How to reduce your chances of being taken for a ride

Recently we had a new patient who was interested in improving the fine lines on her eyelids. This is not necessarily an easy task, but it can be accomplished. As the conversation developed, it became clear that she had been previously treated for this. She had gone to one of the nationally syndicated laser chains with the same request, and was told that they could help her. However, as the treatment was starting, the nurse placed eye shields that covered the lines that she most wanted treated. When the woman pointed this out to the nurse she was told "Oh, we can't treat there."

Unfortunately this type of behavior is fairly common. We not infrequently see patients who have been treated using devices or approaches that will not solve the problem that they presented with. Many "medispas" will offer up some treatment rather than tell the "customer" that they have nothing to help. We have seen patients who came requesting a specific treatment and were given a different treatment, without even being told that this was not what they had requested.
We have seen people treated with microdermabrasion for acne scarring without being told that the effects were going to be very temporary and that ongoing treatments would be required. Other patients with acne scarring were offered the option of trying to lighten the normal skin around the scars. In all cases the common denominator is that the spa wants to get paid for a procedure, whether it helps or not.
Patients often play into this by failing to do some basic research and developing an understanding of what can and cannot be accomplished. We frequently have people come in for laser tattoo removal and want the tattoo gone in a month. That won't happen unless we cut the tattoo out instead, and frequently that can leave an unsightly scar. People ask if we space treatments closer together, will it speed up the tattoo clearing. It won't, but there are offices out there that will gladly do this.
To avoid being taken advantage of, you have to first realize that these facilities are almost completely unregulated. There is no one looking over their shoulders. It's the Wild West. Be skeptical. If you have doubts, ask to speak to patients that have had the procedure performed. Any reputable facility should be able to arrange this. Ask to see before and after photos. Also ask if the photos are their own patients or photos provided by an outside source. I have seen the same set of photos used to illustrate the results of two totally unrelated procedures.
Do some research about your problem and try to learn what are realistic treatments and expectations. Then match this information with what you are told.
Above all, try to get a sense of whether the facility wants to develop a long term relationship with you, or just get you in and get you out. A facility that wants to see you again and hopes you will send your friends is much more likely to treat you honestly and fairly. A facility that has as its main draw the fact that it offers the lowest price around is unlikely to pass this test, and may not be around if a problem develops.
Finally, the place that treats you should discuss potential problems that could occur, and be prepared to treat them. Just telling you to take the problem they created to someone else, does not make the grade.

Gerald N. Bock MD
California Skin & Laser Center
Stockton & Lodi, CA