A med spa looks like one business and is actually three stacked on top of each other: a medical practice governed by clinical regulation, a retail operation with inventory and margin, and a marketing engine that has to fill a schedule. Most people who open one are excellent at the part they came from — usually the clinical or the aesthetic — and underestimate the other two. And almost all of the ones that fail didn't fail at treatment or even at marketing. They failed at a regulatory and financial foundation they treated as paperwork instead of the load-bearing wall it actually is. The roadmap that works builds the foundation first, deliberately, before the parts that are more fun.
This is general education for owners, not legal, financial, or regulatory advice. Confirm your specifics with appropriate professionals in your state.