Citing general concerns over sanitation, the risk of improper transportation of injectables, and a sheer lack of control in unfamiliar environments, Aguilera firmly believes, "It is never advisable for a physician to perform medical procedures outside of a clinical setting. " Other doctors see the house call and bungalow scenarios as more of a gray area than drive-thru Botox. "It is a bit stickier, since [these treatments are] hopefully being performed in a one-on-one delivery with appropriate consultation, examination, and consent," says Herluf Lund, a board-certified plastic surgeon in St.
That depends who you ask, as doctors are split on this issue. "Our new normal has blurred the line between our personal and professional spaces, so it comes as no surprise that medical visits have been crossing over from traditional clinical settings to more nonconformist scenarios," says board-certified New York City dermatologist Shereene Idriss. "That being said, medical procedures… require attention to detail, from [patient] positioning to lighting to, most importantly, sterility and safety, as even a small oversight can have damaging long-term consequences.
Janelle Vega, a board-certified dermatologist in nearby Coral Gables, echoed his sentiments in a post of her own: "Getting drive through #Botox or #fillers can be dangerous and undervalues the fact that you're getting a medical procedure — not fast food. (For the record, Salzhauer is not offering fillers at his drive-thru clinic — although his fans are clamoring for it — because, as he says, fillers have a much greater risk of side effects, complications, and unfavorable results.
While he insists, "It's very safe to administer Botox in [this] way, as long as the person doing the injecting is experienced and competent," many of his colleagues vehemently disagree and have taken to social to speak out against what they see as a brash and unethical commodification of medicine. "Drive-Thru Botox devalues and undermines every safety and care standard we strive to uphold in our sterile clinics," board-certified Fort Lauderdale osteopathic dermatologist Shino Bay Aguilera wrote to his Instagram followers.
Currently, those in Westchester, Long Island, and New York City are eligible. "I [initially] decided to offer house calls for plastic surgery emergencies — dog bites, lacerations, burns — to help otherwise healthy patients stay out of emergency rooms and avoid exposure to the virus [while also] unburdening emergency rooms, so they could focus on treating critical COVID-19 patients," he explains. "Given that we had developed a well-functioning workflow for these essential services, it seemed reasonable to adapt this experience to delivering something a little more fun once it was safe and responsible from a public-health perspective.
In response to Lund's concerns, Salzhauer says, "It does not matter what bacteria you have living under your car seat — it matters what is on your skin, and [that] the area of the injection is cleaned with an alcohol wipe, just [as it would be] in an office. " He also makes the point that "hundreds of thousands of diabetics safely administer their own insulin shots every day in whatever environment they need to — home, office, or car. " And in his opinion, an insulin injection is far more dangerous than Botox.
The leaders of the out-of-office movement offer strong assurances that patient safety is absolutely paramount and stress that they've carefully considered every aspect of their pandemic-inspired pivots. "There is simply no wiggle room when it comes to patient safety," Smith says. "We only embark on a home visit if we know we can control the environment to ensure it meets our exacting standards for safety and sterility. " Before such a visit, the patient is screened by phone and received a consultation virtually.
When treating patients in the flesh, "We wear N95 or K95 masks, gloves, scrubs, and adhere to all aspects of clean technique," she says. "We've transported sterile drapes, gowns, cleaning solutions, and other equipment from the office to MM3 and have followed the local and professional guidelines to ensure legitimacy and safety.
Miami" a board-certified plastic surgeon in Bay Harbor Islands, Florida, kicked off summer by introducing "Drive-Thru Botox", a first-of-its-kind service he's offering to patients on Sunday afternoons when he's not in the operating room performing breast augmentations and Brazilian butt lifts.
Still, the notion of SUVs and hybrids pinch-hitting for exam rooms has some physicians uneasy. "There are over 700 bacteria in an average car as well as mold and viruses," says Lund. “There are numerous reports in the medical literature of illnesses caused by vehicle-borne [pathogens], so having an injection performed in your car may increase your risk for complications.
As for vasovagal incidents, he insists that they almost always happen immediately or within 60 seconds of the exposure. " If patients are prone to that "woozy feeling," he asks them to wait a couple of minutes before driving off. "If this were a major issue, you would have heard about it from the drive-thru COVID-19 blood-draw testing centers," he says.
Vega shares her wariness: "As we collectively struggle through a global pandemic, I don't see a compelling reason to offer elective medical procedures in uncontrolled high-touch environments," she says. "It may be more convenient, but that convenience could come at the cost of subpar results or complications for the patient.
Dermatologists and plastic surgeons are divided on how — and even if — to approach procedures during the pandemic. https://t.co/2zvoeQm8O0— Allure (@Allure_magazine) June 16, 2020