" "The whole experience matters," said Levine, who left internal medicine to design Elle Medical Spa in Birmingham, Mich., and offer patients medical treatments such as microdermabrasion in a tranquil environment. "

" Medical spas, which often offer pricey procedures such as Botox and laser treatments along with massages and manicures in a relaxed setting, are popping up nationwide. "

" But the spas, which can charge about $95 for a facial to upwards of $2,000 for more complex treatments, face scrutiny from critics who say they're dangerous because there are no state licensing requirements and virtually anyone can operate one. "

" While some spas, including Elle, employ licensed aestheticians or nurses who work under a doctor's supervision, others don't. That leaves some medical professionals questioning the safety of medical spas. "

" In fact, the American Society of Plastic Surgeons for Aesthetic Plastic Surgery issued a statement in January warning patients about the lack of oversight of medical spas. "

" "For those providing treatments outside of the physician's office, there are no national standards for medi-spas, no recognized definition of what constitutes a medi-spa and no oversight organizations that provide the information you need to make an informed, safe choice for your medi-spa experience," the statement said. "

" Even some medical spa workers are concerned about the lack of regulation of the industry. "It's just so obscene that anybody can open on the corner," said Hillary Lieberman, director of the Accents Cosmetic Surgery and Medical Spa in Sterling Heights, Mich. "

" Regulation of medical spas is difficult in part because the niche market doesn't neatly fit established categories. And the task of regulating the spas could get even trickier ? and more necessary ? with the industry's growing popularity. "

" The number of medical spas in the United States has jumped from about 45 in 2002 to about 2,000 now, according to the International Medical Spa
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