The emergence of medi-spas (sometimes called medspas) in malls or other locations outside of physicians' offices has given consumers easy access to Botox treatments or other forms of injections. But consumers should know that there are no national standards for medi-spas, no recognized definition of what constitutes a medi-spa and no oversight organization that provides the information they need to make an informed, safe choice.

The American Society for Aesthetic Plastic Surgeons and the American Society of Plastic Surgeons have created a list of questions consumers should ask before committing to any procedure or medical treatment in a spa or non-traditional facility.

Is the medi-spa within a physician's office? Physicians' offices generally have medical personnel available if a problem develops.

Is the medi-spa located in a mall or salon? If so, ask the name of the physician responsible for oversight and when they are available for consultation or questions before having any injectible, deep peel or laser treatment. Also ask about the training of any other medical personnel. This is vital to protect consumers' health and insure an optimal outcome. Although many of the procedures are generally safe with minimal recovery, they have real risks.

Injectibles (such as Botox and tissue fillers), skin treatments (such as laser, intense pulsed light and radio frequency), and chemical peels should be under the supervision of board-certified plastic surgeons or dermatologists. Ask to see these credentials. The ASAPS and ASPS says doctors in other specialties designating themselves as "cosmetic medicine physicians"? may lack the comprehensive training that is needed for administering drugs and treatments to the deeper levels of the skin and lack the experience necessary to achieve best aesthetic results or to manage potential complications.

Depending on the state, injections and deep peels may be performed by a nurse, physician's assistant or nurse practitioner. But consumers should never allow a non-medical, unlicensed person to perform a medical procedure and should make sure that the procedure is supervised by a physician board-certified in plastic surgery or dermatology.

"If you think about it, the laser can do the same thing as a scalpel, so it's important we have a medical professional involved with this procedure,"? says Byron Cook, a Texas legislator, echoing the concern of the ASAPS and ASPS.