Patients who come to his Miami office pay about $800 for Botox, LaGrasso said. House calls for the injections, though, cost about $1,500. Pre- and post-op visits to patients who have had surgical procedures are also extra — about $5,000 on top of the typical $15,000 facelift price, for example.

The additional charge is "absolutely worth it," Valdes said. "I don't see where I'd be saving that much money just going to his office and sitting there waiting. I'd rather not drive to Miami and deal with the traffic."

The service is "a natural" for the cosmetic surgery field, and especially for affluent patients, said Dr. Stephan Baker, a board-certified plastic surgeon in Coral Gables and a South Florida spokesman for the American Society of Plastic Surgeons.

"It's doable," Baker said, "but I wouldn't say it's mainstream."

But not everyone is a fan of the concept.

Dr. Daniel Kapp, a board-certified plastic surgeon in West Palm Beach, called house-call services "gimmicky," adding that having patients come to the office allows them to "verify who you are." Patients who want privacy in his practice are offered weekend hours and back-door access.

Going to patients' homes, he said, "doesn't conform with what we do."

"I don't think it's gimmicky at all," Perez said, adding that for some patients, especially those who have had several procedures done at once, it's difficult to get dressed and drive to a doctor's office for a post-op appointment. "I think it's a conscientious and good service, and frankly, it's good patient care."

LaGrasso agreed, saying his house-call business evolved over the past year because patients have requested it. He doesn't even advertise the service.

"These people want service, they want attention, and they want results," he said. "And they don't mind paying for it."

nbrochu@tribune.com