Dr Joshua Berkowitz - Wimpole Aesthetics in London

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Wimpole Aesthetics is a small cosmetic clinic with a loyal staff on Harley Street in London. Here's our interview with Dr. Joshua Berkowitz.

Dr Joshua Berkowitz - Wimpole Aesthetics in Harley Street London

Name: Dr. Joshua Berkowitz
Clinic: Wimpole Aesthetics, London
Websites: www.wimpoleaesthetics.co.uk / www.ivboost.co.uk

Brief Bio:

My school education was completed in Bulawayo (Rhodesia/Zimbabwe). In 1966 I started medical school obtaining a MB ChB degree from Birmingham University (UK). After several junior positions in Internal Medicine, General Surgery, Urology and General Practice I decided to specialize in Obstetrics and Gynecology. Thus, after further training in the Birmingham Teaching Hospitals, I obtained Membership of the Royal College of O & G followed later by the Fellowship in 1993. I was in private O & G practice in Johannesburg from 1982 till 1996 when I emigrated to the UK/London. During my years in private practice I was also a part time Consultant in the University Teaching Hospital in Johannesburg.

In 1997 I became the Medical Director to Ivax Pharmaceuticals. I was responsible for the Company’s medical activities in the UK, Europe and China. Ivax was sold to Teva in about 2005 and I took a redundancy package to start Wimpole Aesthetics in Wimpole Street, London W1.

Could you tell us your journey toward cosmetic medicine?

I started Wimpole Aesthetics after leaving the pharmaceutical industry in about 2005/6. I initially modelled the clinic upon a clinic I had visited in Israel several years previously. This clinic was using Botox & fillers and using IPL and Laser machines. I have always been interested in Women’s Health and Wellbeing/Functional Medicine and therefore expanded the clinic into these areas and into the treatment of several chronic diseases/conditions.

What could you divulge about your clinic?

I run the clinic together with several nurses and a non-medical assistant who is responsible for the internet sites and other aspects of management, the clinic is located in the medical district of London near Harley Street. Not a big clinic.

How are you as the Medical Director of Wimpole Aesthetics with regards to staff?

There are no stories to tell. I choose staff who are loyal and discrete and obviously capable and affable. I am also loyal to them. Bonuses are awarded when we have a good month.

What technologies are you using in your practice?

I have become disenchanted by the machinery in the aesthetics world since few instruments are able to meet the claims printed on the box. Also the machines are excessively expensive. Prices are based on perceived earning potential not on machine production and marketing costs. Furthermore, manufacturers now include a consumable to ensure that they remain a “partner”. Training is usually poor and inadequate.

I have Syneron IPL and Laser -- both very old and a very modern CO2 Deka.

I have a Vaser machine and several small machines plasma, etc.

What is your marketing strategy? 

 Marketing is by word of mouth by patient to potential patient referral and by internet.

We are a proper medical clinic, hence there are no incentives (buy one get another at half price type stuff) and no social media.

Any stories you would like to share? And what have you learned so far as a physician in cosmetic medicine?

No stories but I am concerned about the many doctors and their egos and many false representations of themselves (e.g.) calling themselves surgeons when they are not putting degrees on stationary they do not have and are not pushing treatments that are completely without merit; making up treatment combinations that are completely unproven; seeking publicity and making false claims about their expertise.

So what I have learned is that I respect and admire very few of my colleagues.

That there is very little evidence based med in the aesthetics field; and that morality and integrity are often absent; and that the aesthetics speciality is littered with doctors and others who are not properly trained or qualified to do the procedures they do or to manage the complications that may arise.

About Dr. Berkowitz:

Dr Josh graduated from Birmingham University Medical School in 1971. He became a Member and later a Fellow of the Royal College of Obstetricians and Gynaecologists (FRCOG). For nearly twenty years, Dr Josh was a Consultant Obstetrician/Gynaecologist in a private medical practice in South Africa. This has given him a helpful holistic perspective on women’s health and the ways that hormonal changes and child bearing can impact on a woman’s skin health, body shape and body image. 

Upon his return to the UK in 1997, and following additional specialist training, he diversified into non-surgical aesthetic and anti-ageing procedures for men and women.

Committed to providing patients with safe and reliable techniques, Dr Josh ensures that Wimpole Aesthetics uses the best quality materials and products. Dr Josh is an expert in all the treatments offered at Wimpole Aesthetics and and he frequently updates his own skills with continual professional development conferences and seminars.

Dr Josh is acknowledged as a preferred trainer of cosmetic medical doctors by the manufacturers of Vaser medical laser technology. Vaser Liposelection is a gentle and non-invasive alternative to liposuction surgery. Dr Josh was one of the first cosmetic doctors in the UK to introduce Vaser Liposelection treatment to his practice.

His warmth and approachability are frequently commented upon by patients, who appreciate the unhurried and thorough consultations offered by Wimpole Aesthetics. Dr Josh is registered with the General Medical Council (GMC). He is a member of the British Medical Association, The Royal Society of Medicine and the British Association of Cosmetic Doctors.

Dr. Hung William Song - Omni Aesthetics in Oakland, New Jersey

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Oakland, New Jersey Cosmetic Physician Dr. Hung William

Name: Hung William Song, MD
Clinic: Omni Aesthetics
Location: Oakland, NJ
Website: omniaesthetics.com

Can you tell us a little bit of your background and how did you get to where you are now? 

I am board certified in internal medicine I practiced internal medicine for 15 years but switched to a 100% cosmetic practice in 2008. I had about a two year transition period when I did both, but eventually turned over all my medical patients to a colleague and started concentrating full time on my cosmetic practice.

Do you have any procedures that you like better than others? Have you dropped any treatments? If so, why?

My favorite treatments are dermal fillers and fat transfers. I stopped marketing acne treatment because acne is more of a medical problem rather than cosmetic, I now refer these clients to a dermatologist.

You offer treatments with fat transfer. Where have you seen the most success with this treatment? What have you learned about getting the most benefit from this? Do you have any special techniques or 'tricks' that you use? 

I offer a full face fat transfer. I like to fill the whole face starting from the hair line and temples to cheeks, nasal labial folds and pre-jowel sulcus. I use the Viafill system and mix platelet rich plasma with the fat for better viability.

Can you share your experience with fat transfer? How would you describe the efficacy and results? Where have been the most successful improvements in keeping the fat alive after transfer?

By using a disposable coated cannula to harvest and inject the fat and mixing the fat with PRP, I have been able to get good uniform fat retention. The fat is centrifuged using the Viafill system.

What are your thoughts about the technologies you’re using now such as Smart Lipo and Ulthera? 

Smartlipo is a good system because it is a very recognized name, but the machine is very expensive with high disposable costs. If I was to do it again, I would have bought the Vaser for half the price.

Ulthera was a moneymaker for me the first two years but now, I am having a difficult time with competition undercutting me on price. Everyone seems to have one these days including the gym across the street. The consumable cost on the Ulthera is also very very high.

I recently purchased the THermiRF system. This one was a home run because the price of the device is very reasonable and the consumable cost is very low. I use this device for stand alone skin tightening and in conjunction with doing liposuction on small areas like face, neck and arms. It is a very versatile machine but it does require some minor surgical skills which his good for me because I don’t think they will be offering this at the gym across the street.

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Dr. Daniela Dadurian - MD BeautyLabs Medical Spa In West Palm Beach Florida

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Dr. Daniela Dadurian, MD Beauty Labs Medical Spa, West Palm Beach Florida

Daniela Dadurian, M.D. specializes in Anti-Aging medicine, Laser treatment and Cosmetic Medicine. At MD Beauty Labs, Dadurian practices a whole-body approach. She evaluates everything from anti-aging to preventative, nutritional and emotional wellbeing.

Name: Daniela Dadurian, M.D.
Clinic: MD BeautyLabs Medical Spa
Location: West Palm Beach, Florida        
Website: mdbeautylabs.com

What's your training and experience like and how did you get to where you are? 

I started my practice specializing in internal medicine. My patients started asking me why I don’t offer Botox in my practice and if I did they would prefer to come to me. So I started educating myself on Botox injections and it all started from there. I then brought in lasers and microdermabrasion and over the years the practice has evolved into a full service medical spa.

What has certainly been your inspiration to start a medspa? What was the greatest obstacle you encountered?

My driving force to open a medical spa was to combine wellness and aesthetic medicine and focus more on preventative medicine rather than fixing problems that are already there

My biggest road block was the overwhelming doubt from other physicians that I wasn’t a real physician anymore. Patients trust their doctors opinion when choosing procedures and many of the times the same colleagues that referred to me for years, now discredited my ability because I was changing my direction to aesthetics. 

MD BeautyLabs Medical Spa, Dr. Daniela Dadurian, West Palm Beach. Florida

What treatments/services do you offer?

I offer a number of different services, however the treatment that consistently generates the most revenue are fillers. I have dropped services in the past. I have dropped services because the market had decreased their value (example Groupon, Living Social), and I have also dropped service because I found a new technology that I feel is superior.

Have you ever had any encounters with technologies that you felt were oversold, either to the physician or to the patient? Are there any specific technologies that you would endorse to physicians to be wary of, either for medical or business reasons? 

I feel like cold lasers have very unpredictable treatment outcomes usually ending with dissastified patients. There is nothing specific that I would say to stay away from, my only advice is to focus on being good at a few things not everything unless you are properly staffed.

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Dr. Janet Turkle, (Turkle & Associates) Phases Skin Care & Laser Center In Indianapolis, Indiana

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Some problems are better handled with less invasive treatment and there are products and treatments that can delay the need for surgery or prolong and protect one’s investment in surgical procedures.

Indiana Board Certified Plastic Surgeon Dr. Janet Turkle

Name: Dr. Janet K. Turkle
Clinic: Turkle & Associates
           Phases Skin Care and Laser Center
Location: Indianapolis (Carmel), Indiana
Website: turklemd.com  phasesskincare.com

That's interesting: Dr. Janet K. Turkle was involved in the clinical trials for the silicone gel implants and provided extensive data to the researchers.

Please tell us briefly about your qualifications and how did you get to where you are?

I have been in Indiana as a plastic surgeon since I completed my residency at Indiana University Medical Center in 1993 and entered private practice.

Are you convinced that being female creates opportunities in attracting prospective clients?

I think it has advantages and disadvantages. As a female, I can relate to my female patients but I hopefully relate to my male patients as well. Some women may feel more comfortable telling you things or showing you things that they would not if you possessed the Y chromosome but it doesn't always work that way.

If you weren't a medical professional, is there anything you'd rather be spending time on?

I truly cannot think of what that would be. I am doing exactly what I want to do.

Janet Turkle MD, Indiana Cosmetic Plastic Surgeon

Aside from a plastic surgery practice, you also have a Skin care and Laser Center. What difficulties did you tackle when you began your practice? 

When we started then skin care portion of the practice it was fairly rare to combine that with a plastic surgery practice. I think that the biggest challenges have been to make people aware of how important lasers and skin care can be in terms of their total improvement. When we do surgery, we can make improvements in structure but we cannot improve things like texture and discoloration. A combined effort of laser treatments, products and other therapies will improve the outcome, regardless of the type of surgery.

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Dr. James Wharton - Louisville Dermatology Clinic In Kentucky

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Dr. James Wharton uncovers insights that could lead to better business decisions.

Dr. James Wharton - Louisville Dermatology Clinic In Kentucky

Name: James R. Wharton, MD
Clinic: The Aesthetics Center of Louisville/ Louisville  Dermatology Clinic
Location: Louisville, KY
Website: aestheticscenter.org and louisvilledermatology.org

Tell us about your clinic? What treatments do you provide?

We have separated our practice into two clinics. The Louisville Dermatology Clinic is a full service general dermatology practice. We evaluate and treat patients with any skin disease or condition. We treat adult and pediatric patients. We perform surgical procedures such as biopsies, excisions and more complicated cases requiring Mohs micrographic surgery. We have a full dermatopathology lab that can provide analysis and examination of specimens on site.

The Aesthetics Center of Louisville is located in the same building but is a separate practice. We separated our practices for the benefit of our patients. We feel this ethically is the best representation we can provide to our patients. We have a state of the art full service aesthetics practice that offers: peels, microdermabrasion, make-up application, waxing, lash/brow tinting, dermaplaining, IPL, laser hair removal, laser resurfacing, leg vein treatments, various radiofrequency procedures, Ultherapy, tattoo removal, Acleara treatments for acne, MiraDry, injectable toxins, dermal fillers, and concierge VIP dermatology.

You possess active medical licenses in Kentucky, Arkansas, Texas, Hawaii, Missouri, and Florida. Are there any specific distinctions regarding how you can practice medicine on each state?

I have active medical licenses in multiple states. While I currently  only practice medicine in Kentucky, it is important that physicians familiarize themselves with all the regulatory requirements for their state. There is a great deal of variation in the laws regarding which procedures can be delegated and the requirements of each state can significantly affect a business and what services they are able to offer.

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Diane Howlin, MD, FACP of Chelsea Medicine and Laser in Michigan

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Chelsea, Michigan Board Certified Physician Diane Howlin, MD, FACP

Name: Dr. Diane Howlin
Clinic: Chelsea Medicine and Laser
Location: Chelsea, MI
Website: chelsealaser.com

That's interesting: In 2001, Dr. Howlin founded Chelsea Hope Clinic, a free Saturday clinic for uninsured patients.  In 2008, she was named the “Howard S. Holmes Humanitarian of the Year” by Faith in Action for this charity work. In 2009, she launched another not for profit free clinic, Chelsea Grace Clinic,  for uninsured and underinsured patients in Western Washtenaw County.

I grew up in Dearborn Michigan. I played the violin in my youth and undergraduate years, touring Europe with an orchestra in the summers. That led me to learn German and be interested in cultures/language.  I went to medical school at the University of Munich in German and married an Englishman. After medical school, we returned to the US for my residency in Ann Arbor, Michigan in internal medicine. I always loved surgery and surgical procedures. But a surgical residency seemed too hard on my family as we had two children. So I chose internal medicine and did my own procedures. I'd spend evenings in the medical library researching cosmetic office procedures like earlobe repair. That led to skin biopsies, lump and bump surgeries, and seeing the cosmetic effects of this work led me to lasers. Now the practice is fully integrated with both traditional internal medicine and aesthetic medicine.

As a female physician, what are the opportunities that you have that

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Dr. Richard Moore - The Lifestyle Center In St. Louis Missouri

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Name: Richard Moore, M.D.
Clinic: The Lifestyle Center
Location: St Louis, MO
Website: TheLifestyleCenter.com

Can you tell us your background and exactly how did you get to where you are now?

I have always had a strong interest in business with an entrepreneurial spirit. Prior to medical school, I obtained a masters of international management and worked in the petrochemical industry in Houston, TX. Following several years as a Hospitalist physician and director of a hospitalist program, I decided to switch my focus and concentrate on health and wellness. A natural evolution of this was my involvement in aesthetic medicine.

How is your clinic structured? What is your work day like? What commitments do you have?

My center takes a team approach starting with the front desk or reception area, moving to my nurse sales consultant and then my team of nurses and estheticians. All employees are incentivized to contribute to the success of the center. My personal involvement is a daily presence in which I step in on several consults a day, perform office based liposuction, and for clients who prefer a physician injector I am available.

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Dr. Douglas J. Key - Key Laser Institute for Aesthetic Medicine

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Dr. Key's passion for research began at an early age, when he earned the opportunity to work with a Nobel Prize winning professor as a freshman at the University of California, Berkeley. Throughout his undergraduate education, Dr. Key travelled the country to take part in research opportunities in various aspects of biological sciences. Through this research, he became interested in the field of medicine.
Dr. Douglas Jeffrey Key Laser Institute for Aesthetic Medicine in Portland

Name: Dr. Douglas J. Key
Clinic: Key Laser Institute
Location: Portland, OR
Website: keylaserinstitute.com

That's interesting:  Dr. Key's most well-known research took place when he was a Clinical Fellow at the National Cancer Institute in Maryland. During this time, his innovative research led to the development of the drug Retin-A, which is commonly used for acne treatment and wrinkle reduction. He also spent time researching skin cancer prevention techniques and cellular methods to repair damaged skin.

Where do you see skin care moving and is there any topical treatments that have the possibility of displacing current medical technologies?

Where things are going in cosmetic medicine is a great question. Let’s begin by saying cosmetic medicine as a defined area of specialty knowledge and practice is barely a little over 10 years old. And by that I mean cosmetic medicine as a specialty medical based practice, a knowledge base deep enough to be exclusively devoted to aesthetics and separate from surgery and general dermatology. Ten years ago Thermage™ was just getting its FDA clearance, allowing us to do the unimaginable at that time - tighten skin without surgery. Fillers were just coming on board, but just used to fill lips. There were no concepts yet as to treating the aging face. There were no fractionated or pixilated resurfacing, it just hadn’t been invented yet. And the idea of using stem cells or platelet rich plasma, it was well off in the future. 

So in the first 10 years of cosmetic medicine we learned how to treat aging. In these next 10 years, we will no longer be just treating aging, we will truly be preventing aging. What a difference that will make. 

The future, which is already here, is not just what treatments we use in the office, but what is the best for your skin care program for every day use at home.

You offer lipo contouring treatments using Liposonix, LipoSelection and CoolLipo. What do you think of these devices’s efficacy? Where could it be improved? Does it have any shortcomings?

The improvement in our patients with CoolSculpting, which is totally noninvasive, are really amazing. We have had CoolSculpting now almost three years, and the results have really improved, partly because we now use overlapping chambers. We just have a better feel for how to place the cooling chambers. We also do a better job of clearly letting our patients know if it’s the best treatment for them, and how many sessions they should do - one, two or three sessions. 

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Dr. Alicia Teska - Skin Temple Medi Clinic & Spa In Melbourne, Austrailia

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Dr. Alicia Teska Australian Cosmetic Physician

Name: Dr. Alicia Teska                  
Clinic: Skin Temple Medi Clinic & Spa
Location: Melbourne, Australia
Website: skintemple.com.au
That's interesting: Dr. Alicia Teska is a founding fellow of the Australasian College of Aesthetic Medicine.

What is it like practicing cosmetic medicine in Australia?

Cosmetic medicine is much regulated for doctors in Australia, but completely unregulated for any other health provider. It can be very frustrating to find that your previously loyal client is now going to the home of a local plastic surgeon’s nurse to have their Botox injections.

Unsupervised (and uninsured) nurse injecting (of just about any substance at all) is quite rampant in Australia. I get a number of new clients coming in each week who have had treatments in salons or at the nurse’s home, with complaints about the outcome.

Australia regulates its own medical technologies independently of other countries. If the technology has been approved for a use in the USA, it definitely assists to get it through the Therapeutic Goods Administration in Australia a lot faster.

I have been reported for calling myself a "Cosmetic Physician". In Australia, there is a frightening holier-than-thou attitude towards medical practitioners who work outside of a “Royal College” setting. It is disturbing to see how ignorant many medical practitioners are of the work being done by Cosmetic Physicians. The regulatory body in Australia (AHPRA) would like to see the Cosmetic Physicians who are vocationally registered (Fellows of the RACGP, such as myself) call themselves Specialist GPs. This would be quite misleading to my patients, as I no longer practice the full spectrum of normal General Practice.

There is an opportunity to establish a subspecialty/special interest group of General Practice in Cosmetic Medicine/Dermatology. I think it’s likely that a group of us who work exclusively in that area will get together and put Cosmetic Medicine on the map in this country.. if the politics allow!

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Dr. Rick Balharry - Canmore MediSpa & Laser Centre in Alberta, Canada

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Technology has allowed this Canadian MD form Alberta to leave Obstetrics and the ER to focus on cosmetic medicine.Dr. Rick Balharry - Canmore MediSpa & Laser Centre in Alberta, Canada

Name: Dr. Rick Balharry=
Clinic: Canmore MediSpa & Laser Centre
Location: Canmore, Alberta, Canada
Website: canmoremedispa.com

Can you give us a picture on how you manage your medispa and laser center?

I have now backed out of Emergency Medicine and Obstetrics and focused on my office apart from my surgical days. This has allowed me to structure visits accurately so there is rarely anyone waiting. I do the invasive procedures and the injections and my technician does IPL, laser hair removal, dermal infusion, peels and skin care advice.

I also have a large vein practice and perform ultrasound examinations, US guided injections and regular sclerotherapy in the office and the surgery if needed at the Hospital. To add to this I have a large rehab practice as I do prolotherapy injections and PRP injections for the treatment of soft tissue injuries. These also are often ultrasound guided procedures. So, my days are...

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Daniel J. Ladd Jr, DO - Tru-Skin Dermatology In Austin, Texas

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Tru-Skin Dermatology, formerly known as Austin Skin, is building a nationwide network based on the "Business Concept Franchise Model".

Austin, Texas Dermatologist Dr. Daniel J. Ladd, Jr.

Name: Dr. Daniel J. Ladd, Jr.
Clinic: Tru-Skin Dermatology
Location: Austin, TX
Website: tru-skin.com

Dr. Ladd is a man of action, an energetic person with various interests and enjoys telling jokes. Aside from founding The Shade Project, Dr. Ladd is a Board Certified Dermatologist and Mohs Surgeon who has seen far too much skin cancer. Committed to help prevent it, he has started a local sun safety dialogue with the Dr. Dan Radio Show. 

The show welcomes guests from all areas of medicine and the non-profit world alike. Listeners can become informed on the many aspects of wellness, healthy skin, skin cancer prevention, and current events on a local, regional and national basis.

Is there anything that is unconventional or uncommon from the average clinic in any way? How do you separate yourself from your competition?

Tru-Skin Dermatology is an industry leading, board certified, state of the art fully integrated dermatology practice; surgical, medical and cosmetic, composed of skin cancer experts and MOHS surgery specialists. Our brand offers patients a dependable, predictable patient centered experience in a clean modern office facility where they will receive expert care. Our affiliation with The Shade Project sets us apart from other clinics. A portion of every service, patient visit and product purchase at Tru-Skin Dermatology is donated to The Shade Project to help skin cancer prevention efforts. The Shade Project is a non-profit organization dedicated to preventing skin cancer through education, community outreach and building shade structures where children and families play.

You’re using video in your waiting room to market to your patients. How effective is that? 

We've begun a concerted effort to promote cosmetic services available at our practice through internal marketing. We're using a customized waiting room video from Frontdesk that has proved effective for awareness of additional services available. Having the videos in our waiting room has allowed patients to feel comfortable bringing up a procedure they saw on the video with the provider during their appointment. The folks at Frontdesk were very easy to work with and responsive to our questions and needs for customization unique to the Tru-Skin Dermatology brand...

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Dr. Naomi McCullum - Personal Botique Cosmetic Medicine In Sydney, Australia

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Dr. Naomi McCullum, Sydney Australia Cosmetic Physician

Bridging the gap from old school to new: How Dr. Naomi McCullum embraced social media marketing.

Name: Dr. Naomi McCullum
Clinic: Dr. Naomi
Location: Sydney, Australia
Website: drnaomi.com.au 

Dr. McCullum worked at several of the leading cosmetic/dermatology clinics in Sydney, and after being admitted as an inaugural Fellow of the Faculty of Medicine of the Australian College of Cosmetic Surgery, opened her own botique cosmetic clinic in Paddington in 2002. 

Can you tell us a bit about your career path?

I first had Botox myself as a young resident shortly after graduating from Medicine. On that day, I saw my future in the industry. Being a cosmetic patient and a proceduralist at heart, there was no choice in the matter. I have always been interested in all branches of the aesthetic tree, from design, fashion and architecture to beauty. It is more than a job for me.

I love having just one boutique clinic, as we can really focus on offering the ultimate specialized service to our patients. This attracts a certain type of client, which makes every day fun and interesting.

What is it like practicing cosmetic medicine in Australia in comparison with what you see in other countries?

The practice of cosmetic medicine is quite unregulated in Australia, with many non-doctors like nurses and dentists, involved in the industry. The laser/IPL industry in most states of Australia is also poorly regulated.

Another difference between what we have to deal with in Austrailian and other countries are the legal requirements for online activity in our industry.

In Australia we are not allowed to mention any of the generic or brand names of the injectables that we use on our websites or through social media. For example, we cannot use the words "Botox", "Restylane", "Juvederm" or even "Hyaluronic Acid" or "Botulinum toxin" anywhere online, which as you can imagine, makes it difficult to educate readers / patients. Potential patients have a right to know what products we supply; they also have a right to know comparisons between products that they might be choosing. The regulations also prevent me from having a useful online discussion publicly with colleagues overseas and in Australia about cosmetic treatments. The Australian regulations are paternalistic and harmful to our patients and industry, and need to...

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Dr. Franco Migliori - Plastic Surgery In Genoa, Italy

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Italian Board Certified Plastic Surgeon Dr. Franco Migliori

Dr. Franco Migliori: What do successful plastic surgeons have in common?

Name: Prof. Franco Migliori, MD
Location: Genoa, Italy
Website: francomigliori.com

With medical malpractice claims that are 10x the European average and a a growing trend towards unregulated minimally or non-invasive proceedures, plastic surgery in Italy is a competitive market.

Dr Migliori's been an early adopter of new technologies, including the internet, where he's been on the web since 1995, ready for the challenges and opportunities of online marketing.

As a plastic surgeon in Italy, how have you seen the aesthetics market developing? 

Italy has a very competitive cosmetic surgery market due to one of the highest number of board certified plastic surgeons in Europe (more than 1,500) and due to a loosly regulated market, with more than 25,000 so-called "aesthetic surgeons", many of which have much less expertise and skill. Nevertheless, Italian plastic surgery is one of the “top quality” plastic surgery countries, planting its roots back in the centuries with famous names like Branca, Vianeo, Tagliacozzi and Sanvenero-Rosselli, and showing so many contemporary high-level practitioners.

Like most places, the patient types are split into “institutional” (gathering all the pathologies, like traumas, tumors, malformations, burns, etc.) treated mainly in public hospitals and paid by National Health System, and “private practice” (which is mainly aesthetic surgery) performed in private clinics and paid by the patients themselves with no

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Dr. Lawrence Broder - Beleza Medical Spa In Austin Texas

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Dr. Broder has a unique combination of primary care experience and surgical training. Now he's has dedicated solely to medical aesthetics and cosmetic surgery. What prompted the move?

Medical Spa Austin TX

Name: Lawrence Broder MD
Clinic: Beleza Medspa
Location: Austin TX
Website:  BelezaMedicalSpa.com

That's interesting: Dr. Lawrence Broder is a decorated veteran. He is a former US Army Major and Flight Surgeon. 

Dr. Broder - Medical Spa Austin TX

Family Medicine is very similar to cosmetic medicine. It's all about customer service. Many of the patients you see as a PCP will get better on their own and your job is to not hurt them and reassure them. As a cosmetic physician, the patients are different and are usually looking for a correction of a specific problem. You have the solution to that problem. Just like a PCP, the cosmetic physician must make sure the patient gets the right treatment without harm and reassure them about the side effects and results. The cosmetic patient who has feels better about their appearance, usually is happier than the patient whose sore throat has resolved. The sore throat probably would have resolved on its own, but I directly helped the cosmetic patient.

The other thing I enjoy about Cosmetic medicine over family medicine is the transparency. My prices, my results, my reviews and my background are all there for every patient to see. As a PCP, the patients did not know what the prices were (insurance), did not know if I had good outcomes with my patients nor knew who I was most of the time. I believe the whole US medical system is designed to extract as much money as possible from the insurance companies and Medicare/Medicaid by upcoding and unnecessary procedures. Cosmetic patients know what they are paying and will even bargain for better prices. Cosmetic physicians have no choice but to be honest about their prices and results, there is no...

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