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How much to tip for facial treatments: tipping etiquette at medi-spas and doctor's offices

Money Rules: Tipping Etiquette At Spas, Your Doctor’s Office, & Medi-Spas


December 7, 2015

We’ve all been there: you’re leaving the medi-spa after receiving injections, or a laser treatment, and it’s time to pay for the service. How much to tip for facial treatments? Should you add gratuity on top of the cost of this kind of service? You may have de-stressed in a relaxation room prior to the treatment—was the service performed by a doctor or nurse? We all know 15-20% gratuity is standard for the spa world, but what about this gray area we call the medical spa?

According to the American Society of Plastic Surgeons (ASPS), the largest area of increase (+ 4%) from 2013 to 2014 included minimally invasive cosmetic procedures like Botox, fillers and chemical peels. Doctors are employing more aestheticians, and dermatology and plastic surgery facilities are opening up exponentially more medical spas.


So, you must be wondering: how much to tip for facial treatments or any other medical spa service? We asked the pros to weigh in on the topic and interviewed four Charlotte’s Book Experts based in New York City: they supplied the dos and don’ts needed to save us from embarrassment, plus the know-how required for confidence at the checkout desk.


Jordana Mattioli, sought-after medical aesthetician with Complete Skin MD on The Upper East Side, says don’t tip in a doctor’s office. Save your tips for the spa. Mattioli doesn’t accept tips at Complete Skin MD, a dermatology practice where she performs medical facials and peels.

Dr. Melissa Doft of Doft Plastic Surgery, also on The Upper East Side agrees. “We do not encourage patients to tip,” says Doft, although some of her facial clientele insist. “If the physician, physician’s assistant or nurse practitioner is performing the procedure, no tip is necessary,” Doft points out.

Juliet Cavallaro is practice manager at Russak Dermatology Clinic located in Midtown East. She says tipping is not expected but appreciated for services performed by aestheticians, including facials or treatments that include massage. “Don’t feel pressured to tip for treatments only offered under a doctor’s license such as CoolSculpting, Ultherapy, microneedling or laser rejuvenation.” When patients feel inclined to tip, Cavallaro lets them know the clinic is not like a spa, where 20% would be expected.

Dr. Cybele Fishman, cosmetic dermatologist in Lower Manhattan, allows her aesthetician to accept tips, although it is not expected or advertised as standard practice on their spa menu. “I think tipping someone you have a relationship with is more important than the one-time visit to a random medi-spa,” she says.

All four experts concluded, tipping at the medical spa is not required or expected, especially for ablative procedures. When it comes to services performed by aestheticians, “go with your gut,” says Fishman.


It’s wise to stay ahead of the game and do some research before visiting a new medi-spa. A quick website skim will likely outline spa etiquette, among other helpful points. “When in doubt, ask the person at the front desk,” advises Mattioli. The receptionist is always a safe bet and should be able to easily fill you in on common practices within the business.

Like with any other spa or doctor visit, arrive early for your appointment as paperwork will be required. Allow yourself time to get a feel for your environment and take a breather. Come prepared with questions you may have about your skin, and don’t be afraid to ask them.


If you still have doubts about how much to tip for facial treatments and feel uneasy about not tipping at all, there’s plenty you can do to show your appreciation and spread good karma. “It is important to do what feels right for you. I think everyone likes to feel appreciated, but there are many ways to show appreciation that do not involve a cash tip” says Doft.

“If you’re getting any treatments done at a dermatology or plastic surgery practice and feel the staff went above and beyond, referrals are the best way to show your appreciation. If you are really adamant on wanting to show further appreciation for those services, send a thank you note, some sweet treats, flowers or a bottle of wine,” says Mattioli.

Thank you cards, online reviews and referrals are some of the best ways clients can say thank you to their medi-spa staff—so take the time to write a review of your Charlotte’s Book provider.

Image: Ceci Gervaso

READ THIS NEXT: Off The Beaten Path: Medical Aestheticians
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