By Alex R. Thiersch, JD, CEO of the American Med Spa Association (AmSpa)

It should come as no surprise that injections of botulinum toxin and hyaluronic acid fillers are the treatments most commonly offered by medical aesthetic practices. After all, they provide good return-on-investment (ROI) and are constantly in demand. According to the 2019 Medical Spa State of the Industry Report, 88% of respondents' medical spas offer botulinum toxin. Furthermore, 73% of respondents' medical spas cite it as being among their top three most frequently performed treatments, and 56% state that it is the most common treatment for first-time patients.

Hyaluronic acid filler injections are similarly widely available—they are offered by 88% of medical spas—but are not quite as widely administered, appearing in 58% of med spas' top three most frequently performed treatments.

In the 2017 version of this report, botulinum toxin and fillers were combined as one option, and they were found to be available at 82% of medical aesthetic practices, so their availability is still growing.

And while it finished fourth in terms of availability, microneedling's ascent into the pantheon of medical aesthetic treatments is perhaps the biggest story of this report. In the 2017 survey, microneedling was mentioned on only a handful of responses; today, it is available at 84% of responding medical spas and is among the top three most popular treatments at 20% of them.

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