For those who seek cosmetic procedures but demand discretion -- or just want greater convenience -- there's an option. Destinations Medical Spa bills itself as Southern California's first doctor-managed mobile cosmetic care service, offering board-certified doctors who provide services such as Botox injections and laser treatments to clients in the privacy of their homes or offices.
"Our doctor shows up in a nondescript SUV and sets up everything in 10 minutes," said Skylar Evans, Destinations' chief operating officer. "The neighbors won't know a thing."
She said that business was "not quite as robust" in 2009 as it was when Destinations launched in 2007 but that many treatments are holding their own. Services include chemical peels, laser hair removal, a liquid face-lift, fillers -- essentially anything offered at a typical medical spa, and at around the same prices.
"Most clients' biggest concerns are the things that make the most difference on the face -- getting rid of sun damage or deep lines quickly. Facials might feel good, but they don't have that noticeable an impact. And clients are doing away with fluff things," she said.
Destinations, which is based in San Marcos, started out serving clients in San Diego and Orange counties and has extended into Los Angeles County. Evans has also worked out arrangements to serve clients of a number of spas in San Diego and Orange counties that have only occasional demand for laser and other pricier procedures.
"Some of this equipment can cost $300,000," she said. "A lot of spas can't afford to put in that revenue, to provide training and insurance for the doctor. So when a client asks for a medi-spa service, they can call on us to come in and take care of it. And we try and make it as affordable for the client as possible, offering interest-free payments."
Teresa Bennetts, the owner of Eurofit Skin & Body Therapy in Fallbrook in San Diego County, said that having access to Destinations has been a boon to her clients, as well as to her business. She schedules five to eight appointments every Monday -- a day when the spa used to be closed -- for clients who want Botox and Restylane, vein therapy or intensive skin treatments such as photofacials, which are the kind of services her spa is otherwise not equipped to handle. The arrangement has another bonus: Clients tend to schedule a micro-dermabrasion session with Bennetts immediately before having a laser facial with Destinations.
"It's brought me new clients and hasn't cost me a penny," said Bennetts, adding that she gets a monthly commission from Destinations. "It would cost me a fortune to offer the same services permanently out of my spa -- the medical insurance alone."
Evans says that though she's noticed that women are skipping monthly facials, they are keeping up with their Botox and other dermal fillers.
"Before, women would spend tons and tons on all this," she said. "Now, they are breaking their treatments into five payments instead of paying in full. But they seem to feel better doing it at home -- they want late appointments, don't have the time to drive to a spa and maybe don't want to be seen. If we can offer them that and keep the costs competitive, they'll see us instead."