“They are not going to get their hair done,” MdCafferty added. “They are having a medical procedure, and they need a medical evaluation pertinent to what they are going to have done.”

Dr. Amaryllis Pascual, an internist, decided to open her first weight-loss and cosmetic medical spa after she became disillusioned with the direction medicine was taking, with ever shorter time slots allotted to patients.

Pascual now operates four Pascual M.D. Cosmetic Surgery and Weight Loss Centers in South Florida, with a staff of four doctors, two physician assistants and one nurse practitioner. The med spas offer everything from weight-loss programs to breast augmentation, facial lasers and injectables.

“We came from a med spa environment but grew into serving all aspects of health and beauty,” said Pascual, 45. “So if someone comes in for weight loss and loses weight, then they may be interested in liposuction or a tummy tuck.”

She estimates that 50 percent of the med spas’ patients come in for weight loss, 30 percent for cosmetic surgery, and the remaining 20 percent for such procedures as lasers and injectables.

And a growing portion of her patients are men, as much as 30 percent.

“When I first started, men really didn’t do Botox, maybe one a month — now it’s a lot more coming, especially older men in their 50s,” she said. “They are competing with younger guys and they want to look good.”

Indeed, treatments that were once done in secrecy, whispered about in hushed tones among girlfriends, are now out in the open. And they are advertised nearly everywhere you look. Deals from med spas like Pascual’s seem to arrive in email boxes daily, promising discounts on everything from Botox to laser hair removal.

But don’t let the name “med spa” fool you, Baker warns.

“The terminology works a little on the fear factor — you’re not really going to a doctor’s office, you’re going to a spa, with aromatherapy, nice music. You’re going to be treated like a queen,” he said. “Do your homework, be aware, ask questions before you buy. Before you sign up for treatments, understand what you are doing and who is doing what to you, and be a smart consumer.”

Laws differ from state to state, but in Florida, anyone with a medical license can practice in any medical field. And physician assistants and nurse practitioners can perform injections.

“The Board of Medicine has stated that lasers, laser for hair removal, Botox injections, collagen injections, and any other noninvasive injections of materials used as procedures to treat patients must be performed by a Physician, a Physician Assistant under supervision, or an Advanced Registered Nurse Practitioner working under a protocol signed by a Physician,” Florida Department of Health spokeswoman Ashley Carr said via email.

Bill Clarke and his wife, Rita Clarke, a physician assistant, have created a growing chain of med spas in shopping malls, offering Botox, Dysport and fillers.

Venus Mini Med Spa, headquartered in Sarasota, operates nine med spas in malls, including Aventura Mall and The Galleria mall in Fort Lauderdale.

The mall, Bill Clarke said, is the perfect environment, because it’s convenient, it’s where women go for fun, and clients don’t have to make appointments.