. Houssock (01:27):
Let's just start with that.

Lindsey (01:28):
Okay.

Dr. Houssock (01:29):
And we'll dive at another time into the other things that can be found there. But that is what I would say a general modern MediSpa offers. And so if you take it back, I'm going to guesstimate here, less than 10 years, less than 10 years in general, the Botox filler Dysport laser world was predominantly in a medical office comprised of either a plastic surgeon or a dermatologist. So it hasn't been that long. Now that doesn't mean necessarily even back then that they were being done by the dermatologist or the plastic surgeon alone, but they were being done in that type of setting, and that was it. And so the reason why we are even talking about this today is I had a patient very recently who asked me a question about Botox and said, I know this really isn't your thing. And I was really taken aback by that.

Lindsey (02:29):
Yeah, it's absolutely your thing. It's always confusing, I think, for people about board certification and what you learn about this nonsurgical side because when you hear the word plastic surgeon, you think, oh gosh, well, you just live in the OR. That's all you do. So what do you actually do when you're in your training that also is nonsurgical?

Dr. Houssock (02:50):
That's a great question. So while of course my residency training was based very broadly in the operating room and doing surgical plastic surgery, the aesthetic world is much broader and so is our training. And so while, yes, the majority of our work is done in that operating theater, we also had training in our residency that was specifically in the non-surgical realm for me. I went to Johns Hopkins for my residency training. We were trained with mentors, how to perform Botox, how to perform filler, and how to utilize lasers. That was part of the training. It wasn't just on the side like, Hey, I'm a surgeon while I'm at it, since I know the anatomy, I'm going to start doing this stuff. It was actually a part of our training, and I would argue it's the same for dermatology as well. While we know dermatologists as medical side of the skin, they also in their training, learn how to do Botox and fillers and lasers.

(03:58):
They learn how to use them. So why is that important? Well, it's important because we're the only two that do to this day. We're the only two groups of medical professionals who actually have it in our training. And you asked about it board certification. We are also the only ones who have it actually as part of our exam to become boarded. So again, when I do my boards, when I studied and did my written boards and then also my oral boards to become a board certified plastic surgeon, there were questions on that exam about Botox and filler and lasers. All of it was on the boards. To this day, we are the only group, again, us and dermatologists who are tested and examined in that way. So why go into that? Because in the end, this is our thing.

(04:48):
This is our thing. And unfortunately, right this second, no other medical professional or otherwise has a regimented way of learning how to do Botox, fillers, et cetera, in a very ethically and regulated realm. So that's how it used to be. And for the early stages of aesthetics that made sense. And so patients would go to plastic surgeons and dermatologists get their Botox. And then somewhere probably in the last 20 years, I would say it became very common for plastic surgeons and dermatologists who have nurses and nurse practitioners and PAs depending on the state. And we're not going to go into regulation today because states are different. State to state is different on who can do what. But in the United States it varies. But in Maryland, legally a nurse can do injections and Botox, they can do some lasers. Nurse practitioners can independently practice in Botox, fillers, lasers, and they can actually, and when I say independently, it means they can practice without a medical doctor overseeing them, and a PA has to have a physician. Is that right?

Lindsey (06:09):
Yep, that's correct. Nurses can't prescribe medications. So when you talk about dosing of Botox, technically that would be prescribing the dose. And so that's where that regulation gets a little funky for nurses in the state of Maryland.

Dr. Houssock (06:22):
Interesting. So Botox is considered a medication, a prescription.

Lindsey (06:25):
Giving a medication. And so you have to be a little bit careful and you have to have someone above you, either a nurse practitioner or a physician to lead that.

Dr. Houssock (06:33):
So again, why are we diving into this? Because as we all know, the world of the MediSpa has, I mean, I can't even use the word blossomed. It's like

Lindsey (06:45):
Exploded.

Dr. Houssock (06:45):
Yeah. It's an explosion. And regulation hasn't been able to keep up fast enough. It's not just because these places are being built fast. The interest is fast, meaning that it used to be that everyone would go get their hair dyed and get their hair cut, and that was a very common thing. But not a lot of people talked about their Botox and fillers. And if you did it, it was a big luxury and not a lot of people were doing it. And this isn't that long ago. Again, this was within a decade ago or less, but now it's kind of mainstream to have aesthetic procedures done, which is really awesome and amazing and we love it and we're so glad for it. But because it boomed so quickly, the regulation has not been able to keep up as fast. And so once again, we started out in a medical practice where you would have a plastic surgeon or a dermatologist overseeing other individuals performing these injections, and it was completely allowed and legal and safe. And when I started here with Dr. Vogel in 2017, he had a nurse performing all of the Botox and fillers. He just found himself wanting to be the surgeon, and he had a nurse who did all of the injections in the practice. She also did, they didn't have a whole lot of lasers back then. This was 2017, but they had a couple.

(08:05):
So she would perform those. She would do microneedling. Again, we're taking you back 10 years. And then I started in practice and I'm a different generation. I was doing a lot of injections on my own. I was doing half and half, I was doing the OR and then I was doing injections as well. And then again, our practice evolved. And so Lindsey started here right around when I did as a nurse, and then she became a nurse practitioner. And then if you wouldn't mind talking about your journey into how you started doing the non-surgical aesthetics.

Lindsey (08:36):
Yeah, so it's interesting because unlike plastic surgery and dermatology and residency and training, we don't get anything in nursing related to aesthetics. So I went to Hopkins for my RN did my NP. There's no specific training in aesthetics, so you really have to do that outside of your school training. I was lucky I was here. So I had great training through being with Dr. Vogel, through being with Dr. Houssock, through trainings arranged by companies. So Restylane would have trainers that would come in and Galderma and teach us, which was fantastic. Since then, I've also done some classes, anatomy classes, cadaver labs, general classes and courses. And those are helpful once you've actually been injecting. I would say if I started there, I think it would be more difficult. Looking back, you really, it's a feel you have to do the procedure to really understand it in a way that you could learn from a lecture about what they're talking about. So I think those classes are more helpful once you're a more seasoned injector and you've got some experience and you can understand what they're talking about just by watching what they're doing. Otherwise, I think you need to be hands-on, which is the kind of training that you had, which is so much more helpful. So most of my training in aesthetics was actually here.

Dr. Houssock (10:02):
Hands on, with a mentor, with several mentors.

Lindsey (10:06):
Right. Several through the years and continue to be. So if we get a new product, if we get an opportunity for just another advanced training, I'm always all in. Yes, absolutely, let's do it. Because you learn everyone injects slightly differently and you pick up small things that I sometimes bring into my practice, and other times I do the training and think, I don't think I will inject that way. And that's fine. But it's just what you like and what you're comfortable with and what you think will give your patient the best outcome. My certification is actually family nurse practitioner, so I'm certified in primary care really across the lifespan.

Dr. Houssock (10:44):
So it's interesting because you have Lindsey who's risen through the ranks. She did it very early in the sense that she wasn't always in aesthetics. She was in the hospital, she's done labor and delivery as a nurse. And then she came here and just got into the practice to do some or stuff with us. She was a recovery nurse. And then over time, we fostered over time the other side of what she can do here. And then she became a nurse practitioner. While she could have done the injections and all of that, still as a nurse legally in the state of Maryland, her NP does allow her a lot more autonomy in this practice where in a lot of ways, I would argue that I kind of run that surgical side of the practice now. And Lindsey runs the non-surgical side of the practice, and it works phenomenal for us.

(11:36):
We don't take that lightly and we also don't take it lightly that not every person who's interested in aesthetics, who's either a nurse and a practitioner or a PA can get a job at a plastic surgeon or a dermatologist's office, be mentored and learn and then go out and do this thing. We get that what she has is a really wonderful thing. And so we not, as we talk about these independent MediSpa here in a moment, we are not saying everyone needs that, but I am saying everyone needs something like it. And right now it doesn't exist. And it is really going to be our job, the people in the community who are out here doing this to make sure that happens. Because everyone whose desires to do this should have the ability to get great education and safe education, and patients should know that you've been educated and that you're safe. And right now, I don't truly believe that that is completely steadfast and perfect.

Lindsey (12:34):
No, I would agree.

Dr. Houssock (12:35):
So we do have a nurse here at the practice who also does inject. She started practicing in another plastic surgeon's office years before she started with us. Her story is somewhat similar. She started in the, or she learned through that plastic surgeon how to trained how to do Botox and fillers and lasers. Then she came to our practice and continues to do that. She's half and half. She does or side and injector side, but again, same story as Lindsay where she had one-on-one experience with a plastic surgeon in the office. And to this day still, they both do. So they're both expert injectors at this point, and they still have the backup and the safety of having a plastic surgeon in-house at all times where if something is going on or they need to, there's an emergency or they need someone to bounce something off of, they have that, right?

Lindsey (13:27):
Yes, absolutely. And the other nice side of it that we won't delve into today because it's a whole topic on its own, is I love the ability to say, I don't know that I can treat you and get you the result that you want. Let me just walk down the hall and grab Dr. Houssock and have her pop in and tell you what she could offer you. And so it gives our patients the best outcomes possible to be able to say, this is what I could do, but keep in mind that this is another option for you. And sometimes that's great and they want to do that, and other times like, I hear you, but let's just do what we can. And that's fine too.

Dr. Houssock (14:01):
I get that too. I'll get consults two, we transfer to Lindsey because I'll start talking about facelifts and what it entails, and they're like, wow, no, I hear you. It's what I need, but I am not ready. Or maybe their skin honestly isn't at the point where it's ready. They've have a lot of damage or it's just not the right time, whatever it is. And so alternatively, they'll be transferred to Lindsey or Val to do some non-surgical treatments. Either get us ready for surgery or to give them something that's maybe not quite as invasive. And so when you might consider a plastic surgeon's office, not our thing to do non-surgical argue that I truly, and I know it's obviously ours, and so we love it here, but I would argue it is the absolute best of both worlds to be able to walk into a plastic surgery and medical aesthetics, that's the name of our practice, JEV Plastic Surgery and Medical Aesthetics practice to know that you're going to be treated the way you should be treated, meaning that we don't have to shortchange you one way or the other because if it's just a surgeon, we're going to push you to surgery because what we do, we love it. If it's just a non-surgical aesthetics practice, they're going to deal with what they've got. We've seen so many people who get Kybella when they absolutely shouldn't have things that just don't give the patient really what they need.

(15:20):
But unfortunately, that is all that person can provide. And so they get nonsurgical treatments for an obviously surgical issue. We work in the luxury of a practice where we don't have to do that. We can easily transfer as needed. We think that's the best. And still to this day, I'm going to argue that's the best. But there are much, much more practices. Now I'm going to call them practices, but we are referring to medical spas where a medical person is doing non-surgical treatments in a standalone business. Very, very common these days. They're popping up on every corner, almost like a hair salon. Some of them are phenomenal.

Lindsey (16:09):
Absolutely.

Dr. Houssock (16:10):
Some of them are colleagues of ours who have been doing this a really long time and they know what they're doing and they're doing it well, and they're doing it safe, and they've had the experience and

Lindsey (16:20):
They put the time in to continue their education and continue learning. I think that's really important too.

Dr. Houssock (16:25):
Yes, there are plenty of them, but there are the other side where they could be a nurse, a nurse practitioner or a PA. And I'd argue even a medical doctor who is not a plastic surgeon or a dermatologist, a medical doctor, a dentist who all have degrees that allow, at least in the state of Maryland for them to inject you with Botox fillers and even do lasers legally, none of them have had the training and the board certification licensing in Botox fillers and lasers like a dermatologist or a plastic surgeon has. But they legally are allowed to perform those things.

(17:09):
We really want to get into the meat of that and why we think it's important for you to know that because not everyone's going to come here. We only have so many hours in the day. First of all, we'd love to see you, we'd love to see you, but not everybody can come here and you might not live here. So how do you determine if you want a non-surgical treatment, what is the best way for you to determine the safest place to go, but also the most effective place? Because safe is important, but you also want your treatments and you want a good treatment. So how do you, let's start, Lindsey, your patients are just at a loss. Where do they start? How do they find, what do they look for?

Lindsey (17:50):
Well, it sounds crazy, but I would typically honestly say steer away from Instagram, which is a fascinating thing because we use it all the time for our marketing. So it sounds very counterintuitive for me to say, maybe don't look at Instagram or take it with a grain of salt because not everything that you see on there is accurate or true.

Dr. Houssock (18:12):
It's getting worse.

Lindsey (18:12):
Keeping that in mind when we post on Instagram, we use our own patients, we've gotten permission for them to post. That's not always the case. So you don't know what you're seeing.

Dr. Houssock (18:23):
Is it ai? Is it filtered?

Lindsey (18:25):
Who knows? You can use it to find people, but then also look beyond just what you see on Instagram and then look at their certification. What are they certified in? Are they a nurse? Are they a PA? Are they an NP? Are they a doctor? What do they have and what does that look like for them? And that's not to say in the state of Maryland, and not all states nurse practitioners have independent practice, so they don't necessarily have to have a medical director over them, but what kind of training have they had in those fields that you're seeking? So if you're looking at Botox or fillers, what is their experience? How many years have they've been doing it? Where did they start? And those are all questions that I would never mind a patient asking. So that's the other red flag is I would say if you start asking questions and you're not getting the answers or you're getting pushback, that would be a red flag for me. They don't mind telling people that, yeah, I'm a family practice NP, but I did all my training here.

Dr. Houssock (19:22):
Unfortunately right now, you have to be asked that because unless you're a plastic surgeon or a dermatologist, we now know because we listened to this podcast that you were not trained in it in your training and you were not tested in it.

Lindsey (19:33):
Correct.

Dr. Houssock (19:34):
So I'd like to know how you did. I'm sure you're great, but how did you do it? And I agree, there's nothing to be ashamed of. If someone asks you that, I love when people please ask me about my training, please. I spent a ton of my life, most of my life and a lot of investing financially for my training. Go ahead and ask me about it. So if someone is funny about that, I would say definitely red flag.

Lindsey (19:55):
Red flag.

Dr. Houssock (19:55):
Nursing is the same idea. The only difference between nursing and NP, and it's not an only, it's a big one. They need to have a doctor who oversees them.Now, I won't dive into this part of it particularly because I'll be honest, I'm not completely sure, but different states require the medical director, the md, or do to be in the building when the nurse is injecting. Some might not. I don't want to speak to No, but I do know that every nurse who injects does need a medical director. And so does to this day, a physician's assistant also needs a medical director, an MD or a DO overseeing the practice where they are technically working under them. And that person is technically responsible for everything that nurse or PA does. If something happens, if there's a complication, no matter what they do, they're responsible for it. And that is a requirement of a legitimate medical spa. And any nurse who is injecting you, if she does not have she or he does not have a medical director, it's illegal.

(21:00):
Again, not exactly in a hundred percent sure of state to state whether they need to be physically in the building or not. Now let's talk about medical director versus having a physician led practice. This goes back to the same thing we've just talked about, so I'm not going to belabor it again, but a medical director can be anything. It can be any type of medical director. It could be a cardiologist. It does not matter. It just be a doctor who can prescribe medications, and it could be anything. They don't have to have a specialty or know anything about aesthetics.

Lindsey (21:29):
They don't. They just have to be willing to take on the responsibility of anything that happens is under them.

Dr. Houssock (21:34):
Yes. And you'd be surprised. A lot of people, and obviously we're talking about this because we're worried about it, there are parts of the world where things have happened where these medical drivers aren't even in the state and they don't even know what's going on there, and terrible things have happened. So the medical director is a requirement to get prescriptions and whatnot, but it doesn't mean a whole lot more than that for your safety. I would say it just means that they can legally order Botox because there's a doctor who's signing for it. When you have a physician led practice, then again, it goes back to what we have here or what a dermatologist practice might look like, where you have in-house specialty trained aesthetic doctors who are not only responsible, but also available for anything that comes through. And we have the expertise again, so we can bounce things off of each other.

(22:21):
That's the difference between them. So a medical director is very, very different than having a physician led practice. And even a physician led practice could be a non-plastic surgeon or a dermatologist, but they might be somebody like a family doctor who has then taken on the role of a cosmetic doctor and they, like a nurse practitioner or a nurse could have learned their training after their residency because again, family medicine does not learn how to do Botox fillers and all that in their training. They don't get tested on it on their boards, but they can just like a nurse practitioner or a nurse learn how to after. So I used to have a hard time with that, but I will tell you over the years, I have certainly warmed up to it and understand that we have a lot of intelligent doctors in the world where they might be able to have additional training just like my own staff and can be very competent injectors and laser technicians. Sure, that's fine. But that's the difference, right?

Lindsey (23:14):
They're also usually very upfront with that, and they're usually, I would argue available. I think the ones that are another red, I'll say red flag for me are when you've got a medical director that's not available, not present, never comes in the practice. I feel like if you're invested in the practice that you're representing and that is representing, you should at least show up.

Dr. Houssock (23:37):
And make sure that things are being done appropriately. Right. I will say, I am going to push back a little bit in the sense that some doctors will call themselves cosmetic doctors or even cosmetic surgeons. And I will tell you, no plastic and reconstructive surgeon and no dermatologist is ever going to call themselves a cosmetic doctor. So be very careful of those words. That's usually a hidden way of saying, I'm not board certified in these things, but I practice it. So be careful of that. A cosmetic doctor, a cosmetic surgeon is most likely not a board certified plastic surgeon and is not trained through their residency to achieve any of those aesthetic things. They are practicing it, but not, and again, just be forthright. I went to someone, a doctor can say, you know what? I did general surgery. I know how to do a liver transplant, but I decided 10 years later I just want to do cosmetic procedures. And just be honest. I mean, it doesn't mean that they can't do it, it just means their training is different, their background is different. And you as a patient deserve to know that.

Lindsey (24:41):
Yes, a hundred percent.

Dr. Houssock (24:43):
So that's the one thing we want you to think about. Who's in this practice? The people who are in this practice, how are they trained? Certain treatments that I think that a doctor needs doctor's supervision. That's a tough one. I'm not going to say that I have anything that apps is an absolute, but I would think there are certain things you just need to know as an injector that are more advanced than others. So can you talk about, go ahead and rank. I hate to do this because every injection, every laser has risk and should be done in the hands of someone who knows what they're doing. But can you do a simple rank of maybe what you think is the lowest risk and then to those things that should really be reserved for those who are highly trained and highly experienced?

Lindsey (25:32):
Well, I'll say this, if we're talking about fillers, when I first started, I started out in the cheek because there's not a lot of things that you're going to hit in the lateral cheek. You're down in a safe space on the bone. And I felt very safe there when I first started because it was a safe plane to be in. I could aspirate and make sure that there was no all the things. It felt very safe. Then I moved to lips, chin, nasal, labial, folds start to get a little bit more. If you're in the wrong depth, if there's a large vessel here, there's things that you want to watch out for. Tear trough is probably one that I would say is a more advanced technique to me. And then also using your biostimulators s Sculptra, you can't reverse that one. That one's stimulating your own collagen. So you need to be thoughtful about where you're placing it. You need to be about thoughtful about how much you are placing because it goes to work and builds collagen. And so you don't want to overbuild collagen in the wrong area. And it can get lumpy if you place it in the wrong area.

Dr. Houssock (26:38):
Not a beginner injector, Injection.

Lindsey (26:41):
Not a beginner injection. No. And the eye, the reason I ranked that higher as well is because that's an area that I've honestly corrected so many times through the years.

Dr. Houssock (26:50):
It's the most common place needing correction.

Lindsey (26:52):
Yeah. Because it's an area that you either should not have had done, you need get a surgery or you can clog up the lymph and it gets puffy and then it's really hard to undo.

Dr. Houssock (27:02):
Let alone the just dangers of the vessels around it and leading the blindness and all of the things. Yeah

Lindsey (27:07):
All of the things

Dr. Houssock (27:07):
Which we always say people get, oh, you're so dramatic. Yes, we know there's risk. There's risk to everything. You're being dramatic. The truth is we're not being dramatic. These are pretty very serious things. And an experienced injector, if something was to occur, will know what to do in the risk of when something bad happens or scary happens. Unfortunately, this is still medicine

(27:30):
And it's not foolproof. There's always risk. It goes back to that, yes, it's rare to have a complication, but when you do, you really want someone who knows what to do with that complication because that is the difference between truly losing your sight. And again, back to this training stuff, it's knowing what to do when something like that happens, God forbid it does happen.

Lindsey (27:51):
Well, and the other area that I won't do is liquid rhinoplasty.

Dr. Houssock (27:55):
To this day, Lindsey will not, and Lindsey, that is reserved. I think I trust everything with Lindsey. And I would say that's probably, if you ask that question, what do I think should have a physician or a physician led treatment? I think it is because it's such high risk. You have so many vessels there. You have risk of necrosis, of the nose, of the septum. There's so many things you can do. It's dangerous. And same thing at the glabella in between the eyebrows a very dangerous place to fill. So yes, there are things that even in our hands are risky, but at least if you have a surgeon doing it or a dermatologist doing it, or at least someone in the practice who knows that anatomy really well, because you have to keep in mind some of the reasons why this stuff just makes much more sense for those who has to operate is because we know what that anatomy looks like underneath the skin. And there is nothing scarier or more dangerous than not knowing what you don't know. Lemme say that one more time. The scariest thing is not knowing what you don't know. And that is probably the scariest thing in the medical aesthetic world right now.

Lindsey (28:58):
A hundred percent

Dr. Houssock (28:59):
Is not really understanding what's underneath the skin, what can happen, and the dangers of it. Because if you don't know that stuff, this stuff seems pretty easy. Oh, it's no big deal. It seems pretty easy, right?

Lindsey (29:13):
It's a little bit of volume.

Dr. Houssock (29:14):
It's a little needle

Lindsey (29:15):
No problem. Poke it once.

Dr. Houssock (29:16):
No problem, not a big deal. But if you actually know what's underneath there and you understand the risk, that number one makes you so much more cautious. It does. But also in the light of something happening, you are able to respond to it. So we want you to look for a reputable person with a medical degree of some type that is legal in your state, that is being appropriately supervised if they need it, who have been properly trained and have had experience in a proper way. And that's tough. And it's where I want to end today, because we'd like to do another session of this talking about, alright, you found your place. Let's talk about actually getting treatments and how to go about figuring out what you need and talking to your provider. But I think this is in the end, the most important part of this is when you get to this place, you find this place.

(30:12):
How do you know that they're safe? How do you know that they're reputable? Are they going to be able to ultimately take care of a complication? There's nothing more important than your safety. And we right now do not have in the United States, and really I would say worldwide, a regimented training program for injectors and laser technicians. That does not exist. And I implore anyone who watches this podcast, who has the ability to talk to your state and talk to our licensing groups, and even the nursing education and nurse practitioner education. We need to fight for you to be able to have the ability to get good education because you deserve that. I was able to have that. You deserve that. So we need to make that a priority for those of us who are interested in aesthetics and want to do it safely. And right now, unfortunately, all that is hopefully finding a situation like Lindsey did or spending thousands and thousands and thousands of dollars on random injectors to train with and watch, which again, has not been regulated or regimented, but it's the best that's out there.

(31:25):
It's all that's out there. That's all there is. And it's not enough. It would be like me saying there was no plastic surgery programs. So I just went and followed a bunch of plastic surgeons and hoped for the best. It's better than nothing. But that is not how you want your plastic surgeon to be trained. So we need a regimented education system for aesthetic medicine, period for the sake of the patients and also for the sake of all of the non-doctors or even non-plastic surgeons and non dermatologists doctors who really want to do this and do it well and do it safe.

Lindsey (31:57):
Absolutely.

Dr. Houssock (31:59):
How far do you think we are from having something like that?

Lindsey (32:01):
Years.

Dr. Houssock (32:01):
Why do you think that's so difficult?

Lindsey (32:05):
I think we're, so far, we've got such a saturated market of, there's such a volume of people practicing now. To draw it back is always difficult. Once you let things go, reining it back in is always hard in anything. It's always hard to pull back. So I think it's going to take time. Now, the AANP, which is my certifying organization, did come out for dermatology. They have a separate board exam that you can actually take to be boarded through a NP specifically in dermatology to start. So we have the ability to do that. I'd love to know for aesthetics. That would be great.

Dr. Houssock (32:43):
I'd love to know if that board has anything to do with aesthetics in it. I would love to know.

Lindsey (32:47):
It's mostly MOHS that I understand and skin lesions and really focused on derm, but it's very difficult board to take. People who've been in derm for 10 plus years are nervous to take it, and that's how they wanted it to be. The people that developed were like, we want this to be a challenge because we don't want to be the year one person in Derm. We want this to be like an extension.

Dr. Houssock (33:08):
Somebody who's been doing it and has experience.

Lindsey (33:10):
And so I think we have the ability to do that. But that situation took a long time to develop.

Dr. Houssock (33:16):
Yeah, I mean, it's possible. It's not surprising. There's always red tape everywhere, but I think we're begging for it. This world is begging for it. Patients are begging for it. It's the right thing. It would be such a great addition to the aesthetic medicine world, to have it properly be regulated and educated. That's good for everybody. That is not stopping people from doing this. It means promoting more patients, having a safe experience so that we can continue to develop this. Because aesthetics medicine is not going away. It's not going away. It's booming. We love it. We are so passionate about it, but we need to figure out how to properly educate and properly regulate to be continued.

Lindsey (33:59):
Absolutely.

Dr. Houssock (34:00):
Well, that's it for today. Wow.

Lindsey (34:02):
Good one.

Dr. Houssock (34:02):
Good one. But I would say ultimately, please stay tuned. We're going to talk about, alright, now you're heading to the Medi Spa. You found the right person. So you found the right practitioner. They're safe, they're effective, they've been educated, and now you want to go in and how do you dive in? So we're going to do that at our next episode.

Lindsey (34:20):
Yep. Stay tuned. Carry on. Dr. Houssock.

Dr. Houssock (34:23):
Carry on Lindsey. Perfectly Imperfect is the authentically human podcast navigating the realities of aesthetic medicine. Got a question for us? Leave us a voicemail at perfectlyimperfectpodcast.com. JEV Plastic Surgery is located in Owens Mills, Maryland. To learn more about us, go to JEVplasticsurgery.com or follow us on Instagram @DrCareHoussock, spelled D-R-C-A-R-E-H-O-U-S-S-O-C-K, or just look in the show notes for links. If you enjoyed this episode, please share it and subscribe to Perfectly Imperfect on YouTube, apple Podcasts, Spotify, or wherever you like to listen to podcasts.