Botox at the mall: Medical spas growing in popularity, The Palm Beach Post

By Susan Salisbury
Posted Oct 10, 2012 at 12:01 AM
Updated Oct 10, 2012 at 12:03 PM

Along with buying a pair of shoes and a sandwich, mall shoppers can have their wrinkles smoothed with Botox injections or their lips plumped with a facial filler.

It’s all part of the mainstreaming of cosmetic services, and the demand from an aging populace that wants to look its best.

“Women want a well-trained person who is a great injector and great prices, and they want it to be convenient,” said Bill Clarke, managing partner of Venus Mini Med Spa. The company, launched three years ago, does $6 million a year and has stores in 10 malls, including The Mall Wellington at Wellington Green and Town Center at Boca Raton.

Injections of Botox and Dysport, a similar product, were the top non-surgical cosmetic procedure performed in 2011 by its physician members, the American Society for Aesthetic Plastic Surgery reports. The number of treatments with the two products aimed at reducing frown lines, grew to more than 2.6 million from 65,257 in 1997.

Injectable dermal fillers designed to diminish the lines around the nose and mouth, including Radiesse and Juvederm, once were done mostly by dermatologists and plastic surgeons. Now, the income stream is being sought by everyone from family doctors to dentists and chiropractors, as well as medical spas, in part because of declining reimbursement from insurance companies for standard practices.

“There is a little bit of a Wild West out there in terms of all these different kinds of venues that are popping up for these sorts of procedures. It is important to realize that with all of these so-called minimally invasive procedures, you are putting things under the skin,” said Dr. Leo McCafferty, a Pittsburgh plastic surgeon who is president of the American Society for Aesthetic Plastic Surgery.

“They are all medical procedures. People should be evaluated with the proper history and a medical examination,” McCafferty said.

From 1997 to 2011, nonsurgical cosmetic procedures including everything from dermal fillers to laser skin resurfacing increased 356 percent, the society found. Women have 91 percent of the procedures, and the 35-50 age group accounts for 48 percent, followed by 51-64-year-olds at 29 percent.

Advice from the American Society for Aesthetic Plastic Surgery

“Going back five years, everybody thought it was just for the rich and famous. It’s not. People want to maintain what is above the neck. They do not want to get old like their parents. They can get wonderful results without going the surgical route,” Clarke said.

The boom in cosmetic procedures that’s fueling med spa growth seems unstoppable.

Allan Share, president of the Day Spa Association and the International Med Spa Association, said it’s difficult to track the growth but the groups’ database has more than 4,000 medical spas listed, up from 950 in 2009.

“We know that the medical community has added spas at a furious pace over the last few years, and the spa has added the medical component,” Share said.

Ipsen Pharmaceuticals, manufacturers of Dysport, and Allergan Inc., maker of Botox, warn the botulinum toxins may affect areas away from the injection site. They can cause symptoms of botulism, and can occur hours to weeks after injection. Symptoms may include swallowing and breathing problems, loss of strength and muscle weakness all over the body, double vision, blurred vision and drooping eyelids, hoarseness, change or loss of voice, trouble speaking clearly, or loss of bladder control.

The state does not regulate med spas, but anyone who performs injections must meet certain requirements, said Ashley Carr, spokeswoman for the Florida Department of Health. Florida law allows nonsurgical cosmetic treatments such as the injections to be performed by a medical doctor of any type. Physician’s assistants and advanced registered nurse practitioners can also provide the services under a supervising physician who must be within 25 miles. They must work under a protocol signed by a physician, Carr said,

At Venus, muscle-relaxing Dysport, is $199 per facial area, or three areas for $550. The treatments are administered by either a physician’s assistant or an advanced registered nurse practitioner, Clarke said.

Competition appears to be driving prices down. Board-certified plastic surgeons, otolaryngolgists and dermatologists charged an average of $328 per area in 2011, down from $398 in 2010, according to an American Society for Aesthetic Plastic Surgery survey.

Venus is the perfect fit for Joan Upson, 54, a Royal Palm Beach dental office manager who visits the Wellington location on a regular basis for fillers such as Radisse and Perlane. Previously, she had collagen injections at her dermatologist’s office, but finds the staff at Venus spends more time with her and answers her questions.

“I walked by one afternoon and went in there. I talked with the girls and got information. I decided literally to give it a shot,” Upson said. “I’m happy with it. It’s a big improvement. It’s almost like a liquid facelift.”

Wellington plastic surgeon Dr. Harold Bafitis, who supervises the Wellington Venus store, said consumers cannot assume that every med spa is safe.

“You have to know where you are going. Some of these med spas have had issues. A lot of times, there are family doctors overseeing these med spas. There should be either a plastic surgeon or dermatologist overseeing them,” Bafitis said.

“Ask who is supervising it and who is doing the work. How many patients has this individual done? If there is an issue or a problem, who is going to take care of it?” Bafitis said.

Price matters, but isn’t always the main consideration. For many, it’s about comfort level, and that may mean getting a Botox shot from a board-certified dermatologist or plastic surgeon.

Dr. Fredric Barr, a West Palm Beach plastic surgeon, sees patients one day at week at the PGA National Resort & Spa in Palm Beach Gardens.

“We have two venues, one more medically oriented in our office, or at the spa,” Barr said. “They want to get a quick fix. That is the spa setting and that is the allure of why people come to the spa. We do both. The common denominator is me.”

West Palm Beach dermatologist Dr. Charles Griff started Dermatology Depot Med Spa in 2011 in another building on the same property as his primary office.

However, no injections are given at the med spa, which offers treatments such as facials, chemical peels, and intense pulsed light.

“As a dermatologist, you go through medical school, then spend at least three more years just learning about the skin,” Griff said. “These are real medicines with real potential issues.”

Griff said that he sees one or two patients a week who had treatments elsewhere that resulted in a rash or fillers that turned out to be lumpy and bumpy under the skin.

“I don’t always ask. They will say they got it cheaper. There is not appropriate education or monitoring of what is being done,” Griff said.

Julissa Caballero, 39, a Boca Raton resident who works in sales, goes to Dr. Steven Caridi, a Boca Raton family physician, for Botox and Juvederm treatments. She chose him over her dermatologist, who only offered the services on Fridays.

“I wouldn’t go to the mall to have surgery on my heart. I am not going to go [there] to have fillers in my face,” Cabarello said.

Cabarello felt confident with Caridi, and said the treatments have made her look 10 years younger.

“I felt more refreshed,” Caballero said. “People are always telling me I look great. I tell them it’s Botox.”

Caridi has been doing Botox and fillers for eight years, and came to Boca Raton from Manhattan in 2005. Demand for skin treatments is strong in South Florida, he said.

“I think it helps people feel better about themselves,” Caridi said. “Being their primary care physician, you know their medical problems.”



licensed esthetician

Shelby Escosa born and raised in small town Redding, California moved to Florida to pursue her dreams as a Dancer. Being surrounded by people who felt embarrassed and less empowered due to issues with their skin, she then found her true passion for esthetics. Wanting to help others feel healthy and beautiful both during and after treatments pushed her to achieve her License from Boca Beauty Academy and be able to do just that.

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Nurse Practitioner




Elmhurst Manager

Candace enjoyed a 35 year as a Health Care Administrator and Consultant. After retiring still
wanting to stay involved in the health care field she decided to explore the aesthetic industry
Happily landing at Venus Med Spa in 2019. Becoming Manager on 2022. And reports “the best
of my job is our amazing Clients and my wonderful work family”!

Photo Makayla



Makayla is a licensed esthetician at Venus Med Spa at our Elmhurst IL location. She received her education at Naperville Skin Institute after a lifetime of wanting to work in the beauty industryMakayla’s goal is to emphasize everyone’s true beauty and bring confidence back. She believes in good vibes and making comfort a priorityWhen Makayla is out of the office, she’s most likely snuggling up with her fur babies and enjoying the sunshine.



Nurse Practitioner

Patrycja graduated from Loyola University Chicago with a master’s degree in nursing and is an ANCC board certified Family Nurse Practitioner. She also holds a bachelor’s degree from University of Illinois at Chicago.

Patrycja has over 8 years of experience working as a nurse practitioner at the Level 1 trauma center emergency department. She has completed hundreds of skin procedures, laceration repairs, wound and burn treatments throughout her career.

Patrycja performed numerous facial procedures at the emergency department which ultimately made her want to transition into aesthetic medicine.

Patrycja is dedicated to making a difference in patient care management and achieving patients’ goals in aesthetics. She believes that working together on a skincare regimen and building a customized plan for each client will bring her patients desired outcomes.

Her goal is to make her clients feel comfortable by communicating effectively and implementing the best care plan to achieve natural-looking results.

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Kirsten obtained her doctorate degree as a family nurse practitioner from the University of Alabama at Birmingham and is certified by the American Nurses Credentialing Center (ANCC). She has experience working in the Cardiovascular Intensive Care Unit as well as the Neonatal Intensive Care Unit and most recently works as a Family Nurse Practitioner in primary care. Kirsten developed a passion for aesthetics and dermatology in 2020. She then decided to further her education and is now trained in neuromodulators and dermal fillers. Kirsten has a passion for enhancing natural beauty. Kirsten believes aesthetic medicine is an art and that communication and close attention to detail are both key components to achieving optimal results. In Kirsten’s free time she enjoys spending time with her daughter. She also loves nature, traveling, photography and music.

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Nurse Practitioner

Deena is a Nurse Practitioner who grew up in the northwest suburbs of Chicago. She received her Bachelor of Science degree in Nursing from Marquette University followed by her Master of Science degree in Nursing from Lewis University. She is a Family Nurse Practitioner certified by the American Academy of Nurse Practitioners (AANP). Deena has over 5 years of nursing experience after working on a pediatric medical/surgical unit where she cared for children and their families.

Deena has always had a passion for aesthetics. Having received aesthetic treatments herself, she can connect with her clients through personal experience. Deena believes it is important to build trusting and positive relationships with her clients in order to help them feel confident and comfortable in their own skin. Her goal is to help clients enhance their natural beauty with the utmost quality and safety.

During her time off, Deena enjoys playing tennis, binge watching reality TV shows, trying out new restaurants, and spending time with family and friends.



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Originally from Buffalo, NY, Kelly moved to the Sarasota area in 2021 to be closer to family. Her undergraduate education was completed at Daemen College in Amherst, NY with a Bachelor of Science in Nursing and then obtaining a Master of Science in Nursing at Daemen college and post Master’s in Family Medicine at D’Youville University in Buffalo, NY. She am board certified through the ANCC and my experience stems from the emergency department where I practiced for over 20 years.

Kelly is excited to be part of the Venus family to help clients achieve their goals. Knowing that feeling confident on the outside gives people an overall sense of well-being.

Kelly is married with 4 grown children who live in NY, Chicago, and Honolulu.

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His career started in Illinois and extended for 18 years in the fitness industry. Subsequent to that he moved to Cape Coral and built waterfront homes. He started Venus Med Spa in June 2009.

With a strong background in management , sales, and marketing, his goal is to continue to make Venus an industry leader which has been the case since 2012. His emphasize on staff development and client relationships set Venus apart from the rest. He prides himself on being able to give clients the best experience, price, and quality while still making it convenient.

Cierra Head Shot


Physician Assistant

Cierra Phillips is a board certified Physician Assistant who completed her bachelor’s degree at Indiana University, and then received her Master of Medical Science degree from Yale University’s PA program. She re-located to Sarasota in 2020 and is now proud to call Sarasota home! Outside of work, you can find her spending time with her husband and their baby girl. They love to travel, drink good coffee, and be outside as much as possible.

Cierra was drawn to the field of aesthetic medicine because it allows her to incorporate her knowledge of medicine and anatomy into a practice that helps clients gain confidence in their own skin. She also has an artistic and detailed eye, which helps make her a skilled injector. She makes it a point to build an individualized relationship with each client and looks forward to helping you reach your cosmetic injection goals!







NUrse practitioner

Alexis is from a small town in North Dakota, but has called Florida home for the last 5 years. She is a board-certified Nurse Practitioner with over 6 years of nursing experience ranging from surgery, critical care, and trauma. Alexis received her Master’s Degree from the University of South Alabama. She has a passion for all things beauty, health, and wellness. Her passion for aesthetics has been present since she was young and has grown into a career. Alexis’s goal as an injector is to help clients achieve their desired beauty goals with natural results. When Alexis is not at work you can find her walking her dogs, riding her horse, and spending time with her husband.

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LIcensed Esthetician

Emma is a Licensed Esthetician and native Floridian who has received formal training at the Aveda Institute in Clearwater, Florida. Her approach is one that encompasses all of the technical knowledge, with a relaxing and calming touch. She offers preventative maintenance and corrective care for your skin using a combination of high-performance modalities and medical grade, restorative skincare. “Continuing Education” in this exciting field is a top priority for her continued learning, growth, and most importantly, client satisfaction. Using safe and effective products for facials and other luxury treatments such as microneedling (Collagen Induction Therapy), chemical peels, and Venus Legacy body tightening while taking a detailed approach to ensure that every single client leaves feeling refreshed, revitalized and beautiful.

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Sarasota Manager

BIO: Lana has 15+ years experience working in customer service, business sales, marketing, and social media.

Success-driven professional with customer service, sales, and store operations experience. Proven ability to effectively communicate brand’s mission, design outreach plans and generate revenue streams in retail. Lana has a background in dermatology, pediatrics and retail management.

She has strong leadership experience and works effectively across organizations, building strong relationships with peers, senior leaders, and clients.

“I have a reputation for my positive attitude and ability to master new roles with excellent working knowledge of business, sales, and customer service.”