Cleaning Up the Wild West:
How Tech Can Bring Real Medspa Regulation to the Industry Boom

When HBO’s Last Week Tonight host John Oliver put medspas under his comedic microscope, he didn’t miss. From eyebrow-raising influencer promotions to shockingly lax supervision, he highlighted what many in the industry have known for years: the aesthetics boom has outpaced medspa regulation. But while the segment sparked much-needed conversation, it also missed a key point—there are companies and practitioners pushing for higher standards. And tech plays a critical role in getting there.

This isn’t just a PR crisis. It’s a patient safety crisis. And if medspas want to protect their reputation and their clients, they need to treat the problem at its source: outdated systems, inconsistent compliance, and the misconception that non-surgical means non-medical.

Billion-Dollar Industry, Bare-Minimum Regulation

The medspa industry has exploded into a $15 billion business by 2024, combining wellness, beauty, and medical treatments in one appealing package. According to the American Med Spa Association’s 2024 State of the Industry Report, there are now 10,488 medspas operating across the United States—up from 8,899 in 2022. This represents consistent year-over-year growth that shows no signs of slowing. But with that rapid expansion comes a concerning gap in medical oversight.

While board-certified plastic surgeons and dermatologists operate with established medical protocols, many medspas lack similar structure—especially when ownership and operation aren’t clearly tied to medical professionals. According to AmSpa’s data, 31% of medspas are now owned by non-physicians (including nurse practitioners, registered nurses, physician assistants, entrepreneurs, and aestheticians), while 75% of medical directors come from specialties outside the “core” aesthetic fields of plastic surgery, dermatology, and related surgical specialties. Additionally, 64% of medical spas experienced medical director turnover in the past year, suggesting instability in crucial oversight roles.

As Oliver pointed out, we’re watching a gold rush without a sheriff. The solution requires building the right infrastructure to support proper medical oversight.

“This isn’t just a legal or reputational issue—it’s about protecting the patients who trust our industry. At Symplast, we believe better infrastructure leads to better care. When providers have the time and freedom to focus on their patients, outcomes improve—and so does trust,” said Symplast’s CEO, Facundo Formica.

HB 3749: The First Domino in Medspa Regulation Reform

Following increased scrutiny of the industry, Texas House Bill 3749 was passed to address growing concerns about medspa regulation and the misuse of medical aesthetics procedures. The legislation reinforces requirements for clear medical supervision, proper documentation of Good Faith Exams (a mandatory medical evaluation to assess patient suitability for treatment, also known as GFE), and proper delegation protocols when performing medical aesthetic services.

The American Med Spa Association rightly calls out the industry’s unregulated “Wild West” atmosphere, supporting stronger standards that protect both patients and legitimate providers. HB 3749 clarifies existing laws to ensure that only licensed medical professionals can diagnose and prescribe treatments—addressing how often these medical procedures are marketed and treated like spa services.

Similar legislation is being considered in Florida, California, and New York, signaling that comprehensive medspa regulation is becoming a priority across multiple states. This represents a turning point, and both regulators and industry leaders must respond with smart tools, clear protocols, and a culture of accountability.

This growth reflects strong consumer demand and confidence in the industry. The average patient visit value sits at $558, and 73% of patients are repeat customers—up from 65% in 2022. With 84% of medspa owners expecting revenue growth and 18% of all medspas having opened in just the past year, the industry momentum is undeniable.

However, this rapid expansion brings challenges. The data shows that treatments requiring a GFE or direct physician supervision are sometimes administered without proper compliance in many jurisdictions. That’s not just a legal liability; it’s a threat to patient safety.

The Dangerous Myth of “Non-Medical” Aesthetic Treatments

Let’s be clear: neuromodulators like Botox, dermal fillers, laser treatments, and energy-based devices aren’t beauty products—they’re FDA-regulated medical interventions with real risks and contraindications. But somewhere between TikTok tutorials and Black Friday Botox specials, the industry allowed marketing to eclipse medicine.

This misconception is reinforced by software and operational systems that prioritize spa-like scheduling and marketing automation over medical compliance requirements. At Symplast, we see this disconnect daily when practices contact us after struggling with platforms that weren’t designed for medical use. If your practice management system doesn’t include tools for GFE documentation, provider supervision tracking, medical orders, or telemedicine compliance—it wasn’t designed for medical practice.

Using spa software to run a medspa is like using a restaurant POS system to manage a hospital’s patient records. It might handle scheduling, but it completely misses the medical requirements.

Want to Avoid the Headlines? Start With the Backend

While glamorous before-and-after photos grab attention on social media, patient safety depends on what happens behind the scenes:

• Good Faith Exam Documentation: Was a proper medical evaluation performed and documented before treatment? This isn’t just good practice—it’s required by law in states like Texas, Florida, and California for injectable treatments.
• Medical Supervision: Was a licensed physician involved in the treatment plan and supervision? Many states require that non-physician injectors work under specific supervision protocols.
• Orders and Delegation: Are treatment orders and delegation protocols documented and trackable in real time? Verbal orders and assumptions about supervision create compliance gaps and safety risks.

These aren’t optional luxuries—they’re legal requirements in many states and medical best practices everywhere. Without proper systems, even well-intentioned medspas struggle with compliance. Documentation gets scattered across texts and emails. Delegation happens verbally. Supervision becomes assumed rather than verified.

The technology supporting medical aesthetics should eliminate these gaps, not perpetuate them. This is especially critical as medspa regulation continues to evolve, and states implement stricter oversight requirements.

What Medspas Should Demand from Their Software

The right practice management platform should support medical standards from the ground up. When evaluating software, medspa owners should ask these five questions:

1. Does it track and document Good Faith Exams? Look for systems that prompt providers to complete required evaluations and store them securely with treatment records.
2. Can it manage telemedicine compliance? If your medical director provides remote supervision, the platform should support compliant video consultations with proper documentation workflows.
3. Does it handle medical orders and supervision? The system should enable delegating providers and medical directors to create, approve, and track treatment orders in a transparent, auditable format.
4. Is communication HIPAA-secure? Treatment plans and patient information should never be discussed via text message or unsecured platforms.
5. Does it adapt to changing requirements? As medspa regulation continues to evolve, your software should be able to incorporate new compliance requirements without major overhauls.

From our experience at Symplast, working with hundreds of aesthetic practices, we’ve seen how the right infrastructure makes all the difference. Coming from a background in plastic surgery practice management, we built our platform to treat aesthetic procedures as the medical interventions they are—with the documentation, oversight, and compliance tools that medical practice requires.

Leading the Industry Starts with Infrastructure

Compliance software doesn’t just help practices avoid violations—it fundamentally changes how teams operate. When systems prioritize safety, structure, and accountability, communication becomes cleaner, roles become clearer, and supervision becomes routine rather than assumed.

Most importantly, patients notice the difference. They see the thorough documentation, the clear communication between providers, and the systematic approach to their care.

At Symplast, we’ve seen practices transform their operations when they move from spa-focused software to medical-grade platforms. The change isn’t just in compliance metrics—it’s in team confidence, patient trust, and overall practice culture. This transformation becomes even more critical as practitioners navigate the evolving landscape of medspa regulation.

This is why we at Symplast support organizations like The Aesthetic Society and their efforts to establish professional standards across the industry. The AlliedPro program, launched in 2023, provides education and ethical practice guidelines for non-physician aesthetic professionals—exactly the kind of initiative that elevates the entire field.

“Initiatives like AlliedPro give the industry a chance to lead, not just react. Symplast is proud to support tools and training that raise the bar—for everyone in medical aesthetics,” said Formica.

The answer to industry problems isn’t better marketing or damage control. It’s better infrastructure that supports proper medical practice.

Building a Safer Future for Medical Aesthetics

The industry doesn’t need defenders; it needs partners committed to change. At Symplast, that means:

• Working directly with medical directors to design workflows that meet both regulatory requirements and practical operational needs.
• Building features that support compliance standards which go beyond minimum legal requirements to reflect medical best practices.
• Developing technology that aligns with professional medical standards rather than following social media trends.

Patient safety isn’t a checkbox to mark. In fact, it’s a culture to build. And the right technology can help shape that culture through every exam, every order, and every patient interaction.

“A medical director should be intimately engaged with the operations of a med spa. This includes developing treatment protocols, determining which providers are qualified to perform certain procedures, ensuring the safety of any new devices or technology brought into the practice, overseeing training and credentialing, and being readily available to address complications, answer questions, or provide clinical judgment,” shared Dr. Franco, of Austin Plastic Surgeon, “A true medical director doesn’t just sign off on paperwork—they’re part of the patient care team. They help prevent problems before they occur by designing safe processes and being present as a medical resource. Ultimately, they set the tone for safety, professionalism, and excellence in care.”

The Future of Medspa Regulation Isn’t Coming—It’s Already Here

Last Week Tonight’s segment may have used humor to make its point, but the underlying message was serious: the medspa industry has serious regulatory gaps, and patients are paying the price.

Rather than waiting for more legislation or media attention, industry leaders can act now. At Symplast, we work with practices every day who are making this commitment—implementing better processes, establishing stronger oversight, and adopting medical-grade technology that transforms how medspas operate while protecting both patients and practitioners.

The real transformation in medical aesthetics won’t come from better filters or flashier marketing. Instead, it will come from the systems and standards that ensure every patient receives safe, professional medical care—and from proactive approaches to medspa regulation that truly prioritize patient safety first.

At Symplast, we’re committed to supporting this transformation. We built our platform specifically for medical aesthetics practices that understand these are medical procedures requiring medical-grade infrastructure. From Good Faith Exam tracking to secure physician oversight workflows, we help practices maintain the standards that protect both patients and providers.

All in all, the future of medical aesthetics isn’t about avoiding regulation—it’s about embracing the higher standards that regulation represents. And that future starts with the infrastructure decisions practices make today.