Microneedle Patch May Replace Lasers & Injections for Fat Removal

Researchers created a skin patch to deliver a drug that can convert white fat to calorie-burning brown fat.

Liposuction is still one of the top procedures performed by surgeons worldwide. It is consistently in the top five in the ISAPS Global Statistics, and it may continue to rise.

On the other hand, fat freezing, lasers, radio-frequency, and ultrasound technology are the common treatment modes of treatment for fat removal. These devices have different effects on each individual, some may work, some may not.

What if patients do not need to go to a clinic and could eventually stick a patch on themselves to remove the fat?

A patch is currently being developed to burn the fat in your “love handles”, and it is being tested in mice. A study by Zhang et al. (2017) They use brown fat by using nanoparticles and Rosiglitazone on the patch. The researchers used brown fat because of its properties. They used the in vivo method in their study. Their patch seemed effective on the mice and it could serve as therapeutic use for patients with obesity. In their study, the researchers found an increase in the following factors: energy, oxidation, and body weight control (Zhang et al., 2017, p. E).

Zhang et al., ACS Nano

The research team designed a skin patch with 121 cone-shaped polymer needles that can be filled with a drug encapsulated by nanoparticles. The tiny needles penetrate the skin and the ends collapse. The nanoparticles then slowly release the browning drug into the fat cells. By delivering the drug directly to fat cells, the drug’s side effects in other parts of the body might be prevented or minimized.

The researchers tested the skin patch, which was a little larger than a pencil eraser, on the abdominal fat pads of three groups of normal mice. The first group received a skin patch without any drug; the second group received a patch containing rosiglitazone (a diabetes drug that’s also known as Rosi or by its trade name Avandia); and the third group received a patch containing a compound called CL 316243. In mice treated with either drug, the white fat cells shrunk and beige fat cells appeared. A genetic analysis and other tests confirmed that both drugs induced fat browning and improved metabolism in the mice.

The research team then treated obese mice with skin patches for 4 weeks. The drugs increased browning, as evidenced by smaller fat cells and increased expression of brown fat cell genes. They also reduced the size of the fat pad and improved metabolic signs.

It's possible, even likely, that patches may eventually replace surgical and non-surgical means of losing fat in the love handles? For now, patients would still need to undergo either a surgical or non-surgical procedure.

Non-Surgical Nipple Reconstruction or Correction Using Dermal Fillers

Using filler injections to treat the areola nipple complex (NAC) after surgery.

Most hyaluronic acid filler studies focused on dermal fillers are about injection techniques and areas of injection in the face, and sometimes the hands, but hyaluronic acid fillers’ other function can also be used in reconstruction. There are only a few cases in using dermal fillers to correct or reconstruct any physical surgical complications.

One case of using dermal fillers was to reconstruct the nipple areola complex, which for some patients, they lose the Nipple Areola Complex (NAC) projection after surgery (Belman et al., 2017).  The article’s case focused on a 49-year-old woman who has undergone a mastectomy, and the researchers observe that sometimes after surgery the NAC suffers from atrophy. As such, the physicians of the study sought to correct the surgery using dermal fillers. A bilateral injection was made on each nipple, and the procedure was a success adding projection after injection.

Key Findings:

• Increase of 1.5-1.6mm on both breasts
• Nipple projection for both breasts are 3.3mm after injection

A similar study was conducted back in 2010 where the researchers used Artecoll to augment the nipple (McCarthy, 2010). It also focused on creating better nipple projection. Twenty-three patients underwent the procedure in the study, and with the use of Artecoll, the mean post-injection was higher than pre-injection.

There was a case wherein a patient had multiple cleft lip and palate surgeries (Stolic et al., 2015). The injection was carried out after biphasic therapy. The researchers mentioned the importance of injection technique when correcting the surgical complications.

Another case involved injectables to reconstruct soft tissue on the ear. In that case, the study’s investigators used Macrolane. The study’s investigators conducted multiple injection sessions to expand the ear needing reconstruction and expansion. There were no reported complications after the treatment sessions.

Despite the studies’ outcomes, adverse effects may arise with the patient, and it could be necessary to follow-up with the patient after a few weeks or months. Bottomline is, dermal fillers help patients give a natural look, if the physician knows what they’re doing. It is important to know injection techniques as well to avoid any complications.

Podium: 5 Questions To Ask Patients For More Powerful Testimonials

Want better patient reviews? Check out this this special offer for Members from Podium.

Most cosmetic clinics, and now almost every medical practice, asks for patient reviews and testimonials. Make sure they're powerful by asking the right questions.

You're asking for testimonials, and if you follow up and pester your patients you're getting them.

However, there's a problem that most clinics have. The testimonials you're getting are powerless.

Testimonials are really just very short stories, and that's how you should be treating them. But if you look at your testimonials they come across as just pablum. These milquetoast testimonials are what you're left with if you don't understand how to ask the questions that allow your patients to give you memorable and powerful endorsements, and that start's with how you ask.

We're going to pump up your testimonials but helping you ask the right questions, in the right way.

5 questions to get a powerful patient testimonial:

1. What was your main concern about buying this treatment?
2. What was the result of buying this treatment?
3. What specific result did you like most about this treatment?
4. What are 3 other benefits of this treatment?
5. Would you recommend this treatment to your friends? If so, why?

You'll also want to follow up with : Is there anything you'd like to add?

Note: you'll change "treatment" to a specific service: Botox, Restylane, liposuction, etc. Specific is good. There's no need to shy away from saying "buy" or "bought" or "purchased". Many of the concerns that your testimonials will directly address will be about "buying", 

Also, make sure that you're ask about the objections and concerns that the patient overcame to buy. It's critical information that both elevates your testimonial and helps you identify concerns that you can address with your marketing and consultations.

Why these 5 questions work

Let's take a look at why we want to ask each of these 5 questions.

1. What was your main concern about buying this treatment.

You're going to ask this question because no matter how popular or safe a treatment ins, in the patient's mind there's always a concern. It could be money, time, pain, outcome, or almost anything. It could be all of those.

When you ask this question it brings out those concerns, and it goes further. When the patient searches her memory to think through what may have been a deal-breaker, they'll come up with a number of things that you may not have considered to be relevant before.

There is always a concern. So, when the patient brings up this concern it presents an angle that's unique, personal, and dramatic. A concern that other patients will relate to directly.

2. What was the result of buying this treatment?

You want to ask this question to show how the obstacle or concern was overcome. When a patient answers this question, she talks about why the treatment was worth it despite the concerns.

3. What specific result did you like most about this treatment?

Here's where we start digging deeper. "Specific" is the key word. If you ask a patient to focus on the benefits of the treatment they'll provide a vague 'overview' type of answer that may be nice, but it won't move anyone. That's why you want to focus on a single result that the patient liked most. This brings out the one feature and the patient will be much more explicit

4. What are 3 other benefits of this treatment?

Since you already asked about the primary benefit from the treatment, now you can go a little wider, adding color to whatever else the patient liked about her results. 

Depending upon the treatment you can substitute any number, 2 or 1, or even eliminate the number completely, but the number does make it easier for your patient to try and address the question. It let's her focus on a limited number of factors and ranks them for you in what the patient found most useful.

5. Would you recommend this treatment? If so, why?

Psychologically this question is important. When a patient makes a recommendation an they are personally tied to it, there's more at stake for them. This ties to the way that they think about their own integrity. Unless the patient feels strongly they won't be forward about recommending it, and when she does recommend it, she communicates clearly to perspective patients, "Hey! I recommend this and here are the reasons why!"

Bonus: Is there anything you'd like to add?

Most of the testimonial has already been addressed but here's where you may catch something that the patient overlooked or thought differently about. There's never any harm in picking up a few last tidbits after the first questions have got the patient thinking. Occasionally you'll find that this last answer is where you really illicit something great.

Using testimonials to discover and address patients objections

The way that we're looking at constructing testimonials brings us to the reason behind the methodology; the testimonial actually answers the buying objections. When we ask the patient, "What was the obstacle that would have prevented you from buying this treatment?",  the "obstacle" the customer brings up is going to be the concerns that we'll address in our marketing and consultations.

We should plan our testimonials to directly defuse each objection

Let's just take filler injections; Restylane, Juvederm, etc. If you talk to the average potential patient you'll hear any number of objections:

• It's too expensive. / I'll get stuck on an expensive treatment program forever.
• I'm afraid of needles and pain.
• I can get it cheaper somewhere else.

Let's assume that these are the three main objections. If you're asking the questions above, what are the testimonials that you capture going to say?

• I thought it was too expensive, but (here's why it was worth it).
• I'm afraid of needles, but (here's what happened and why I'm not afraid now).
• I thought about getting it cheaper somewhere else, but (here's what I found).

Each testimonial is a mirror image of each objection

You may know it's coming. You may have heard it often before and addressed it early in your marketing materials and sales copy, but new patients get a third-party perspective when they see your current patients defusing their objections in your testimonials.

A third party is always far more believable to your potential customers, and because each of these testimonials is linked directly to an objection, it systematically reduces the risk. 

How do I control the testimonial?

You may want to try and exercise control of your testimonials or give guidance to drive patients towards specific outcomes. You may want to talk about your length of time performing fillers, you education, or awards, but your patient may want to talk about price. So how do you control what your patient says?

Er... you don't.

You're part is constructing the questions. If you're doing this correctly you don't need to control the responses or the process. But that doesn't mean that you can't exert some influence on the direction that those responses take.

Start with the key objections you know you need to address

When you reach out to the patient. Ask her if cost, pain, or results were one of her big objections. If she says yes, follow up to find out the specifics. But if she says no, and mentions a completely different issue, follow up and run that objection to ground.

For example, a patient may say, "A friend had it done and it didn't look natural."

That feedback reveals an objection you hadn't considered, and it may be an objection that you haven't been addressing yet.

Examine it carefully, but you many decide that the new objection isn't worth pursuing and you can't use it. No problem. If that's your decision there will always be more patients who get the angle you're going for.

This process will extract the exact buying objections and testimonials that will help you defuse key objections. The result is that the testimonial is going to do some real grunt work for you in overcoming the fears and objections of the patients you're marketing to.

Get believable testimonials that are complex and detailed

Testimonials are among your most powerful sales and marketing tools simply because they come from patients, not you. They're told from the patients view point, about their concerns, and the results that they achieved. When a patient produces a testimonial that is rich in detail and emotion, and is believable it's done it's job.

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— Dr. Josh Wyatt

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— Dr. Chad Ellis

Survey: How Efficient & Productive Is Your Medical Clinic?

The New Clinic Efficiency & Productivity Survey

As part of a new course we're building for the new Training Academy, we're looking into how clinics and medical practices operate, and how efficient and productive they are.

The new course? The Ultimate Clinic Operations Blueprint.

Please take a moment and answer 9 quick questions on your clinic's productivity and efficiency. It should take just 2 minutes and we'll send the results to all participants.

Take the survey right here.

Contribute to Medical Spa MD

The New Medical Spa MD Academy: Clinical + Business Training For Physicians

A few months ago we started thinking about how we could add more value for Members - and we came to the conclusion that there was a lot more we could do to help you. So we decided to bite the bullet, roll up our sleeves, and build it.

This is kinda a big deal... so cut us a little slack if we sound a little giddy.

Until now, we've focused on building what is essentially a somewhat 'soft information' community built around the blog and the forums. It's worked incredibly well. We've gown into a vibrant community with thousands of members, millions of page views and unique visitors, there have been millions dollars exchanged through the classified ads (lots of 'millions' in this post), and we've helped many Members find info or answers that have grown their practice or save them from making mistakes. (Just read some of the testimonials on the Join Us page.)

We're going to keep all of that. 

But we're adding something new: An incredibly powerful training platform.  : )

Over the last few months we've been heads-down building out an entirely new technology stack and some amazing new capabilities. We've been polishing code and tweaking copy. Our testers have run through more than 100 usability trials and security tests.

The result: We're launching the Medical Spa MD Training Academy — real-world courses for Members will provide clinical and business training for our Members.

(The first course: A Botox and filler injection course taught by Marc Scheiner MD, a Certified Allergan Trainer who has already trained hundreds of clinicians.)

Now, a physician who has spent years training clinicians a few at a time, can take that training and make it available to any clinician, anywhere, at any time. And it all happens auto-magically.

It's as easy to train a doc in Mali or Singapore or Toronto as it is to train them in your clinic.

And online clinical training works — something we learned from our friends at http://MedMastery.com who teach online clinical courses on Cardiac MRI, ECG, Epidemiology, Coronary Angiography and Transesophageal Echocardiograpy... all of which will earn you CME.

For clinicians, there are real benefits for learning online.

It used to be that you'd pay Dr. Scheiner $2,000 for a two day training. You'd have to pay for your travel. You'd have to pay for a hotel. You'd have to bring your own patient. You'd miss a couple of days of income and you'd spend those two days looking over the instructors shoulder trying not to miss anything and remember everything that you were seeing. (The old see one, do one, teach one.)

And it was still worth it.

But now it's easier.

Now, you spend a couple of hundred dollars for an online course. You can watch the trainings over and over and refer to them at any time. You don't have to worry that you'e missing something. You get every file, video and lesson in one place.

And there's a 30 day money back guarantee so there's zero risk.

What's not to like?

But there's much more to this than publishing a single course.

The 'light bulb' moment was when we realized that all of the expertise we would ever need was already here on the site. You. Thousands of Members with - we're guessing here -  hundreds of thousands of years of experience. You guys - in aggregate - know pretty much everything there is to know about clinical cosmetic practice.

If only there was a way that we could help you extract those skills and knowledge, design a beautiful course that would be available to anyone, and supply you with a massive audience of potential buyers.

So that's what we built: A new training platform and perfect target audience that's going to allow you to take your clinical expertise or business savvy, and create an awesome course that will be seen world-wide.

It's the best deal we could possibly think of.

It removes all of the risk that has stopped you from doing this on your own. You'll build your credibility, personal brand, visibility and influence, and you'll make money every time your course sells.  : )

And there are no preconditions other than they provide massive value for our Members.

If you're a clinical trainer. If you've given a clinical presentation. If you're a consultant that can teach clinicians something of value. If you're a clinician who's discovered a new technique. If you're a savvy operations manager who can improve a clinics consultations. If you already have a course that you're teaching offline, or if you think you might be able to build a course that will benefit our Members, we want to chat.

So here's what we'd like you to do: Take a look at the new Training Academy and read the "Become and Author" page. (links below) Then contact us and tell us about your new course. If we like it, we'll help you build it, market it, and put it in front of  hundreds of thousands of potential buyers who want to know what you can teach them.

Let's get started.

Face Lifts For Smokers.

A new study suggests that cosmetic surgery could help a patient quit smoking long term. Most surgeons in North America suggest a cessation period of 2 weeks before surgery. However, it was found in previous studies that those who ceased smoking 4 weeks prior showed lesser rate of complications. Nineteen (19) percent of patients in their research attained complications. A follow-up was made by the researchers stating that only 10 of their patients have not smoked since their surgery.

Previous studies also delved in cosmetic or plastic surgery and smoking cessation.

In a study conducted earlier in the year found that there were postoperative complications as expected. The study was on a larger scale examining more than 40000 patients. However, among the 40425 patients in their study, 15.7% were smokers. Additionally the researchers of the study found that smoking had an effect as to where the procedure had been done.

Findings:

• 3376 (8.4%) patients incurred postoperative complications
• 732 (1.8%) patients had medical related complications
• 1611 (4.0%) patients had wound related complications

There were surgical complications for patients who underwent breast reconstruction, craniofacial/head and neck, and upper and lower extremities. Wound-related complications were found for craniofacial/head and neck and upper lower extremities patients.

E-cigarettes are no exception either since it contains nicotine. In 2016, a study focused on the use of e-cigarettes and if it has lesser detriments as compared to regular cigarettes. The effects weren’t as severe, but it did not eliminate the incidence of complications.

Additionally, according to many plastic surgeons, they have a smoking cessation session prior to surgery. Despite some efforts to do so, several patients had also reported smoking before their surgical procedure. It is unclear whether cessation intervention helped the patient quit smoking prior and after surgery.

Physician Burnout: Why it still matters

Medscape recently released its annual National Physician Burnout and Depression Report. It reveals that out of the 29 specialties, plastic surgeons and dermatologist rank the lowest in the bunch. While it is no cause for alarm, it is still important to take care of yourself as a physician as some studies find there is a connection to patient care and medical errors as well.

Bureaucratic tasks are the most cited reason for burnout. The second reason for burnout is working too many hours, and the third top reason is lack of respect from peers or colleagues or employees. Burnout is still an important cause for concern due to the effects that take a toll on physicians. Depression also affects their interaction with staff. 

In this regard prior to releasing Medscape’s annual results, a study was published that examined if doctors also sought cosmetic surgery when they were burned out (Milothridis et al, 2017). Liposuction was a preferred surgical procedure as exercise was less practiced by the physicians that took part in the study.

Findings:

• Doctors were more interested in undergoing elective cosmetic procedures because exercise, while an option, seems like a long term process in losing weight
• Burnout may trigger low self-esteem and distorted body perception.
• Women in their study were more interested in undergoing cosmetic procedures.

In the study, the sample size was small, but it shows that there are tendencies to look into cosmetic surgery when physicians are burned out and consider procedures that would result in something instant.

Who is the most burned out?

Women are the most burned out physicians based on the survey. Based on a JAMA article, sexual harassment is also another factor for burn out. Depression also contributes to physician burnout. Even if that is the case, the Medscape survey reveals that physicians’ depression does not affect their interaction with their patients.
 
How to deal with burnout and depression?

Apparently, based on the survey plastic surgeons are willing to seek help for depression or burnout.

Burnout and depression, while crippling at times, can be managed. Based on the survey, exercise, talking with loved ones, and sleep are ways to cope and manage their stresses. Self-care is a necessity for all physicians.

Software applications can also help curb burnout. There’s no exact one application in managing the burnout, but meditation applications and breathing exercise applications or any other lifestyle applications can help ease one’s mind.

Burnout is a common phenomenon across different industries. Learn to acknowledge it and manage and balance work and life activities.

References:

https://www.ncbi.nlm.nih.gov/pubmed/28779405
https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235?src=ban_burnout2018_desk_mscpmrk_hp

Strengthening Your Medical Spas Local SEO Strategy

Many say, it’s always best to start small, which is true, because going big could cost you. It is crucial to keep up with the trends, and a solid marketing strategy can help you make your way to Google’s 1st page, without being banned. Thus, it is important to keep marketing at a steady pace while still following the rules. In this case, we advise you to start LOCAL.

Local SEO could help boost your website’s visibility in your city or state.

When you search for Local SEO, Google My Business (GMB) always comes up. This is a great way to be known through the search engine. Google is very much intuitive, knowing one’s location as they search. Thus, it is important as you update or set-up your website, to have a GMB listing underway. Google My Business also added a feature which is schedule appointments.

NAP, NAP, NAP

No don’t take a NAP. NAP means Name, Address, and Phone. All of which should be consistent in all your pages or social media websites. Aside from NAP, you also have to input your times and days of operations.

List on Local Directories

All businesses can start by listing their companies on Google My Business, so should your medical practice. Local directories could also help you put your practice on the map. Here are several directories you can start listing in:

• Google
• Yahoo!
• Yelp
• Facebook

Ask for reviews with Podium's special offer for Medical Spa MD Members.

It’s not bad nor it doesn’t violate HIPAA practices when asking for reviews. After all, most patients look for reviews first prior to scheduling an appointment with the doctor. Ask your patients to include the location of your practice when you encourage them to write their review. If some patients have already submitted their own, you can filter out the bad reviews, if any. Note, never to call out the patients that gave you a bad review.