New York Busted 87 Med Spas. Here's What That Means for You.
New York Busted 87 Med Spas. Here's What That Means for You.
We all want to believe that every med spa follows the rules. But what happens when state investigators walk into 223 facilities and find that nearly 40% of them are breaking the law?
In New York, inspectors uncovered something that should make every consumer and provider pay attention. From unlicensed people performing medical procedures to life-threatening infections caused by dirty practices, the investigation revealed a pattern that goes way deeper than a few bad actors.
When Cosmetologists Start Injecting
"She was found to have injected unknown substances into a patient's face, neck, and breasts. They were told this patient was told she was getting Botox, stem cells, collagen treatments, and other injectables." — Dr. Kate Dee, Med Spa Confidential podcast
One case involved a cosmetologist named Faye Min who ran a business in Queens. Patients thought they were getting legitimate treatments. Instead, they ended up with disfiguring complications that took months to heal.
This wasn't happening in some back alley. This was a licensed cosmetology business. The kind of place that probably had nice Instagram photos and good reviews. But a cosmetology license doesn't give anyone the right to inject anything into anyone's body. That's practicing medicine without a license, and it's a felony.
For consumers, this means you can't just trust that someone's "licensed" without knowing what that license actually allows them to do. For providers, it's a reminder that crossing into medicine without proper credentials puts patients in real danger.
The MRSA Infection
"That is methicillin resistant staph aureus. That's a very dangerous, life-threatening infection. Those bacteria are very, very difficult to treat because they're resistant to most of the antibiotics that can be used to treat them." — Dr. Kate Dee, Med Spa Confidential podcast
An esthetician named Patricia Rivas was providing cosmetic injections, cryotherapy, and laser services out of an unlicensed salon in Warwick. One of her patients developed a serious MRSA infection that could have killed them.
The images from this case are graphic. This patient suffered for weeks, possibly months, dealing with an infection that never should have happened. MRSA doesn't just appear out of nowhere. It comes from contaminated equipment, poor sanitation, and people performing procedures they're not trained to handle safely.
If you're a med spa owner, this is your wake-up call. Proper protocols, sterilization, and scope of practice aren't just paperwork. They're what stand between your patients and serious harm.
Why Even "Good" Med Spas Get Caught
"Not all plastic surgeons and dermatologists are offering legal aesthetic treatments. Most of them are, of course, most of them are. But see, this sliver over here and this little sliver over there, those are illegal because they're not quite compliant." — Dr. Kate Dee, Med Spa Confidential podcast
Now here's where it gets tricky. The investigation didn't just target shady salons. It exposed compliance gaps in practices run by board-certified doctors too. Some dermatologists and plastic surgeons were letting nurses see new patients without a physician doing the required good faith exam. That's illegal in every state.
A busy plastic surgeon's office loses a provider, staffing gets tight, and suddenly an RN is handling new consultations and treatments without proper oversight. The doctor doesn't mean to be non-compliant. It just happens.
But intent doesn't matter when a patient gets hurt or when state inspectors show up. The law is the law, and right now, New York is proving they're willing to enforce it.
Before Your Next Appointment
"My hope is that the really great ones survive this and thrive. And these really scary super duper illegal ones get put outta business." — Dr. Kate Dee, Med Spa Confidential podcast
New York found violations in 87 out of 223 inspections. That's just what they caught during a focused investigation. The real number of non-compliant med spas across the country is probably much higher.
If you're booking treatments, you need to know who's legally allowed to do what. If you own or work in a med spa, certification and compliance aren't optional anymore. States are watching, and patients deserve better.
Listen to the full episode of Med Spa Confidential to hear what questions you should ask before your next appointment and how quality providers can stay ahead of the crackdown.
Visit the https://medspaboard.com/ to learn more about how you can help make Med Spa visits safer.
Episode Transcript:
[00:00:00] Dr. Kate Dee: Hi, I am Dr. Kate d and I'd like to tell you today about a backlash that is happening in New York State because of the recent med spa investigation there. recently I did a podcast telling you about this initial report in New York City. This first screen I'm showing you shows you the results of that report.
[00:00:20] Dr. Kate Dee: There were 15 investigations of. So-called medical spas in New York City, finding that every single one of them was operating [00:00:30] illegally. They found all kinds of pretty disgusting things including contaminated, uh, surfaces and things like that. But the most important thing is that spurred a additional, over 200 inspections throughout New York state, and now we are seeing the backlash there were.
[00:00:50] Dr. Kate Dee: So many violations. The New York State, department of State, which is the entity that issues state business licenses, [00:01:00] they did a series of inspections of over 200, so-called med spas, and there were 87, uh, violations that were found and. they issued this warning to the public about medical spas, and together the Department of State and the dermatology group in New York and also nationally issued a joint recommendation.
[00:01:27] Dr. Kate Dee: And I would like to tell you about those because this is a [00:01:30] giant backlash and is potentially, uh.Earth shattering for the med spa industry in New York and possibly the whole country. So first of all, what the state did is they went through, over 200 inspections. 223, to be specific. 87 were cited for violations, um, including among other issues, the unlawful practice of medicine, which.
[00:01:55] Dr. Kate Dee: As I've mentioned, uh, is a, a felony. Okay. Practicing [00:02:00] medicine without a license, whether you are. A completely non-medical person, sticking concrete in people's butts for fake Brazilian butt lifts. Or if you're a nurse practicing medicine without the oversight of a doctor. Nurses are not licensed to do any medical procedure or prescribe any medical treatment without it being delegated to them.
[00:02:25] Dr. Kate Dee: By a licensed provider who knows how to practice medicine, [00:02:30] and that is rampant in this country. And as we saw a few weeks ago, there was a nurse who was arrested in Arizona for that, which a lot of people have poo-pooed that. But frankly. This is totally illegal. These people do not have medical training to allow them to practice medicine on their own.
[00:02:49] Dr. Kate Dee: That's why they are nurses. They're not doctors. So let me just tell you what's happening in New York, because this is really big for the med spa industry. You think it's bad now? So I don't [00:03:00] know how they decided which 223 businesses to evaluate. I have been on record estimating that at least half of all medical spas are operating illegally.
[00:03:14] Dr. Kate Dee: I, I don't have data to, to prop that up. I just, that's my intuition. I think it, that number was much lower 11 years ago when I started in this space of, Medical spas and the industry itself has [00:03:30] exploded from somewhere around 3000 med spas back then to well over 20,000 med spas now in 2026. So, this report focuses on two different people as examples, and they have some pretty graphic images in here.
[00:03:47] Dr. Kate Dee: The first one is against a cosmetologist who, her name was Faye Min. her business was called Princess Beauty, LLC. She had a cosmetology license [00:04:00] in Flushing, Queens. She was found to have injected unknown substances. Into a patient's face, neck, and breasts. They were telling, they were told this patient was told she was getting Botox, stem cells, collagen treatments, and other injectables.
[00:04:18] Dr. Kate Dee: The pictures, I'm gonna bring them up. They are graphic. And you can see she has had multiple. Injections in her neck that have caused significant, [00:04:30] abnormalities that did not heal very well, took a long time to treat those. I'm gonna go back and show you the second set of images and the second case. So the second case, so obviously the first case was somebody with.
[00:04:42] Dr. Kate Dee: No medical background injecting illegal stuff in people. Okay. In the second case, there was a esthetician named Patricia Rivas, who was operating, an unlicensed salon in Warwick, New York, and she was providing [00:05:00] cosmetic injections, cryotherapy, and laser surfaces. Laser services and ultimately gave somebody a M-R-S-A infection that is methicillin resistant staph aureus.
[00:05:13] Dr. Kate Dee: That's a very dangerous, life-threatening infection. Those bacteria are very, very difficult to treat because they're resistant to most of the antibiotics that can be used to treat them. I'm gonna show you this graphic. This patient suffered. I mean, you, you can [00:05:30] see this. It's absolutely outrageous. The infection that was caused in this person.
[00:05:35] Dr. Kate Dee: This could be easily life-threatening. So, the result of that is, this is, it's very interesting because,This report was put out by the department of State. Okay. That is the entity in, in Washington state. My state, it would be the Secretary of State's office, but they are the people who issue state business licenses.
[00:05:58] Dr. Kate Dee: , and [00:06:00] interestingly, this was not put out by the board of health, by the medical board or by the nursing board. Or by the cosmetology board. I'm sure all of those boards are scrambling right now to deal with the outcome of this investigation. The Secretary of States, these are not, this is a non-medical en entity.
[00:06:21] Dr. Kate Dee: Consumers need to be aware of the dangers when medical procedures, including cosmetic medical procedures are being performed by individuals without an [00:06:30] appropriate license. Such as a physician or a nurse, unlicensed or unqualified staff, dirty needles expired or counterfeit drugs such as Botox or fillers and unsanitary conditions can lead to serious injury or even death.
[00:06:45] Dr. Kate Dee: I urge consumers to pay close attention to our tips so they can get the services they want and not pay the ultimate price with a botched treatment. Okay, so. That was what the department of State said. [00:07:00] Then there was a joint statement by the American Academy of Dermatologists and the New York State association of Dermatology and Dermatologic Surgery.
[00:07:12] Dr. Kate Dee: And you can see here, uh, they are commenting on the exact same information that I just presented you. Okay. And they said that, you know, because of this investigation into improperly licensed medical spas, the [00:07:30] American Academy of Dermatology association, A A DA and the New York State Society of Dermatology and Dermatologic Surgery joins the New York City Council and the New York State lawmakers to pass legislation.
[00:07:44] Dr. Kate Dee: Requiring medical spas and other appearance enhancement businesses, including cosmetology and nail establishments, to clearly disclose to consumers that they are not licensed to perform medical procedures. Such facilities should be required to [00:08:00] publicly post and educate consumers about the specific procedures they're legally prohibited from performing as non-physicians and notice that language specifically lumps.
[00:08:12] Dr. Kate Dee: Non-medical people in with. The term medical spa. Okay. Unlike a physician office medicine and surgery practice in a med spa does not have clear regulations or oversight from federal state agencies. This is actually not true. There's just no inspections, [00:08:30] cosmetic medical procedures. Including laser treatments are safest when performed in a dermatologist's office under direct onsite supervision of a physician.
[00:08:40] Dr. Kate Dee: While lasers used for hair removal are safe and effective, when operated by properly trained medical professionals, professionals, improper use can result in painful burns, permanent scarring, and long-term complications. I would agree with that sentence. Consumers may be confused about the seriousness of the [00:09:00] cosmetic procedures offered in a med spa and trust the personnel performing them as appropriate medical and cosmetic training and at and state license.
[00:09:09] Dr. Kate Dee: While cosmetic treatments may appear simple, performing them safely requires an in-depth understanding of the structure and function of the skin Board. Certified dermatologists undergo rigorous medical education and specialized training and facial anatomy. Including nerves and muscles. This advanced expertise allows them to minimize risks and [00:09:30] effectively manage any complications that may arise.
[00:09:32] Dr. Kate Dee: And I agree on all of that statement, They encourage, New York State lawmakers to enact legislation requiring medical spas to meet essential standards for patient safety and transparency. Bravo. Completely agree. We also join the New York City Council and New York State to launch a public education campaign informing consumers about the risks of receiving cosmetic medical procedures in [00:10:00] unlicensed or improperly supervised facilities. Completely agree with every single bit of that. The interesting leap here though is. Tying all medical spas to unlicensed cosmetologists. Okay. That's where I get a little bit concerned that the a a d which I wrote a whole chapter about the turf battle, okay. In my book, meds, spa [00:10:30] Mayhem. And dermatologists would prefer that no other doctor touch or treat the skin, which is basically impossible.
[00:10:40] Dr. Kate Dee: Family practice Docs treat skin diseases all the time. Internal medicine physicians, emergency physicians, pediatricians, basically anybody who sees a patient is often confronted with all kinds of skin issues that they have to treat, [00:11:00] and we are able to treat. Many, many of them. Obviously there are tons of things that, you know what?
[00:11:06] Dr. Kate Dee: This is out of my scope. I will send you to a dermatologist. 'cause this could be skin cancer or this could be an unusual kind of skin disease that I'm not familiar with, but the vast majority of infections and rashes and basic. Simple burns and things like that can be treated by any physician or sometimes mid-levels who have experience in that [00:11:30] area of of medicine.
[00:11:31] Dr. Kate Dee: And so it's very kind of interesting. They would like to equate medical spas with these dirty, unlicensed, you know, hair salons that should not be performing anything medical. They've created a new term called appearance enhancement businesses. Okay. So basically a hair salon or a nail salon that is, or you know, a place that does makeup or browse or something.
[00:11:59] Dr. Kate Dee: they are [00:12:00] not allowed to perform medical procedures. Absolutely not. They were never allowed to. That's been illegal from day one. That is a felony. Okay. But you know what else is a felony? An rn, practicing medicine without a license, without a medical license, meaning not under a doctor. And someone was working for a board certified dermatologist in Arizona who got arrested for exactly that.
[00:12:26] Dr. Kate Dee: So I'm gonna show you my own Venn [00:12:30] diagram of the medical aesthetics industry, and I'm gonna explain this. I know it looks like a lot of bubbles right now, but if you look at this larger big circle, okay, the larger big circle. Is all the medical aesthetic procedures done in the United States. Okay. The smaller, big kind of purple blue circle is all the legal ones and everything outside the legal ones.
[00:12:54] Dr. Kate Dee: Those are illegal. Okay. And I specifically wanna point [00:13:00] out what it is with dermatologists and plastic surgeons. They think that everything they do is actually legal, and I'm telling you. It's not always true. I know personally plastic surgeons and dermatologists who operate their aesthetic practice illegally.
[00:13:18] Dr. Kate Dee: Why? Because they mostly do plastic surgeons mostly do surgery. Dermatologists mostly do medical dermatology. Both [00:13:30] plastic surgeons and dermatologists employ nurses and mid-levels and other assistants in there. Aesthetics part of their practice. Some of them call it a med spa, plastic surgeons. Many, many plastic surgeons own medical spas, dermatologists.
[00:13:47] Dr. Kate Dee: Pretty much never call it a medical spa, but a lot of them have a separate part of their practice where, where aesthetics is performed. There was one big dermatology group here in downtown Seattle where their [00:14:00] medical dermatology is all in this office over here. And across the hall was a separate little aesthetics suite where an RN ran it completely and.
[00:14:12] Dr. Kate Dee: That RN is not allowed to see new patients or do good faith exams, and I know for a fact that that rn, I mean this particular practice that RN was performing you know, new treatments on new patients that hadn't been seen by any of the dermatologists in the main [00:14:30] office, this is also very true of plastic surgery offices.
[00:14:34] Dr. Kate Dee: And I can tell you that having talked to. Some very close friends in plastics. It's been difficult for them to maintain their staff and sometimes they have just an RN there who there is no one to do a good faith exam. And I have I have witnessed it myself. And it's not that they wanna be non-compliant, it's just hard to staff a medical spa and they have personnel issues.
[00:14:59] Dr. Kate Dee: And [00:15:00] before you know it, there's only an RN there. So not all plastic surgeons and dermatologists are offering legal aesthetic treatments. Most of them are, of course, most of them are. But see, this sliver over here and this little sliver over there, those are illegal because they're not quite compliant.
[00:15:18] Dr. Kate Dee: Mostly it's because, some patients lack a good faith exam. Now let's look at the non-core doctors. That's like me. I'm not a plastic surgeon or a dermatologist. I've been doing this for [00:15:30] 11 years, and I think I'm pretty good at it. And I have a license to practice medicine in my state. So my med spa, which I call a medical spa, that's what I call it, sits in here, it's legal.
[00:15:42] Dr. Kate Dee: Okay. And all my provi, I don't have any RNs because they can't see new patients. So I prefer not to have one. But I do have a nurse practitioner and a PA in my practice who work under me. I also have two other doctors who I work with. but some non-core doctors, they're non-legal. Why? Because [00:16:00] they also have some issue the same way the plastics and the derms.
[00:16:04] Dr. Kate Dee: They have an rn, they're, they're not always present in their own spa. The RN sometimes sees new pa, whatever. They, there are always non-compliant practices for any doctor. It's all possible, and that includes that. Doctor in Arizona, the board certified dermatologist who didn't actually have. License to practice medicine in Arizona.
[00:16:25] Dr. Kate Dee: But besides that, he had an RN seeing new patients performing good [00:16:30] faith exams and prescribing, which is completely illegal in every state. So let's look at mid-levels, uh, nurse practitioners and physician assistants. Are those legal? Well, some of them are. Many of them are not. Why? Well, in most states, an NP or a PA cannot own a medical practice.
[00:16:50] Dr. Kate Dee: In some states, NPS can, in some they can't. In most states, PAs cannot. In my state, for instance, a PA can own up to [00:17:00] 49% of a medical practice but can't own 50%. So there are issues with ownership. There are issues with whether they have all the licensure and stuff, but I would say probably half of those are legal and half are not legal.
[00:17:14] Dr. Kate Dee: Now let's look at nurses, registered nurses. Okay. Registered nurses have a nursing degree. They do not have any advanced degree. They are not allowed to practice medicine. They must take a doctor's order. They can inject Botox or do laser if it's [00:17:30] ordered by a doctor. Okay. They can't see that new patient.
[00:17:34] Dr. Kate Dee: They also, for the most part, in no state can own a medical practice. They would need to set up a special legal entity in order for them to. Own a medical practice. So I would say most med spas that are owned by nurses are not legal. And then you have everything else, all the meat of this bigger circle with, uh, you know, cosmetologists and other people without any doctors involved.
[00:17:57] Dr. Kate Dee: And most of those are illegal. [00:18:00] There is a way to be legal with that, and I have no issue with forming MSO, which is a management services organization that is a legal. Ownership where business people can own a med spa, but then they have to have all of the proper care inside the med spa. There has to be a medical director who knows what they're doing.
[00:18:20] Dr. Kate Dee: There has to be licensed providers inside that med spa. many, many of these other things are not legal. And I will say that the [00:18:30] investigation in New York showed exactly this, that out of 223. Investigations. Right. They found 87, uh, violations. Okay. That to me is probably pretty accurate. I would guess that of the remaining.
[00:18:51] Dr. Kate Dee: People that they inspected. There's probably some corporate ownership issues. There's probably some other issues about good faith exams. My guess is if you [00:19:00] were to evaluate all the different things, ask all the questions, you'd find that over half of those. 223 med spas were probably illegal. So changes coming in New York.
[00:19:12] Dr. Kate Dee: There is a huge, momentum there to change the laws and make it harder for these dangerous practices to exist. My hope is that the dermatologists don't have their way and pro prohibit doctors like me from practicing medicine. I don't think they'll [00:19:30] be able to do that. But that's their stance and I understand it.
[00:19:34] Dr. Kate Dee: I understand that absolutely. Dermatologists are the experts in the skin. If I have a new lesion, I get it checked out by my dermatologist. They treat skin cancer, they treat, skin diseases of all different kinds, autoimmune diseases, different kinds of rashes and infections. I have to tell you that the rest of us treat a lot of dermatologic issues that [00:20:00] never, ever go to the dermatologist because they're pretty simple.
[00:20:03] Dr. Kate Dee: I'm not saying that dermatology is simple, it is not okay, and it's a great specialty and but this move to lump all med spas. In with the slimy, you know, cosmetologists who are injecting concrete into people's, you know, submentum. I don't think that's fair. So it'll be really interesting to see what happens in New York.
[00:20:27] Dr. Kate Dee: I encourage anybody listening [00:20:30] to this to go to the website, meds spa board.com and find out about getting certified as a medical spa if you are a provider. Totally do it. It's gonna help you prove that you are legal and legit. And if you are a consumer and you've got a favorite med spa and you think, oh my gosh, my place should get certified. Send us their contact email, or just tell us what the spa is and let us know that you love them and you want them to [00:21:00] get certified. And we'll try. We'll reach out, we'll see if they're responsive. Thanks so much. I think this is a really interesting development. I do fear that more complications are gonna be revealed around the country.
[00:21:13] Dr. Kate Dee: We are gonna see more and more reports like this, and there's gonna be a political movement to shut down med spas, and I'm very much hoping that the really great ones survive this and thrive. And these really scary super duper illegal ones [00:21:30] get put outta business. Thanks for listening. If you found this helpful, do me a favor and share it with a friend who's considering any aesthetic treatments. Subscribe so you don't miss the next one and drop a comment telling me your biggest takeaway. I actually read them all. Let's keep each other safe and elevate the standards in the MedSpa industry.
