Bad Med Spa Outcomes Are Rising. Here’s How to Protect Yourself

The aesthetics industry is constantly evolving, and one sector that’s experiencing rapid expansion and a major boom is the med spa category. Partially due to the advent of regenerative aesthetic treatments alongside more traditional treatments, such as Botox, lasers, and microneedling, med spas now offer a more holistic, all-inclusive approach to beauty and aging with cutting-edge treatments that push the envelope. Despite popular med spas promising beauty, wellness, and rejuvenation wrapped in the soothing veneer of a high-end spa, beneath the surface lie significant issues: inconsistent regulation, unqualified providers, the use of counterfeit products, and serious risks to patient safety. As John Oliver recently pointed out on Last Week Tonight, many med spas operate in a regulatory “wild west.”

At AEDIT, we take these issues and risks seriously. As demand for cosmetic procedures grows and med spas multiply rapidly across the country, there’s more confusion for patients. While many reputable providers operate safely and ethically, others cut corners, compromising staffing, training, and product sourcing. For the patient, this creates a confusing and potentially dangerous landscape where it can be hard to tell the difference between a qualified medical provider and a risky operation. This is why our soon-to-launch AEDIT Cosmetic Wellness medspa sets the standard for safe, transparent cosmetic treatments rooted in science, results, physician leadership, and high-quality, verified products. Medical oversight, ethical sourcing, and patient-first care are non-negotiable because we believe beauty shouldn’t come at the cost of safety. AEDIT founder and board-certified facial plastic and reconstructive surgeon Dr. William Kennedy shares, “What sets AEDIT Cosmetic Wellness apart is our uncompromising commitment to medical excellence. In an industry where the quality of care can vary widely, we ensure every treatment is overseen by clinically trained providers who prioritize safety just as much as results. Our clients don’t have to choose between expertise and experience — they get both.”

Before you step foot into a med spa, we want you to know how to spot the red flags. Here’s everything you need to know to keep yourself safe and protected while reaching your beauty goals.

The John Oliver Last Week Tonight Med Spa Reveal

In his June 2025 segment, British-American comedian, actor, political commentator, and television host John Oliver exposed the dark and dirty underside of the American med spa expansion touching key issues including lax oversight, dangerous practices, and counterfeit treatments. He highlighted how, in many facilities, procedures like Botox injections and IV drips are continually performed by undertrained or unlicensed staff and claimed to be supervised by a physician who oftentimes barely sets foot in the building. Dr. Kennedy adds, “As the medspa industry expands, we’re seeing an increase in treatments performed by providers who simply aren’t qualified. This is exactly where physicians need to lead: by setting clinical standards, supervising care, and making sure patients understand the credentials of the person performing their procedure.”

Some of the most alarming med-spa horror stories included burns, scarring, paradoxical adipose hyperplasia (PAH) after cryolipolysis (CoolSculpting), bacterial infections, the transmission of HIV, and the use of counterfeit injectables and fillers bought on the black market. The segment also called out compounding pharmacies and unverified suppliers, emphasizing that patients have little recourse when something goes wrong. Oliver’s overarching message was clear-cut and called attention to red flag problems: “If they respond by acting defensively or won’t show you the vials, get out of there.”

How Common Are Unlicensed or Underqualified Providers?

According to reports, many med spas operate without on-site physicians and, instead, rely solely on nurse practitioners (NPs), physician assistants (PAs), and even less qualified staff. These non-physician providers often receive minimal training at best—sometimes it’s a weekend seminar where they learn about every treatment and procedure they’ll be performing, versus the years of medical school a qualified physician goes through—before being tasked with injecting neurotoxins or performing laser treatments. “When a treatment is performed by someone without proper medical training, the risk of complications rises dramatically.” Dr. Kennedy cautions, “These procedures may look simple, but they require deep knowledge of anatomy, sterile technique, and clinical judgment. In the wrong hands, even routine treatments can lead to serious and completely avoidable issues.”

On top of that, physician oversight is weak. Dr. Kennedy explains, “Many physicians underestimate the level of ongoing oversight a medspa truly requires. Between busy clinical schedules and competing priorities, it can be difficult to dedicate the time needed for consistent supervision — and that gap is often where safety issues arise.” While some medical spa physicians are removed from the day-to-day treatments and operations of the business, others often operate via remote supervision (which is often permitted). Without a licensed and qualified physician on site, patients can unknowingly leave themselves in a vulnerable position if complications arise, causing them to bear the brunt of the damage.

How Does Lack of Physician Supervision Affect Patient Safety?

When a physician isn’t physically present during any cosmetic treatment or procedure, takes a hands-off approach, or is only nominally involved, the risk of complications and side effects skyrockets. Without a doctor on-site, the following can happen:

• There may be no proper medical evaluation before treatment.
• Emergency protocols may be weak or nonexistent.
• Delegation to non-physicians may occur without clear accountability.

In John Oliver’s segment, he spotlighted a specific incident at a med spa where a woman had a seizure after Botox, and the supervising physician, a pediatrician, was hours away. That’s not just negligence—it’s a breakdown in medical standards that needs to be stopped. Dr. Kennedy adds, “What’s most alarming is that these stories are becoming more frequent. When medspas cut corners on credentials or supervision, patients are left vulnerable to complications that could easily have been prevented. As an industry, we have a responsibility to stop normalizing this and to put patient safety back at the center of care.”

Why is There a Lack of Consistent Regulation for Med Spas?

One reason med spas seem to get away with anything is that there is no federal definition of a med spa and no uniform federal oversight, so the rules vary from state to state. Loose laws equal inconsistent regulation, making med spas a risky business and a regulatory grey area.

Some states treat injectables and laser treatments as medical procedures, while others see them more as beauty services. Enforcement is inconsistent, and many states lack clear laws on who must be present, who can administer them, and how medical oversight should properly operate. For all these reasons, med spas are inconsistently regulated, and that’s where the problems arise. “At a minimum, we need standardized rules across all states that define who can perform medical aesthetic procedures and what level of oversight is required. Every medspa should have a qualified medical professional on-site, clear protocols for supervision, and documented training requirements for anyone delivering treatment. These are basic safeguards — and they shouldn’t be optional,” says Dr. Kennedy.

Why Unverified or Counterfeit Products Are a Problem

Part of the risk in going to unqualified and unlicensed med spas lies in the safety of the treatments and procedures, as well as the origin and authenticity of the products used. Counterfeit and black-market products, as well as watered-down versions and mislabeled vials, are unfortunately on the rise.

Some of these products are sourced from compounding pharmacies or unapproved sources. Worse, certain med spas reportedly order products via online marketplaces, bypassing the FDA altogether. Without rigorous sourcing and chain-of-custody controls, patients simply don't know what they’re getting and what harm that might cause.

What Are the Real Risks and Reported Complications?

The outcomes that Oliver highlighted weren’t theoretical. They’re actual. Real people are being seriously hurt and damaged, and some of these incidents aren’t reversible, causing long-term pain, emotional and mental damage, and permanent disfigurement. Some of the risks and reported complications that people are experiencing at unsupervised and poorly run med spas include:

• Burns and scarring from laser hair removal
• Paradoxical adipose hyperplasia (PAH), which causes fat to increase in the treated areas after treatments that are meant to reduce it
• Infections and sepsis, including bacterial infections from B12 or IV injections, and more alarmingly, HIV infection following PRP (platelet-rich plasma) treatments
• Counterfeit injectables: cases of “Botox” and fillers purchased from overseas, via unregulated sources like Alibaba, tragically leading to disfigurement, necrosis, or systemic illness
• Death: such as the tragic case of Jenifer Cleveland, who died following IV therapy at a med spa where the medical director was more than 100 miles away

Dr. Kennedy warns, “When complications occur in an environment with poor oversight, the damage is often not something we can simply reverse. Patients are left with physical scars, emotional trauma, and in some cases permanent disfigurement. The weight of that experience stays with them long after the procedure — and no one seeking a cosmetic treatment should ever have to endure that.”

What Are the Legal and Compliance Risks for Med Spas?

Operating a med spa isn’t just about offering aesthetic services; it’s also about compliance and regulation. Key issues that are commonplace within the med spa include:

• Licensing and supervision: Many states don’t require a medical director to be physically present during treatments and procedures.
• Delegation: If a physician delegates certain responsibilities to an NP or PA, there must be documented protocols, medical director agreements, and supervision. Many of these providers skip these steps entirely.
• Product documentation: Transparency around vials, batch numbers, storage, and chain of custody is often lacking, which only increases the use of counterfeit products.

What Regulations or Laws Are Being Proposed or Enacted?

There is some effort to bring forward laws and regulations that will hopefully offer recourse to patients who have been harmfully wronged and damaged. In Texas, House Bill 3749, also known as Jenifer’s Law, passed and took effect on September 1, 2025. The bill requires that elective IV therapy only be administered by a physician assistant, nurse practitioner, or RN under physician supervision.

Originally, the bill was stronger, proposing to regulate more cosmetic procedures while limiting the roles of NPs and PAs, but many of those provisions were removed in the final version. This law underscores just how reactive regulation has been, often coming only after tragedy strikes. Outside Texas, regulation remains fragmented. Some states impose strict requirements; others have virtually no med spas-specific laws.

How Can Patients Vet a Med Spa Before Booking?

Patients need guidance when it comes to what to look for and which questions to ask. This practical checklist is an easy way to protect yourself:

1. Research the medical director
2. Who is listed as the medical director?

3. Do they have specialty credentials in dermatology, plastic surgery, or aesthetic medicine?

4. Check provider credentials
5. Ask for the names of the injectors.

6. Google them and check their licenses via your state medical board.

7. Inspect the product vials
8. During a consultation, ask to see the actual product vials and make sure they look right.

9. Look for FDA-approved brands, lot numbers, and expiration dates.

10. Evaluate the consultation process
11. Does the provider do a full medical evaluation before injecting?

12. Do they clearly explain potential complications?

13. Understand protocols
14. What happens if something goes wrong? Do they have emergency protocols?

15. Verify liability coverage or medical malpractice insurance.

16. Check for transparency and documentation
17. Do they keep digital or physical records?
18. Can you get a copy of your treatment plan or consent form?

What Questions Should You Ask During Your Consultation?

During your consultation, don’t be shy about asking the questions you want answers to, especially since your health and safety are on the line. If you’re not sure where to start, use these questions as a guideline:

• Who is your medical director? How often are they on-site?
• Are the injectables you use FDA-approved?
• Can I see the vials and batch numbers of the products you'll be injecting me with?
• What education and training do your injectors have?
• How long have your injectors been working here?
• What’s your protocol if there’s a complication or side effect?
• Do you hold liability insurance? Will you provide documentation?

What Should You Do If Something Goes Wrong?

If a cosmetic treatment or procedure goes awry and leaves you with a bad experience and outcome, here’s exactly what to do according to Dr. Kennedy:

• Seek medical help immediately. If something feels wrong or you experience an infection, pain, or abnormal swelling, get seen by a medical professional immediately.
• Document everything. Take photos, save vials, and keep records of all communications between you and the med spa, so you have receipts for when needed.
• Report the incident. Contact your state medical board, the FDA’s MedWatch program, or your state health department.
• Consult legal help. Retain an attorney who specializes in medical malpractice or patient rights who can help you navigate the incident and how to handle it properly, especially if your provider was unlicensed or uninsured.
• Protect others. Your experience can warn others and potentially save them. Take action and share your story, report the med spa, leave honest reviews, and contact advocacy groups.

How Can the Industry Improve to Protect Consumers?

For change to take place, it needs to start with both industry accountability and consumer education. Here’s what patients need to demand and what the industry needs to be responsible for providing:

• Stronger regulation. More states need laws like Jenifer’s Law with clear definitions and enforceable standards.
• Transparent supply chains. Spas should only be able to source injectable and filler productos from licensed distributors and authorized manufacturers. They also need to be willing to show patients the vials.
• Standardized training. Certifications and training programs for aesthetic injectors should be rigorous, accredited, and consistent across states.
• Patient advocacy. Consumers need access to aesthetic and med spa education so they can feel safe, get answers to their questions, and be confident when reporting unsafe practices.

The Bottom Line

Med spas offer powerful treatments and effective tools for self-care and aesthetic transformation, but not all providers are equally committed to safety. Oliver’s Last Week Tonight segment reminds patients, providers, and the industry of weak regulation, the rise in inexperienced injectors, and the explosion of counterfeit products, all of which can have devastating consequences.

By educating yourself, asking the tough questions, and demanding transparency, you can protect yourself and reduce the risk of potential side effects and complications while helping to push the industry toward higher standards.

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