Demand Letters for Botched Cosmetic Procedures and Med Spa Treatments
Aesthetic clinics and med spas sit at an uncomfortable intersection of beauty marketing and real medicine. Injections, lasers, peels, microneedling, thread lifts, IV drips, and “non-surgical” devices are medical treatments, even when they are sold like spa packages. When something goes wrong, you are suddenly in the world of burns, scarring, pigment damage, nerve injuries, and disfigurement – not just disappointment.
A well-crafted demand letter is often the first serious step toward getting a refund, funding for corrective treatment, and, in appropriate cases, negotiating a release of claims on terms that actually protect you. This guide walks through how to approach those letters in the cosmetic and med spa context.
Why med spa demand letters are different
With most consumer products, the dispute is about whether an object works. Med spa cases add layers:
You are dealing with medical procedures, even when performed in a spa-like setting. In California and many other states, treatments such as Botox, dermal fillers, and other injectables are explicitly treated as medical procedures regulated by state medical boards and allied boards.(Medical Board of California)
Informed consent is not just a formality. The law generally requires that patients be informed of the nature of the procedure, its material risks and benefits, alternatives, and the likely outcome before treatment.(Medical Board of California)
The person who actually injected or treated you may not be the physician whose name is on the door. Many states, including California, require physician ownership or supervision of medical spas, yet day-to-day treatments are often done by nurses, physician assistants, or sometimes practitioners operating outside their scope of practice.(Holt Law)
On top of that, med spas are heavily marketed. The FTC requires that health-related advertising claims be truthful and supported by competent and reliable scientific evidence, and has focused in recent years on misleading medical aesthetics advertising.(Federal Trade Commission)
Your demand letter, therefore, is not just “I do not like the results.” It is often about failures in informed consent, deviation from the standard of care, scope-of-practice violations, and misleading marketing, all wrapped around very personal injuries to your face or body.
Step one: Work out who treated you and what went wrong
Before writing, pin down exactly what was done, by whom, and under what paperwork.
In most states, you are entitled to a copy of your medical records from a med spa or clinic, including chart notes, consent forms, treatment logs, and pre- and post-treatment photos. These records should show the type and amount of product injected, the device settings used, and who actually performed each procedure.
In California, for example, a proper “good faith exam” by a qualified provider is expected before invasive medical spa procedures.(Qualiphy) If no one ever took a meaningful history or examined you, that gap may matter both medically and legally.
Clarify whether the injector was a physician, nurse practitioner, physician assistant, registered nurse, or esthetician. Also determine whether the clinic itself is a physician-owned medical practice or a spa owned by non-physicians contracting with a doctor. These details tell you which licensing board has jurisdiction if you later complain: medical board for physicians, nursing board for nurses, barbering and cosmetology board for estheticians, and so on.(Medical Board of California)
Finally, be precise about the harm. Lumps, asymmetry, overfilled areas, drooping brows, or minor bruising are different from burns, open wounds, necrosis, infection, vision loss, or permanent scarring. The more serious the injury, the more careful you must be about signing any broad release in exchange for a quick refund.
Legal hooks you can use in a med spa demand letter
There are four broad categories of legal theories that frequently show up in these disputes.
The first is medical negligence or breach of the standard of care. Even elective cosmetic procedures must be performed according to the accepted standard of care for that procedure and for that type of provider. Injecting filler into an unsafe plane, ignoring vascular anatomy, failing to recognize and treat signs of vascular compromise, or using inappropriate laser settings on darker skin types can all be departures from that standard with serious consequences.
The second is lack of informed consent. The doctrine of informed consent requires that the provider explain the nature of the procedure, material risks, likely benefits, and reasonable alternatives, and obtain your voluntary consent.(Medical Board of California) If no one warned you about the possibility of pigment changes from a chemical peel or burns from a laser on your skin type, or you were reassured the procedure was “low risk” when it plainly was not, your letter can highlight that disconnect between what should have been disclosed and what was actually said or written.
The third is practicing outside the scope of licensure. An esthetician who performs medical-grade chemical peels or microneedling to a depth reserved for medical professionals, or anyone injecting fillers without appropriate licensing and supervision, may be operating outside the scope of practice defined by state law and regulatory boards. In California, for instance, the Board of Barbering and Cosmetology enforces scope limits and can discipline licensees for gross negligence, incompetence, unsanitary conditions, and unlicensed practice.(Cal Barber & Cosmetology Board)
The fourth is misleading or unlawful advertising. Med spas rely heavily on social media and online marketing. The FTC’s health products guidance and recent commentary on medical aesthetics make clear that claims must be truthful, non-misleading, and backed by solid evidence.(Federal Trade Commission) Guarantees of “no downtime,” “risk-free,” or “permanent results” can be problematic when reality looks very different.
Your demand letter does not have to name every possible cause of action, but grounding your narrative in these ideas makes it clear that you are not just unhappy with a subjective cosmetic outcome; you are raising compliance and safety issues that regulators care about.
Evidence to gather before drafting
These cases are often won or lost on the documentation. Before putting fingers to keyboard, assemble what you can.
Request a full copy of your chart from the clinic, including intake forms, consents, treatment notes, and any internal photos. Keep your own before-and-after photos, ideally with consistent lighting and angles. Save screenshots of the clinic’s website, price lists, and any social media posts or ads that influenced your decision, particularly if they contain bold promises or downplay risks.
Retain every text message, email, and direct message between you and the provider, along with voicemails or call logs. If the provider admitted anything about a mistake, deviated from the usual narrative, or mentioned complications that they did not previously disclose, those statements matter.
If you have already sought corrective care elsewhere, obtain records and statements from those providers describing the damage they observed and the corrective treatment they performed or recommend. In the filler space, for example, records describing dissolution with hyaluronidase to fix migration, lumps, or vascular compromise can be powerful evidence that the initial injections were not competently done.(Bodyvie)
Finally, note any board complaints you have filed or are considering filing with bodies such as the Medical Board, Nursing Board, or Board of Barbering and Cosmetology, and keep copies or confirmation emails.(Medical Board of California)
What you are actually trying to accomplish
In a botched cosmetic or med spa case, your goals may differ from a typical personal injury dispute. Many patients primarily want the damage fixed and their money back, not a courtroom trial.
Typical objectives for a demand letter include a full or substantial refund of what you paid for the procedure, coverage for corrective treatment with a provider you trust, not the same injector, and in some cases, compensation for ancillary expenses such as medications, dressings, transportation, missed work, or additional consultations.
Sometimes, clinics propose a package that combines a refund or payment toward corrective care with a release of claims and a confidentiality clause. That is where you must be especially careful. Once you sign a broad release, you may be waiving your ability to pursue any further legal action, even if complications later turn out to be more serious than you realized at the time. The demand letter stage is often where those negotiations begin, so it is crucial to understand the trade you are making.
How to structure a med spa demand letter
A good med spa demand letter reads like a clear case memo designed for a busy person.
Start with a professional heading that identifies you and the clinic. Use a subject line that instantly signals the issue, such as “Botched Lip Filler Treatment on [date] – Demand for Refund and Corrective Treatment Costs.”
Open with a short introduction explaining that you are writing in connection with specific cosmetic treatments performed on a specific date, that those treatments caused concrete harm, and that you are demanding defined remedies.
Next, tell the story. Set out the background: the name and address of the clinic, the titles and names of the providers involved, the procedures you were sold, the prices you paid, and the advertising or assurances that influenced your decision. Then describe the treatments themselves, the setting, and what you recall about the consent process. If you were told the procedure was “simple,” “no downtime,” or “just like a facial,” and nothing significant was said about risks such as burns, scarring, pigment shifts, asymmetry, or vascular compromise, say so plainly.
After that, describe the complications or poor results in concrete terms. Explain when symptoms began, what they looked and felt like, how the clinic responded, and what subsequent medical care you needed. If you sought emergency care or saw another practitioner to correct the damage, summarize those visits and attach the records.
Then connect the facts to the legal framework in accessible language. Explain that these were medical procedures and should have been performed and supervised in accordance with medical standards, that proper informed consent and a thorough medical evaluation were required, that your provider appears to have operated outside the standard of care or perhaps outside their scope of practice, and that the advertising and assurances you relied on were inconsistent with the severity of the risks you actually faced.(Medical Board of California)
Once the factual and legal foundation is in place, state your demands. Specify the exact dollar amount you want refunded, any additional sums you are seeking for corrective treatment and related expenses, and the timeframe in which you expect payment or a binding written commitment. Make clear whether you are open to discussing a written release of claims and under what general parameters, such as a release limited to the injuries known at the time and excluding future unknown serious complications.
End with a polite but firm statement of what you will do if the clinic does not resolve the matter by your deadline. Mention that you are considering or will file complaints with appropriate licensing boards and consumer authorities, and that you may pursue your claim in court. You do not need to threaten publicity, social-media campaigns, or criminal charges; staying within the lane of regulatory and civil remedies keeps your letter credible and avoids unnecessary risk.
Regulatory leverage: boards and agencies
Cosmetic injuries from med spa treatments are not just private disputes; they are also regulatory issues. That is part of your leverage.
The Medical Board of California and similar boards in other states publish consumer guidance on medical spas emphasizing that injections and lasers are medical procedures, that these facilities must have proper medical oversight, and that patients who believe they were harmed should consider filing complaints.(Medical Board of California)
The Board of Barbering and Cosmetology, where estheticians are licensed, investigates complaints involving gross negligence, unsanitary conditions, and unlicensed or out-of-scope practice, which includes the use of medical-grade products and procedures reserved for medical professionals.(Cal Barber & Cosmetology Board)
State departments of consumer affairs typically provide central complaint portals and can route grievances to the correct board.(Department of Consumer Affairs) At the federal level, the FTC can pursue med spas and clinics that engage in deceptive health-related advertising or make unsupported medical claims.(Federal Trade Commission)
You do not need to turn your demand letter into a regulatory treatise. It is enough to show that you understand these bodies exist, that you are prepared to use them, and that the clinic’s practices raise not just customer service issues but potential compliance problems.
When a demand letter overlaps with serious malpractice
Some med spa mishaps are largely cosmetic and reversible; others are life-changing injuries. Vascular occlusion leading to tissue necrosis, infections requiring hospitalization, vision loss from filler emboli, severe burns, or disfiguring scarring can all move a case from “consumer refund with a release” into the territory of high-value malpractice.
In that zone, the function of a demand letter changes. It is no longer just a prelude to a small-claims case or a refund negotiation; it becomes a piece of a larger liability record. You must be extremely cautious about releasing claims too early or too broadly, especially before the full extent and permanence of the injury are known. The same practices apply: careful documentation, precise chronology, and clear demands. What changes is your tolerance for trading significant future legal rights for a quick but inadequate payment.
Frequently asked questions about med spa demand letters
Is a bad cosmetic result enough for a demand letter, or does it have to be a clear medical injury?
A demand letter can address both. Mild dissatisfaction with a subjective cosmetic result might support a polite request for a touch-up or partial refund, but not every disappointing outcome is legally actionable. The stronger cases involve a combination of promised results that were unrealistic or misrepresented, gaps in informed consent, and objective harm such as burns, scarring, pigment changes, asymmetry that clearly exceeds what was disclosed, or medical complications that required further treatment.
Even if you are not sure whether the law defines your experience as malpractice, a carefully written letter that documents what was promised, what was done, and how you were harmed can still lead to a business resolution. The key is to be honest about the severity of the outcome and not to exaggerate minor cosmetic concerns into catastrophic injuries.
What if I signed a consent form that listed many risks – does that kill my claim?
Consent forms are important, but they are not absolute shields. A consent form that recites risks you were never meaningfully counseled on, or that glosses over serious possibilities while marketing the procedure as essentially risk-free, does not automatically defeat your case. Informed consent is a process, not just a signature.
Your demand letter can acknowledge that you signed a consent form but explain what was and was not actually discussed. If the form lists rare but severe risks yet the staff brushed them off, or if crucial risks such as burns on your skin type or vascular complications from fillers were not mentioned at all, you can highlight that mismatch. Courts and boards look at what a reasonable patient in your position would have wanted to know, not just whether a form existed.
How do I address a situation where an esthetician performed what seems like a medical procedure?
This is common in the med spa world and a serious red flag. Many state laws limit estheticians to non-medical cosmetic services and explicitly exclude deeper peels, microneedling to medical depths, and all forms of injection, which must be performed under a physician’s oversight by appropriately licensed medical personnel.(Cal Barber & Cosmetology Board)
In your demand letter, set out who performed the procedure, what their title is, and what the procedure involved. If it appears that an esthetician used medical-grade products or devices beyond their scope of practice, say so. You can note that you are considering complaints to both the cosmetology board and the medical board regarding unlicensed or out-of-scope practice. This angle is often taken very seriously by regulators and can motivate a clinic to resolve your claim more quickly.
Should I mention that I am planning to file a complaint with the medical or cosmetology board?
It is usually appropriate to mention regulatory complaints in a calm, factual way. You can write that, unless the matter is resolved, you intend to submit complaints to the relevant licensing boards so they can review the clinic’s practices and supervision. You do not need to frame this as a threat; regulators exist precisely to review potential violations and patterns of harm.
What you want to avoid is wording that sounds like “pay me or I will ruin you with the board,” which can be interpreted as coercive. The tone should be that you are protecting yourself and others by alerting regulators if your concerns are not addressed, not that you are using complaint processes as a cudgel for personal gain.
Can I still get corrective treatment at the same clinic while I am disputing what happened?
Medically, time often matters, especially with complications from fillers, lasers, or peels. You may need urgent care to prevent worse damage. The tricky part is that returning to the same clinic for corrective treatment can complicate your narrative and, in some cases, give the clinic arguments that they did everything they reasonably could once the problem emerged.
If the complication is acute and you are still in that clinic’s orbit, your demand letter can acknowledge any corrective steps they took, while explaining why those efforts were inadequate or why you lost trust and sought care elsewhere. In many situations, especially after serious burns, deep pigment changes, or repeated mismanagement, it is more sensible to have a new, independent provider handle correction and to seek reimbursement for that care in your demand rather than relying on the original clinic.
What if the clinic offers a refund only if I sign a broad release and confidentiality agreement?
This is common in the cosmetic space. A refund tied to a release and confidentiality clause can be sensible in a minor dispute where the harm is limited, you feel fully informed, and the amount offered truly makes you whole.
In more serious injury cases, broad releases are dangerous. They can extinguish your rights for injuries that have not fully declared themselves, or for future complications tied to the same event. Your demand letter can make clear that you are willing to discuss a reasonable, narrowly tailored release that addresses the specific injuries and time period at issue, and that you are not prepared to sign away rights to unknown future medical consequences in exchange for a modest refund.
Treat any release as a separate contract with real consequences, not as boilerplate. If the document includes sweeping language covering all claims of any kind, known or unknown, in exchange for a relatively small payment, that is a serious decision, not a routine formality.
Does it matter that the med spa advertised “no downtime” and “risk-free” if they had a consent form listing risks?
It matters because advertising and consent must be viewed together. The FTC’s rules and guidance on health-related advertising stress that claims must be truthful and not misleading and that they must be backed by competent evidence.(Federal Trade Commission) Ads that portray procedures as virtually risk-free and equivalent to a facial, while burying serious complications in small-print forms or never discussing them, can mislead consumers.
In your letter, you can lay out the overall impression created by the marketing and sales process. If the Instagram feed and consultation repeatedly emphasized “no downtime” and “lunch break procedures,” while you ended up with weeks of visible burns or swelling that kept you out of work, that disconnect is legally relevant. Consent forms do not automatically sanitize aggressive or deceptive marketing.
Can I ask the clinic to pay for future corrective procedures as part of a settlement?
You can, and in many med spa cases that is a central part of the demand. The difficulty is estimating future costs and ensuring that the payment structure actually protects you. A vague promise that the same clinic will “fix it for free” may not be attractive if you no longer trust them or if your injuries require specialists they do not employ.
Your demand letter can frame this as a request for a specific sum earmarked for corrective treatment with independent specialists of your choosing, supported by estimates or opinions from those specialists. It is better to negotiate concrete funding than to accept open-ended offers of in-house fixes that keep you tethered to a provider you believe harmed you.
Is it safe to talk about my experience on social media while I am negotiating?
You have the right to talk about your own experience, but how and when you do it can affect both settlement prospects and legal risk. Factually accurate, measured posts are less problematic than emotional claims of criminality or intentional harm, especially if you name individuals and businesses. Some settlement proposals will include non-disparagement or confidentiality clauses, and public posts can complicate those negotiations.
Your demand letter does not need to reference social media at all. Focus the letter on formal remedies. If you decide to post, stay close to verifiable facts, avoid embellishment, and be aware that everything you say online may later be read by the clinic’s lawyer or a judge.
What if the clinic is in another state or country?
Cross-border cosmetic tourism is common, but it complicates enforcement. A demand letter can still be sent to an out-of-state or foreign clinic and may prompt a refund or other accommodation, especially if they care about their reputation. Identifying the correct legal entity and mailing address is the first step, usually through receipts, websites, and corporate registries.
However, suing a foreign provider or enforcing a judgment against them can be expensive and uncertain. Your letter in that setting is more a negotiation tool than a prelude to straightforward small-claims litigation. That reality may influence how much time and energy you invest in the process and how you value any settlement offers.
Is there any point in a demand letter if my injuries are relatively minor?
Yes, provided your expectations are calibrated. For minor but clear missteps, such as overfilling that required dissolution, small burns that resolved, or temporary pigment changes, a letter can be a polite but firm way to ask for a refund, partial refund, or credit. Med spas often have internal authority to grant these kinds of resolutions when presented with a documented, reasonable request.
The letter also creates a record in case the clinic repeats the same mistakes with others and regulators later look for patterns. Even if your individual case is small, a documented complaint may carry weight in aggregate.
How soon after the procedure should I send a demand letter?
Timing is a balance between medical stability and preserving evidence. In many cosmetic procedures, there is an expected window of swelling, bruising, or peeling, and it can be premature to call something “botched” while you are still in the normal recovery phase. At the same time, certain red-flag injuries, such as burns, blistering, necrosis, severe pain, or visual symptoms, require immediate medical attention and may justify early written notice once you are medically safe.
Once it is clear that your outcome is outside the normal recovery curve and the clinic has either failed to help or made things worse, it becomes appropriate to write. Document the unfolding course with photos and medical visits. Your letter should reflect that you gave the process a fair chance and did not rush to judgment, but also that you did not sit on your rights until memories faded and records became harder to obtain.
Free demand letter template for botched cosmetic procedures and med spa treatments
You can adapt the following template to your situation. Replace bracketed sections with your details and adjust the tone and legal references for your state. This is written as if you are the patient writing directly to the clinic or med spa.
[Your Name]
[Your Mailing Address]
[City, State, ZIP]
[Email Address]
[Phone Number]
[Date]
[Clinic or Med Spa Name]
[Clinic Street Address]
[City, State, ZIP]
Re: Botched Cosmetic Treatment on [date] – Demand for Refund and Corrective Treatment Costs
To Whom It May Concern:
I am writing regarding cosmetic treatments I received at [Clinic Name] on [date] and the serious harm that followed. This letter sets out what occurred and demands that you refund what I paid and reimburse the cost of corrective medical care.
On [date], I attended your facility at [location] for [describe procedure, for example “lip and cheek filler,” “Botox injections to the forehead,” “fractional laser resurfacing,” “deep chemical peel,” “microneedling with PRP”]. Before the procedure, I met with [name and title of provider] who represented the treatment as [briefly describe how it was sold, for example “simple, low risk, with little or no downtime”]. I relied on your advertising and our discussions, which emphasized [describe marketing themes, for example “natural results,” “no significant risk,” “fast recovery”].
At the time of treatment, I was asked to sign paperwork, including consent forms, which were presented to me [describe circumstances, for example “briefly in the lobby just before the procedure”]. The risks were not meaningfully explained. I was not warned about [list key risks that materialized, such as “burns,” “pigment changes on my skin type,” “tissue necrosis,” “asymmetry,” “the possibility of needing corrective procedures,” “the chance of permanent scarring”]. No one conducted a thorough medical evaluation or discussed my medical history in a way that would satisfy a proper pre-procedure medical exam.
The procedure itself was performed by [name and title of injector or practitioner]. According to your records and my recollection, [he/she/they] used [describe product or device, amount, and areas treated, for example “X mL of [filler brand] injected into my lips and cheeks,” “a Y% TCA peel applied to my full face,” “a fractional laser set at [settings] on my cheeks and forehead”].
Shortly after the procedure, I experienced complications that were far beyond anything described to me as normal recovery. Specifically, on [date or time frame], I developed [describe symptoms, such as “intense burning and blistering,” “dark patches of hyperpigmentation,” “lumps and visible asymmetry,” “areas of skin that turned white and then black,” “significant swelling and pain,” “visual disturbances”]. I promptly contacted your office on [dates], reported these problems, and followed the instructions given to me.
Despite these efforts, my condition worsened. On [dates], I sought evaluation and treatment from [name(s) of independent physicians or clinics] who diagnosed [describe diagnosis or findings]. They documented that I suffered [describe injuries, such as “partial-thickness burns,” “post-inflammatory hyperpigmentation,” “filler migration and nodules,” “signs of tissue necrosis,” “scarring”] as a result of the procedures performed at your clinic. I have attached copies of relevant records and photographs for your review.
Based on the facts above, it appears that the treatments I received at [Clinic Name] fell below accepted standards for cosmetic medical procedures and were performed without adequate informed consent. Injections, peels, lasers, microneedling, and similar procedures are medical treatments that must be preceded by a proper medical evaluation and a full discussion of material risks and alternatives. The advertising and assurances I received about these services did not match the true risk profile or my actual experience. In addition, the role of [identify provider’s title, for example “an esthetician”] in performing or overseeing medical-grade procedures raises concerns about compliance with applicable licensing and scope-of-practice rules.
As a direct result of your treatment and its complications, I have incurred the following losses to date:
– The full price of the procedures performed at your clinic: $[amount]
– Corrective and follow-up medical care with independent providers: approximately $[amount to date]
– Related expenses, including medications, dressings, and transportation: approximately $[amount]
I am continuing to undergo evaluation and treatment for the injuries caused by your procedures. My face and skin have not returned to their pre-procedure condition, and I have experienced significant pain, disruption of daily life, and emotional distress.
To resolve this matter without formal proceedings, I demand that [Clinic Name] do the following:
Refund in full all amounts I paid for the procedures on [date], totaling $[amount], and
Pay an additional $[amount] toward the cost of my corrective medical care with independent providers of my choosing.
Payment should be made by [state preferred method, such as check or electronic transfer] within fourteen days of your receipt of this letter. Upon satisfactory resolution of my claims and payment of the amounts above, I am prepared to discuss a reasonable written agreement addressing the scope of release and other terms. Any proposed release must be appropriately limited and may not require me to waive rights with respect to unknown or future serious complications arising from your treatment.
If I do not receive a satisfactory response within fourteen days, I will consider all available options. Those options include filing detailed complaints with the appropriate state licensing boards and consumer protection authorities and pursuing my claims through the courts for the full measure of damages allowed by law. I will also continue to seek necessary medical care to address the injuries caused by your procedures.
I would prefer to resolve this matter quickly and privately. Please direct all written responses to me at the address and email listed above.
Sincerely,
[Your Name]
Attachments:
Copies of receipts and payment records
Copies of consent forms and clinic records
Photographs documenting injuries
Records from independent medical providers
You can customize the legal references in the middle section to match your jurisdiction and the particular facts of your case. For minor disputes, you might simplify the legal discussion and focus more heavily on customer service and fairness; for serious injuries, you can strengthen the discussion of informed consent, standard of care, scope of practice, and regulatory obligations.