Beauty is big business, especially here in the capital of the entertainment industry, so it’s no wonder that the Valley is home to a wide variety of plastic surgeons, dermatologists, aestheticians and cosmetologists all touting the latest and greatest scientific and naturopathic cosmetic enhancement processes and products. Nearly 11 million cosmetic procedures were performed in the U.S. in 2006, just over 3 million of them in the Western U.S, according to the American Society of Plastic Surgeons. For comparison, in 1996, the number was about 200,000. The Valley is home to hundreds of doctors and allied health professionals who are members of a wide variety of organizations ranging from the American Society for Aesthetic Plastic Surgery to the Medical Spa Association. You might be surprised at some of these aesthetic practitioners. Take Dr. Renee Cotter, an OB/GYN in West Hills who, in addition to delivering babies, now also offers aesthetic laser treatments for hair removal, varicose vein remediation and skin rejuvenation. Studio City-based board-certified dermatologist Dr. Gene Rubinstein said he has seen a real increase in doctors like this who are now doing cosmetic work for business reasons. “There are lots of economic factors rising rents, rising wages, lower insurance reimbursements that are sort of driving these traditionally non-cosmetically-oriented specialists into the cosmetic specialties,” said Rubinstein. “You hear of things like neurosurgeons who are now going into hair removal and starting medispas because they’re not making as much money as they did before and they’re feeling the economic pinch.” Rise in medispas Medical spas, also referred to as medispas or medspas, have also proliferated as more and more treatments such as Botox, whose use has grown by nearly 200 percent since it was first approved by the FDA for cosmetic use in 2002, have come available. The growth comes also as the stigma of having a cosmetic procedure done has been lessened with shows like Nip/Tuck and Dr. 90210 becoming major hits on television. Speaking of Dr. 90210, one of the physicians regularly featured on the show, Dr. Daniel Yamini, is the supervising physician and part-owner of Blue Med Spa in Encino. Manager and co-owner Ronda Hawara-Nofal said she first opened the spa in 1999. At the time she had one laser and about 900 square feet of space. The facility has now grown to 6,000 square feet and is the largest purchaser of Botox in the San Fernando Valley. Blue has been featured in countless beauty magazines and was even used as a location for a CSI:Las Vegas crime scene. Hawara-Nofal said it hasn’t been easy being a pioneer and trying to stay abreast of ever-changing rules and regulations regarding the industry. “The Medical Board (of California) approached us with a letter about compliance,” she said. “There’s really no guide out there that says ‘this is what you need to open up a medical aesthetic practice.'” In order to be considered in full compliance, Hawara-Nofal shelled out about $30,000 to create the proper corporate structure, comply with OSHA requirements and create detailed legal agreements detailing how every tiny detail of the business will run. She said two Valley competitors had to shut down because of compliance issues, one of which was only open for about eight months.