Spas considering the addition of medical services are partnering with physicians to offer in-spa Botox treatments. Botox ('botulinum toxin') is a chemical (technically a type of food poisoning) that blocks the stimulation of muscles and thus allows the muscles to relax. It is the most popular cosmetic procedure, according to the American Society for Aesthetic Plastic Surgery (ASAPS). A million injections were performed in 2000. The number of procedures has risen 2,356% in 5 years, with more than 1.6 million procedures performed in 2001, 89% on women.

Each physician-administered Botox treatment consisting of one to several injections takes about 15 minutes. Effects are seen within five days and last three to six months. Most physicians consider the treatment to be a safe and effective way to reduce, and in most cases erase the results of a lifetime of furrowed brows, wrinkles on the forehead, and crow's feet. All know it is a BIG moneymaker (physicians pay approx $400 per vial, charge approximately $350 per treatment, and there are approximately 3 tx per vial.)

For several years, dermatologists and plastic surgeons have been adding spa services, thus indirectly competing with spa businesses. Some spas are adopting an 'if you can't beat them, join them' mentality, providing Botox treatments in order to take advantage of cosmetic surgery's increasing popularity. The number of cosmetic surgical and non-surgical procedures has increased 48 percent compared to the previous year's total, from 5.7 million in 2000 to nearly 8.5 million in 2001. The overall increase in procedures has risen an astounding 304 percent is just five years!

The arrangement can be highly lucrative for the spa, if structured properly. Clients usually pay from $350 to $650 per treatment in addition to the incremental revenues derived from pre- and post-treatment product sales. Botox can also lend results-oriented credibility. It was approved by the FDA on April 15, 2002 for the treatment of frown lines, deepening the pockets of Botox's manufacturer, Irvine-based pharmaceutical firm Allergan.

'The most important rule when looking to offer Botox in a spa is to find a qualified physician,' says Sara Whisler, a paramedical consultant. 'Go for quality, not price.' Although side effects are rare and usually very minor, they may include headaches, swelling, and bruising. A recent Time magazine article, however, paints a grimmer picture of Botox 'gone bad'. The article quotes Dr. Debra Jaliman, a dermatologist who teaches a Botox course at Manhattan's Mount Sinai. She points out possible complications from misapplied injections, including 'eyelid droops, slurred speech as if they've had a stroke, dropped mouth, asymmetrical forehead, eyes that don't shut.'

Spas can provide 'one-stop-shop' convenience in a stress-free environment, and that seems to be what consumers are asking for. Enter the 'Botox Party'. A recent Wall Street Journal Articles featured these 'tupperware parties with needles.' According to the article, hors-d'oeuvres are circulated and soft music plays on the stereo, but instead of dinner being served, there are plates of Botox vials.