Effective Link Building Strategies to Increase Your Medical Spa's SEO

If you are new to "link building", it really isn't as hard as it seems.

Basically, link building is just a link from another website back to your own medical spa or laser clinic. The more back links your site has, the higher it will rank on the major search engines.

Link building can be very time consuming, but the FrontDesk SEO tool can really help you go out there and find the sites you should be listed on. This saves you a tremendous amount of time.

Because you will be resubmitting the same text over and over again, make yourself a document that you can keep all of your submission text on. This should include your Page Title, your website's URL address, a brief description of your practice, and important keywords. Website submissions also ask for a name of the submitter and email address. I would suggest setting up a email address with Google or Yahoo, one that you only use for submissions, this way your personal email won't become inundated with confirmation and/or spam emails as a result of your submissions.

View: 5 minute video introduction to linkbuilding and SEO

There are several types of link building methods you can do. Some are just basic data submissions, and some are blog and article submissions. I will describe the differences amongst the major link building methods:

Article Submission

There are directories on the web designed just for submitting articles and some for writing blogs. When you submit something you wrote about your practice or even a particular therapy you offer, you can attach hyperlinks to keywords in your article that direct the reader back to your website. Some quality sites are Squidoo, Hubpages, Blogger, and Wordpress.com. Let me show you how this works with just one line taken from a blog I wrote on my own blogpost:

"It's your body and you do have to be careful of who you choose to perform your laser lipo procedure. While no physician can have a 100% satisfaction rate, don't be afraid to ask questions about how long a physician has been performing these procedures, who they trained with, how many procedures do they perform a month, and also if they have any satisfied patients you can chat with. Also, it's important to ask to see a before and after photo book with their patients, and not someone else's."

By choosing a keyword you think your reader would be interested in, you can immediately direct them right to that page on your website with the hyperlinks.

Google considers a "Yahoo Directory" link as a quality back link. Unfortunately, they charge an annual fee of $300. It may be worth submitting to; however, there is no guarantee from Yahoo Directory that your site will be accepted.

Directory Submission

DMOZ is a directory worth submitting your site to. DMOZ is an Open Directory Project (ODP) mainly known as DMOZ which stands for "directory.mozilla.org" and is owned by Netscape. While DMOZ can substantially increase your SEO ranking, it's tough to receive their approval and the entire process could take months. If you are fortunate enough to receive their approval, many smaller directories use the DMOZ directory categories so if you can become listed with DMOZ this would mean you would also become listed on many other web directories as well.
There are other major directories you can submit to such as the BOTW (Best Of The Web) directory ($99/year or $299/permanent).

Social Bookmarking

Social bookmarking is changing in it's effectiveness all the time. In social bookmarking websites, users save links publicly (not personally on their own computers) to web pages that they want to store and/or share with others. Usually, these bookmarks are shared within an individual "group" someone may subscribe to (such as "Laser Hair Removal"). You can add descriptions to your bookmarks in the form of metadata, or meta tags, so that other users can understand what the content is of your bookmark without having to download it beforehand. Different types of "descriptions" can include comments or even reader's votes (favorable or not - like on YouTube or Digg). Again, FrontDesk SEO makes this process relatively easy.

Blog Commenting

MedicalSpaMD is a blog and, like most blogs, it is highly susceptible to spammers like we have all seen and Jeff so diligently tries to eliminate on a daily basis as it can be a true nuisance for people like us who use this site as a valuable tool for your practices.

If you want to find blogs to participate in and comment on, try to find quality blogs that are related to what you do as a profession. Again, FrontDesk SEO can help with this. And when you add your comments, try to make them content-relative because not only do your comments add value to the blogpost in general, they also have greater chance of staying on the blogpost with a link back to your website.

Press Releases

Press Releases have worked well for me, and I'm not too proud to say that I didn't write the ones that really worked. There are a lot of good and bad example press releases out there and I am no exception. Writing a quality press release is an art and, frankly, I don't have the talent for them and pay someone else to do it. Let me give you an example of my own good and bad press release experiences.

While this press release still continues to give my website hits, all it is is words: Paula's Bad Example

Now look at the one I paid Fran Acunzo from Acara Partners to do for us. It includes a photo, links and even video: Paula's Good Example

If writing a good press release including videos and back links is not your forte, then it's worth it to farm it out. Just writing a good press release is half the battle. Submitting it to the right press release agencies that will index it effectively for you is the other half.

Social Media Sites

Social Media sites such as Facebook, Twitter, Flickr and YouTube work very well by providing quality and relevant back links to your site that all the major search engines love.

So, this is back linking in a nutshell and we can really go deeper into the categories, but I fear you will become bored or even glassy-eyed if you're not a geek like me. So if you don't have someone out there performing these activities for you and you really are serious about your web presence, you really might want to take a look at FrontDesk SEO and see what it can do for you. Just remember, building links doesn't increase your website's internet presence overnight. It does take some time, like my good friend Jeff keeps reminding me! In a world of available "instant results", it's hard to be patient sometimes! 

Author: Paula D. Young RN runs internal operations and training at Young Medical Spa and is the author of the Medical Spa Aesthetics Course, Study Guide, and Advanced IPL & Laser Training course for medical estheticians and laser technicians.

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Marketing Your Medical Spa With A Blog Part 1

Part 1: How to market your medical spa, laser clinic or plastic surgery practice with a blog.

In Part 1 of this video series on building patient traffic with social media, Alex Panagiotopoulos of Freelance MD explains how plastic surgeons, dermatologists and laser centers are using blogging and blog marketing to increase patient traffic and increase SEO for their websites and clinics.

Marketing Your Medical Spa With A Blog Part 2

Part 2: How to market your medical spa, laser clinic or plastic surgery practice with your own blog.

Alex Panagiotopoulos of Freelance MD explains how plastic surgeons, dermatologists and laser centers are using blogging and blog marketing to increase patient traffic and increase SEO for their websites and clinics.

Do-It-Yourself & Outsource Search Engine Marketing (SEO)

Frontdesk SEO is Medical Spa MD's newest Select Partner.

View the announcement here.

Frontdesk offers do-it-yourself SEO software that lets you use your front desk staff to market your business. (They offer outsource SEO as well.) You can start for as little as $59 a month which is killer.

If you haven't already, run a free SEO report on your website and see where you rank according to the major search engines.

This is the same system that we use at Medical Spa MD to keep our #1 rankings in all of the major search engines and I can't say enough about the back end and how easy it is to use and works eaqually well for any business or web site. And, if you want to kick it up a notch, the have outsourcing options that use their SEO experts to do the work.

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Medical Spa MD Members get a Podium patient review marketing account and save $1,257

Protect your reputation. Get new patients. Medical Spa MD Members receive a special, full service Podium account that includes: no setup fee (save $300), a 10% discount forever (save $330/year) and on-demand patient review marketing training for your entire staff ($597 value).  This offer is not available anywhere else.

Social Media Marketing: Part 1

Last week we had a webinar on social media marketing and more than 70 Medical Spa MD Members signed up. I'd expected somewhere from 10-15 so having 70+ surprised me somewhat.

Alex Panagiotopoulos of Freelance MD explains basic Twitter functions for physicians running medical spas, laser clinics, and cosmetic medical practices

We had intended to post the entire webcast but, due to some technology issues, the audio wasn't usable. So, Alex was kind enough to recreate the entire presentation in smaller parts.

We'll be posting a number of 'how to' videos as they're available around social media marketing with easy step by step instructions, from how to set up your Twitter account, to advanced techniques on Facebook to attract followers and promote your medical spa.

This video is the first in this series, Social Media Marketing for Medical Spas: Part 1, Alex goes over setting up a Twitter account correctly.

Setting up a Twitter account for your medical spa, laser clinic or plastic surgery practice. of course you'll want to follow Freelance MD and Medical Spa MD on Twitter.

Plastic surgeons, dermatologists, laser clinics, medical spas, skin clinics and laser centers will all benefit from learning about the newest social media marketing tactics and strategies. Social media is growing and your cosmetic medical practice can benefit from it's growth with Twitter, Facebook, Blogging, SEO and do it yourself search engine marketing.

Facebook, Twitter, & Media Attention For Your Medical Spa.

We've already covered how to launch a Facebook page, what to post, and how to advertise your social media pages. 

The next step in getting more people to opt in to be marketed to is to find media, third party Facebook groups and influential Twitter users who will recommend or tout your information.

Every city has a bunch of blogs, twitterers, and Facebook groups whose sole reason for existence is to find local spa and beauty deals and to cover their experiences trying them out. They have large local followings who trust their source to be up to date and give them the best information possible. If you want to make a splash in your local scene of social media and beauty, you should definitely spend some time researching this.

Let's take a city like Denver, for example. There's a blog called Pamper Yourself! Denver, which highlights spa and beauty deals and giveaways. They also have a great Twitter feed, @denverbeauty, which has over 5,000 followers. If you have promotable events going on like giveaways and live procedures, or want someone with a local following to review your services, this is a great target. There is a "Contact Us" form on the blog, or you could tweet @denverbeauty to get their attention.

With some more googling, you can find that there's a producer at ABC-7 (KMGH, if you're keeping score at home) named Deb Staley. She has a popular weekly feature called Deb's deals, which has an online version found here. She also has a Twitter feed, with @debbiesdeals.  It is her job to report on local things that are on sale or when there's a special going on, and everyone who follows her on Twitter or reads her stories is actively seeking out that information. She's an ideal target to contact with your giveaway or special info.

Searching on Twitter for terms like denver beauty, denver spa, denver Botox, denver giveaway, denver doctors, etc. will give you info on what your competitors are doing to promote themselves as well as who would be interested in hearing about what you're doing.  @weheartdenver, with 840 followers who "heart" Denver, would be a great feed to contact with information on yourself.  @DNVDealofwk, with 1,600 followers would also be interested, provided you're doing a giveaway. Doing the same on Facebook comes up with Denver Fashion (164 fans),  Fashion Denver (1700 fans), Denver Fashion Beat(393 fans),  Denver Pure Fashion (71 fans), WOW Denver (71 fans).

So far we've only talked about third party sites that only exist to help out their readerships by promoting local deals and giveaways. Once your page is rolling, other potential targets are cross channel businesses, preferably those that already have their own Facebook pages. For example, in Denver, one could search on Twitter and Facebook for Denver nail salon, Denver beauty salon, Denver boutique, Denver lingerie shop. Send them a message and offer to give away a few of their products on your page to your fan base, if they reciprocate on theirs. You're marketing to the same people, so joining forces with related services can be a huge help.

Social Media For Cosmetic Surgeons & Medical Spas.

Social media is a major reason why traditional forms of media are collapsing across the country.

Major newspapers and tv stations are cutting staffs in half or closing up altogether, in the face of declining audiences and sagging ad revenues. Social media gives people the chance to create their own virtual newspaper, completely comprised of what they're interested in. If a topic is boring or irrelevant, it's gone. Social media groups and pages make this possible, because no matter what the topic, there's a social media group dedicated to it.

A 45 year old mom in Sacramento, for example, might not be interested in sports, but she likes California politics, wine, the TV show Lost, the actor Antonio Banderas, and beauty.  On Facebook, she can be a Fan of "California Senate Democrats", Red Red Wine - Sacramento, Lost, and Antonio Banderas. On Twitter, she can follow @CAPoliticsRSS,@thegrandwinebar, @Lost_initiative, @oficialantonio, etc. When it comes to beauty in Sacramento, she can follow her hair salon, favorite spa, plastic surgeon, etc.  Every day when she logs in, she'll see what's going on in the state senate, hear about last night's Lost episode, read about Antonio Banderas' upcoming movie, and see all of the specials, before/after pictures, and upcoming events at her favorite local beauty providers.

These are all examples of direct social media exposure. Someone knows who you are, they become your fan/follower, and whatever you post will be seen by them. We've already covered how to start and sustain this attention in previous blog posts. Once you're established with existing customers and patients, the next step is to get random local consumers who are interested in you to find you.

One extremely cost-effective method is to buy pay-per-click Facebook advertising for your fan page.  These 160-character ads with a small JPEG and link to your Fan Page will run down the right side of certain certain people's web browsers while they are on Facebook.

The beauty of PPC Facebook advertising is that it can be extremely targeted, and you only pay for the local people who click on the ad and check out your Facebook page. If you have a promotable event coming up, such as a giveaway day or a live procedure that you are performing on Facebook, they are highly recommended. 

For example, you can specify that you only want the ad to be seen by women between the ages of 18 and 64, within ten miles of Sacramento, who list an interest in any of the following: beauty, shopping, tanning, travel, jewelry and spa days, the TV shows Nip/Tuck, Real Housewives, Glee, and Jersey Shore.  You can add as many keywords as you like, and remember that due to the public nature of Facebook profiles, few people are going to brazenly volunteer to the world that PLASTIC SURGERY, BREAST AUGMENTATION, AND INJECTABLE FILLERS are their interests. But they will say they like beauty, or the tv show Nip/Tuck. 

According to Facebook, this ad will be seen by 14,200 people, and there will only be a charge of about 60 cents every time someone clicks on it to go to your page. The odds are pretty good that if someone lives within ten miles of your practice, likes the keywords above, and clicks on an ad that says a local med-spa is doing a live cosmetic surgery procedure on Facebook or is giving away beauty products, that they'll want in on the action.  You can set a minimum budget of $10 a day. If you are investing money in advertising, you have to promise yourself that you will keep the Facebook page updated with good content, or else it's a waste of money.

Be creative! Valentine's day is coming up. If you have some sort of spa day or gift set special that you'd like husbands to get for their wives, put up a detailed post with pictures and video on your fan page, and then create an ad that targets local men over 30 who mention having a wife in their profiles.

Just like with traditional media, there's paid PR (advertising), and earned PR. You have to convince third parties to cover you. Our next social media post will cover this! 

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Medical Spa MD Members get a Podium patient review marketing account and save $1,257

Protect your reputation. Get new patients. Medical Spa MD Members receive a special, full service Podium account that includes: no setup fee (save $300), a 10% discount forever (save $330/year) and on-demand patient review marketing training for your entire staff ($597 value).  This offer is not available anywhere else.

What Should Your Medical Spa Post On Facebook

We started with what to do if your medical spa doesn't have any Facebook fans. But 'content' that your patients want is what will drive readership.

Once your medical spa or plastic surgery marketing page is built and you've have a kickoff to get local potential patients aware of you, you should have at least several dozen people on your Facebook and Twitter pages.  The next step? Engaging them.

Always keep in mind the kind of in your face exposure this is going to bring.  When people are your fan or follower, whatever you write is going to appear in their "feed."  When people sign in to Facebook and Twitter, they are presented with a list of posts from everyone they have opted to follow. 

For example, when your made-up cousin Sally logs in to her Facebook account, she sees a post from her college boyfriend, a note from her mom, an invitation to a Tupperware party from her neighbor, and if she is a fan of your practice, your latest post.

If you are posting things that don't interest her, it is extremely easy for her to delete you from her account.  If you are posting things that interest her or add value to her Facebook experience, it is extremely easy for her to recommend you to her friends. If you don't have something good to say, don't bother! 

Facebook is great for embedded multimedia like pictures, video, and links, so simply writing text like "Come in and get Restylane for your lips, everyone is doing it!" is like buying a Ferrari and keeping it in first gear.  Instead, show people why they should come in and get Restylane injections.

An easy to digest mix of entertainment, usable tips, and reality content that shows off what you do best is a winning formula.  For example, over the course of a week, you could compare "The Octomom" Nadya Suleman's "trout pout" lip filler results with your own before/afters, have your aesthetician give ten winter makeup tips, and post a hand-held video (using a FlipHD video camera) that one of your assistants shot of you performing a procedure.

Posting your own reality content can even garner local media attention, just for the novelty that you are performing cosmetic surgery or injecting Botox live on Facebook. 

Any of this content that showcases your expertise in a fun and interesting way provides you with easy exposure.  Keep your website URL and phone number in several places on your fan page, so if someone sees something that sparks their interest, they can get in touch with you.

The biggest follow up question many doctors ask after this is, "How often should I post?"  As it says above, if you don't have something good to say, don't bother. Just posting endless plastic surgery liposuction ads or touting your laser hair removal treatments is a short trip to the off-list. But, if you have quality content, then set up a schedule and figure out what you'll do for the next month. 

Give your patients a feeling that they know you. A post every other day is fine to start and the more personal the content is, the better.

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Medical Spa MD Members get a Podium patient review marketing account and save $1,257

Protect your reputation. Get new patients. Medical Spa MD Members receive a special, full service Podium account that includes: no setup fee (save $300), a 10% discount forever (save $330/year) and on-demand patient review marketing training for your entire staff ($597 value).  This offer is not available anywhere else.

Medical Spa MD: Filler Injection Tips (Restylane, Juvederm)

Restylane, Juvederm and filler injections tips for physicians running medical spas and laser clinics.

The following is from a string of emails that were circulating among some of Medical Spa MDs Members. I've edited this somewhat to make it readable and get rid of all the extraneous copies. I'm also not displaying the identity or email addresses of the physicians in this thread.

Please leave your thoughts below as a comment.

Note: Some of the comments below might be out of order from the original thread. Emails' somewhat difficult to follow as a thread but you'll get the gist.

Filler Injection Discussion & Tips: Restylane | Juevederm | Evolence

1.  When I use the "push ahead" technique, I feel that I get better "plumping" per cc of filler.  I learned this from Kevin (thanks Kevin).

 

2.  When I use the "push ahead" technique, the filler fills a few millimeters in front of the needle tip.  You need to realize this to be able to put the material exactly where you want it.  Sometimes you have to "feel" the injection because you can't "see" the plumping.

 

3.  I mix 0.1 cc of lidocaine with epinephrine with my Juvederm.  This helps with bruising (epinephrine) and when the lidocaine goes away and the Juvederm attracts water, the two effects cancel each other and there is not as much enhancement after the injection due to the hydrophilic nature of the Juvederm.

 

4.  I use Juvederm Ultra under the eye and above the lip.  I use Juvederm UltraPlus everywhere else.

 

5.  I constantly complain to my Juvederm Rep about the 0.8 cc syringes.  I use lots of Radiesse because you get almost twice as much material for the same price.  Volume, volume, volume.  Please complain to your rep, maybe we can get them to change. 

 

6.  I hear the Evolence is very good.  We will be getting trained and start using it next month.

Thanks for the filler tips.Can you explain how you get the Lido with epi mixed into the Juvederm syringe? --PD

Fluid Dispensing Connector from Braun Medical Inc (you can get from PSS)

BD 1 ml Luer-Lok Syringe

 

This syringe allows you to get very precise amount of lidocaine (swish back and forth 20 times).

 

I use this syringe to put exaclty 1 cc of saline in my Botox Bottle. When I reconstitute the Botox (this gives it full strength per unit). The chances of intravascular injection might be lower with push ahead because the material will push the vessels out of the way as you advance --  Jeff

Hi Jeff,--I agree w/ #6.  I seem to get good augmentation, less redness, swelling and bruising with Evolence.  I use it for deeper fills in cheeks, NLF, etc.  Don't use it for lips or under eyes.  I do same with Lido w/ epi.  I tend to use Juvederm in lips.  Perlane / Restylane for other areas.  I agree w/ why Allergan uses 0.8 cc syringes. I've moved away from Radiesse.  I feel that the duration is not that much longer than a good correction with the HA's.  Besides, I believe a fair amount of the volume of Radiesse is a gel carrier, thus needing touch-ups at 2-3 months.  Perhaps that's why the went to the larger syringes? -- Don

The push ahead technique also moves small blood vessels out of the way, so you may notice less ecchymosis is overall pts. -- Greg

Jeff: --"Push ahead" has a higher risk of vessel cannulation & potential for vascular effects - skin necrosis in glabella, even potential for retro-grade flow to eye (causing visual loss).  I wouldn't recommend that technique for the periorbital area.

Restylane is recommended for the tear troughs;  it's less hydrophilic than juvederm - which means less post-treatment swelling.--Tom  --  [note from Jeff:  Tom is a plastic surgeon]

I would not use push ahead around the eye, I agree with Tom's comments. It works great for NLF. I was actually taught this by a PS -- Greg

Thanks Jeff for your kind comments. However I must make a few points in regards to fillers:

1) There are some areas that one has to still do the retrograde injection either b/c the purpose was to make a straight line (eyebrow lift and vermillion border and the bow-tie (the vertical lines connecting the base of nose and the upper lip border) AND when injecting the most inner 1/3 of the tear-trough to avoid risk of filler getting into the orbital space due to its close proximity to the orbital rim.

2) On the glabellar injection, it is best to first push and pull the needle thru the space underneath to break up the tissue before actually injecting the filler both in an anterograde and retrograde pattern

3) I ONLY use the 1/2 inch needles in all my injections

4) One can inject even Radiesse and/or Perlane via an 1/2 inch 30 gage needle. Why is this noteworthy to mention?? When I work on the lips and Marrionette's lines, I ususally first build the Vermillion border with Radiesse or Perlane (I get the best "lifting outcome" with heavier filler). I push the 1/2inch needle all the way forward then slowly and steadily inject while withdrawing (retrograde method). Then I re-evaluate how much of a correction I already get of the Marrionette' line and lifting up of the lip body. My next step is to inject into the most lateral lip section (about 1 cm distance) starting at the corner (using Perlane or Restylane or Juverderm). This time I inject slowly as I push forward (anterograde). Often I ended up correcting about 50% of the marrionette's line by going after the lip's border and most lateral body. Besides, the patient loveto see that they now could see their lip body all the way to the corner and more "smiley shape". The last step is the trickiest one, I use either Radiesse or Perlane on an 1/2 inch 27 gage needle. First placing my left thumb at the patient's lower half NLF's I retract the skin upward (about 2-3cm upward) then I approach my needle in an upward (vertical) position at about one centimeter lateral and one cm below the mouth corner of that same side. Then I aim diagonally toward the corner and start injecting anterograde just 1-2 mm below the imaginary horizontal line of the mouth corner (about 0.2 cc), then I withdraw the needle and reaim straight up and inject just below the horizonal line (0.2cc) then I do it one more time aiming diagonally outward (0.2cc). What was I attempting to do?? I was laying down a new flooring along the imaginary horizontal line. After the injection, release the left thumb. You will be surprised to see the retracted portion just rest right along this new floor, thus the Marrionette'line has been corrected. This is different from the common fanning technique of using the filler to "blow up" around the Marrionette's line. If you look carefully at those company's issued photos, the area around the Marrionette's line now appeared very swollen and puffed up. It is aesthetically unpleasant. It looked like the patient was beat up below the mouth. It reduced the profile of the chin.

5) For those of you that use fillers on the highly vascularized and shallow areas such as the temporal, crow's feet, undereye area lateral to the submalar area and along the lateral border of the cheek prominence (especially in those older skinny Caucasian ladies with much excessive very thin skin) I now emulate the same technique used in the hand. I would pinch to levitate the skin itself above the bony structure, then I bolus Restylane into the empty space. Then I massage it down. This elimates the risks of injecting into the vessels and nodules.

Interesting discussion.  So Kevin, how do you account for the difference in that anterograde injection you need less filler than in retrograde injections, assuming all else being equal?

Second, I am understanding one group claims anterograde injection carries a higher risk of vessel cannulation and possible intravascular injection, while another group claims that anterograde injection "pushes away" blood vessels, thus decreasing the risk. Not sure how anterograde increases risk of intravascular injection any more than retrograde.  If you push the needle ahead, transfixing a vessel, then begin injection, you can still conceivably deposit some material intravascularly, can you not?  Am I missing something here?

I also found an interesting idea of sub q bolus technique in areas of thin skin, ie crowsfeet, etc.  Anyone else try this method? ~ Don

Tom:

I do agree with you about those risks with anterograde injection. The key is always the skills in doing it, be it retrograde or anterograde. One always has to be very carefully doing anything around the eyes. However, the anterograde techinique has been advocated some of the best known experts such as Arnold Klein, MD and Kent Remington, MD. I also believed that the filler amount used was critical. It takes much more amount to get the same result with the often taught retrograde technique compared with the anterograde one. For example, I almost never required more than one full syringe in correcting bilateral NLF's vs what was typically used ( 2 syringes) by most others. I attached the before and after of a case wherein I used Readiesse to correct her NLF's and Marrionette's lines with anterograde technique. The after photo was taken right after. You can still see some of needle marks. I used one full 1.3 cc syringe, 1/2inch 30g for the Vermillion border and 1/2inch for NLF's and Marrionette's line. Notice also there was no "puffy/swollen look" medial to the Marrionette's line often seen with retrograde and fanning technique used by most others. ~ Kevin

All interesting comments.  The only place, I use “push ahead” is in the cheeks when doing them via the intra-oral route. (Apparently Radiesse is no longer teaching this method because may practitioners couldn’t get the hang of it but it works for me.)  I might try it in the “safe” areas such as NL folds.  We use only Radiesse and Juvederm and  I find that neither filler lasts as long as advertised in “first-timers”.  I’ve also had disappointing longevity in my older patients (>65) with both types fillers despite using numerous syringes.  I’m sure this has to do with their inability to generate collagen around the filler once the carrier gel is gone.  Does anyone know the age range of patients done in the filler studies? ~ SD

I came across this old thread way down in my inbox and read it again.  I’m not sure who wrote #4 below.  It sounds interesting but I’m having a hard time visualizing it.  Do you steadily move the needle forward  toward the lip edge as you are injecting or do you hold it in place while the area fills?  I’d love to see a drawing on where you start.  ~ SD

SD: I wrote those threads. The techniques that I described were similar to what you could see watching the video instruction on www.thederm.org by Kent Remington and his colleagues (lower face injection portion) THe only thing new from my thread was when fixing the Marrionette's line, his doctor (Nowell Solish) injection upward and anterograde from the lower part toward the lip corner only one time vs what I now do is I do the same thing but with a fanning pattern where (with the skin lifted about 1-2cm upward with the other thumb) I laid down "three such "anchoring points" along an imaginary horizontal floor starting from the lip corner going laterally for about 3-5cm long. Here I used something firmer such as Radiesse or Perlane. Having done this, you would release the thumb letting the skin go back down. Often you will see the Marrionetter's line is much improved because "part of that Marrionette's line" now is positioned along the horizontal flooring that you just created. ~ Kevin

PS: It is hard for me to send over some graphic illustration but I will attempt to do this in the future

The Medical Spa Aesthics Training Course & Study Guide for medspas & laser clinics.

The Medical Spa Aesthetics Training Course & Study Guide for Medspas, Laser Clinics & Cosmetic Medical Practices.

NOW AVAILABLE!

Written by Paula D. Young, RN, the Advanced Medical Spa Esthetics Training Course & Study Guide is a two part learning cirriculum for non-physicians. The course is delivered in two parts that include a text book and a study guide.

This is an invaluable tool for any Laser Center, Med Spa, Plastic Surgery or Cosmetic Dermatology practice to train every new medical spa staff member on what cosmetic proceedures you offer, how they work, and what alternatives there are.

This study course is being used in medical esthetic schools and leading medical spas and laser clinics to provide every new esthetician and laser tech with a study course, and test their knowledge before they're hired.

For the first time, your laser clinic or medspa staff has the latest information on the newest nonsurgical medical treatments, from Botox, Restylane, and the newest filler injections, to fractional CO2 laser resurfacing and IPL treatments.

Your medical spa staffs knowledge and expertise is a critical componant to your success. Now you can be confident that your front desk, estheticians and laser technicians have the information that they need, and can answer patient questions with confidence.

Memberswill only be available to existing Medical Spa MD Members so be sure that you've signed up for your free membership.

Medical Spa MD: The 6 best ways to earn and use patient testimonials, associations, and third party endorsements.

Patient testimonials, third-party reviews and endorsements, media coverage... these can all differentiate your medical spa, plastic surgery, or cosmetic dermatology practice and convince potential patients to give your clinic a shot.

While search engine marketing (SEO), pay per click (ppc) and direct mail can put your practice in front of potential patients, third party patient testimonials can provide the needed level of ‘trust building’ to initiate a first contact.

The three types of third party validation for medical spas, plastic surgeons, and cosmetic dermatologists:

Direct Patient Testimonials: You’ve seen this if you’re not already doing it. Prominent display of your patients saying nice things about you.

Trust Through Association: The reason that you’ll put your FACS, ASAPS, AAD, or ASDS logo on your site is to build patient trust. It works. Of course, theses associations are completely restricted and very protective of their turf, leading to less restrictive medical associations who want to gain credibility. The reason MAPA was formed was to add some legitimacy to a group of non-core physicians. These associations are always pay to play.

Third Party Endorsements and Validations: Botox ‘premier providers’ is an example of third party endorsement as are others that are run by medical service companies. (If Medical Spa MD links to your medical spa it’s a third party endorsement.) Interestingly, third party endorsements actually have a more favorable impact than association endorsements since the third party is often more ‘relevant’ to the initiation of a financial transaction.

When you receive these kinds of accolades or promotions from prominent third-party players, if validates what you’re doing and provides the potential patient you’re marketing to a level of instant comfort that you’ve already been checked out and are the ‘real deal’.

Subtle changes to the way you’re handling your patient testimonials and third party endorsements can produce dramatic effects, especially online, where the majority of patients are now searching for information.

Medical Spa MD: Quick strategies for piling up and using patient endorsements

Target the places your patients already are: First and most importantly is your existing medical spa or cosmetic practice but you’ll be able to reach far out into the community and gain the endorsements of other prominent businesses and individuals

Identify third-party recognition programs: These are most often paid inclusion but there are ways to get these types of third party endorsements for free, or at reduced cost.

Prepare legal and media write-ups: The media only runs two types of story; we found something good and, we found out something we thought was good, was really bad. Uncover the ways to build this kind of content that you can use on your own site, and share with you local media outlets.

Provide ready-made strong human interest and strong visuals: Patients and the media love photos. If your fractional laser resurfacing before and after pictures suck, you’re losing traffic and paying patients. Learn how to manage your photos and make them more than just snapshots.

Give patient testimonials prominent placement: If you don’t have your patients smiling photo, full name, and a stellar testimonial, you’re less effective that you could be. Learn how to get patient testimonials that are truthful, candid, and really work. Read these testimonials from Medical Spa MD Members touting the benfits of belonging to the best cosmetic medicla commuity on the web.

Look for latent patient traffic, not spikes, from these techniques: The effective use of third party endorsements and patient testimonials work and drive patient flow, but it’s not a technique that provides an instant boost. It’s begins a trend and compounds over time.

If you’re not using patient testimonials and third party endorsements to drive patient flow, start now, your medial spa, cosmetic dermatology clinic, or plastic surgery practice will benefit far into the future.

And of course Medical Spa MD uses testimonials too. Read these testimonials from Medical Spa MD Members:

Mitchell Chasin, MD: Reflections Center for Skin & Body, Livingston NJ

Medical Spa MD helps us to stay focused on the details that make the difference between a thriving practice and one that is languishing in this sagging economy.

Medical Spa MD is an important resource that I recommend to anyone who wants to understand the trends and stay connected to the ever changing aesthetic community.

Paula D. Young RN: Young Medical Spa, Allentown - Lehigh Valley, PA

To really know what's going on in the aesthetic business you MUST join Medical Spa MD! Nowhere else can you find the information crucial to your success in this ever changing arena. From the classified ads section, to the professional community forum discussion threads, to real equipment reviews by aesthetic professionals. I especially value the articles on marketing and the community forum discussions on therapy management like melasma, fillers, laser lipolysis, and skin resurfacing. Medical Spa MD keeps me on my toes as a medical spa owner, marketer, and nurse!

Susan J. DeGuide, MD: Inovamed, Rockford IL

I found Medical Spa MD several months ago and immediately added it to my “Favorites” list. I check the site several times a week to look through the new posts. I enjoy learning about new technology, expanding my knowledge of the technology I already own, and knowing that I’m giving the best available care. I would not buy a new piece of equipment now without first consulting Medical Spa MD.

Ronald Berglund, Former Medical Spa Franchisee. Sybaritic, Inc.

...we no longer feel like we are "all by ourselves" out there. There are a myriad of challenges involved with operating a successful and profitable medical spa, including marketing, sales, operations and procedures, clinical, human resources, regulatory and legal. Another huge issue for everyone is choosing the best equipment for the price. With the help of the "medical spa equipment for sale" feature I have been able to sell several pieces of used equipment. Trying to use E-Bay and other Internet-based options was a nightmare.

Jeffery E. Epstein MD: Founder Medical Aesthetic Practice Association
& Cherry Hill Laser & Skin Care Center

When we look back on the early 21st century with regards to Cosmetic Medicine, we will think of R. Rox Anderson, The Carruthers and we will think of Medical Spa MD. By providing this platform (Medical Spa MD), Jeff Barson has done more to advance Cosmetic Medicine than Anderson and the Carruthers combined. There has been a paradigm change in the cosmetic medical world and it can be directly attributed to Medical Spa MD!

Medspa MD: 9 Rules for Setting Your Prices

 

 

Setting prices for your medical spa or laser center?

 
Part guesswork, part experience, part number crunching - how ever you look at it, determining how much you're going to charge is a difficult task. Here are nine factors to take into consideration:

1. Your Costs
If your prices don't include enough just to break-even, you’re heading for trouble. Medical businesses are expensive to run. The best thing to do is add up all your costs so that you absolutely know how much you need to make each month. If you've made the mistake of paying your staff on commission, you'll need to figure all of this out as well.

Also make sure you factor in all the hidden costs of your business like insurance, services that never get paid for one reason or another, and everyone’s favourite - taxes.

2. Your Profit
Somewhat related to your costs, you should always consider how much money you are trying to make above breaking even. This is business after all. You will actually need to decide how much money you want to make.

3. Market Demand
Cosmetic medicine is in high demand, but the markets getting more and more competitive as well. You should be aiming to make your services more expensive. Conversely if there’s hardly any work around, you’ll need to cheapen up if you hope to compete. You're fortunate here in some respects. There are ways of maximizing physician time for where it's most needed, physician treatments and consultations.

4. Market Standards
It’s hard to know what others are charging, but try asking around. Find out what all the spas, medical spas, plastic surgeons, and dermatologists charge. The more you know about what others are charging and what services they provide for the money, the better you’ll know how you fit in to the market.

5. Demand level
If you're a plastic surgeon to the stars, you're going to be able to charge more. If you're a GP that's offering Botox twice a month, you're going to be charging less. You need to be realistic, not about what you think, but about what the marketing thinks. We all know that injecting Botox is not that hard, but the truth is that the market doesn't know that. You'll need to come to grips with what demand you can expect.

6. Experience
Although often bundled with skill, experience is a different factor altogether. You may have two very talented doctors, but one with more experience might have better client skills, be able to foresee problems (and thus save the client time and money), intuitively know what’s going to work for a certain audience and so on. Experience doesn't mean medical experience but a combination of medical and business experience. The markets acceptance of how much experience you have should affect how much you charge.

7. Your Business Strategy
Your strategy or your angle will make a huge difference to how you price yourself. Think about the difference between Revlon and Chanel, the two could make the same perfume but you would never expect to pay the same for both. Figure out how you are pitching yourself and use that to help determine if you are cheap’n'cheerful, high end or somewhere in between. (More on this in future posts.)

8. Your Services
What you provide for your clients will also make a big difference to your price tag. For example you might be a touchy-feely doc who will do whatever it takes to get a job just right, or perhaps you are on call 24-7, or perhaps you provide the minimum amount of communication to cut costs. Whatever the case, adjusting your pricing to the type and level of service you provide is a must. Surface charges a premium since we specialize. Generalists tend to have less pricing pull.

9. Who is Your Client
Your price will often vary for different clients. This happens for a few reasons. Some clients require more effort, some are riskier, some are repeat clients, some you'd do for free since they know everyone, some you wouldn’t want to go near with a stick. You should vary your price to account for these sorts of factors. While it's often assumed that only the rich are cosmetic patients, we all know that's not true. We have patients arrive in both limos and busses.

Give it lots of thought
Your pricing needs to be carefully thought out. I see a lot of physicians who set their prices on what the doc down the street is charging. There are a lot of docs who continually try to undercut the prices of everyone, exactly where you don't want to be. There can always be only one lowest price and the patient who will come to you based on price, will leave you just as fast.

Pricing isn't simple. You should keep an open mind about your ability to charge a premium. If you're charging too much or to little the market will tell you. Be receptive. 

Review: Squarespace.com

You can find a list of other reviews I have completed and links to the products and resources I use to run my businesses in the Resources Section of this website.

Review: Squarespace.com - Dynamic web sites

Name: SquareSpace
URL: www.squarespace.com
Purpose: Dynamic web sites, blogs, content management for laymen. 

Let me start by saying that my personal experience to date with Squarespace has been 100% satisfactory. I have never had a complaint the system has always done what I wanted it to do. I’ve been blogging for the last four years and have switched all of my blogs from hosting systems like Wordpress or Blogger, and my static sites (I still have one) to squarespace.com.

Your web site is the most important part of your online presence. How it looks. How it acts. And more importantly, how easy it is to change, are of prime importance in making a decision on what kind of system to use.

What are your options?

 

Static Sites:

By far the most common choice are static sites. Of course it's not really by choice, they were simply the only available choice until recently. If you have a site, it's probably static, meaning that it's not easily updatable and you can't to it yourself unless your pretty technically inclined.

Pros: You already have one.
Cons: Hard to build. Expensive. Search engines hate them. No traffic.
Cost: Expensive to build and host.

Blogging Software:

Extremely uncommon for medical businesses in the current market. Wordpress , Blogger, Typepad... these were the first attempts at making dynamic sites that are easily updatable and they work as far as they go. Their somewhat technical and again you'll have to hire someone if you'd like to customize your site and offer more than a standard template. 

Pros: Relatively easy to set up. Inexpensive or free. Search engines love them if regularly updated.
Cons: Hard to customize. Limited function. Still need some tech savvy to implement.
Cost: Cheap. From little to free depending on configuration.

Dynamic Sites:

Squarespace.com is the next generation of content management systems that go far beyond what's previously been available. Squarespace has built a system that takes absolutely no knowledge of html, css, or other geek speak and it's built from the ground up for ease of use. If you can use Word, you can use squarespace.

Pros: Easiest to use and setup. Completely functional with advanced features like built in RSS feeds. You can try it for free.
Cons: None, if you don't mind the price tag.
Cost: About what a static site costs: From $7 to $25 a month.

The Bad.

I always like to get the bad news out of the way so here it is... I used to have here that I couldn't think of anything but I've since stumbled across some shortcomings. Here it is:

Squarespace is not open source so they don't have nearly as many members or or growth as Wordpress has. While it means that squarespace provides detailed support (which is excellent I might ad) it also means that they don't have nearly the footprint or developer time that Wordpress does. So, squarespace does not support at least one of the options that I would like to use on my blog. Text Link Ads uses server side scripts. Since squarespace is hosted, they don't allow you to install server side scripts and so I can't use one of methods I'd like to monetize my traffic. Text Link Ads doesn't offer a scripted solution yet so I'm SOL on this one.

I emailed Anthony about this and he responded that if they felt any platform gained enough of a foothold they would start supporting it. I would expect this negative to resolve itself and I certainly can't consider it as anything but a note but I thought I'd include it since I it is something I would like.

How I found Squarespace.

Back in 1999 I started to need web sites. So I learned how to write and code so I could build them the way I wanted.

As usual I conducted extensive due diligence before deciding to use squarespace. (As a guy the definition of horror is finding out later that there was a better choice I could have made.). I read forums and surfed around the web. I talked to my geek coder friends. I quickly came to realize that squarespace different from everything else available. It was clean, it was customizable, and most of all, it just worked perfectly and had everything I could want and nothing I didn't. The fact that they were charging actually made it an easier decision for me since it convinced me that they were going to make money and actually stay in business, making it easier to get help and service rather than have to research and do everything on my own with a 'free' service.

Now I'm inherently nervous about putting all of my eggs in one basket, so I started a new site in order to test squarespace and find out if it was as good as I hoped. 

To be honest I have very little confidence that squarespace would live up to my expectations. I've been more than pleasantly surprised. In fact, every site but one (Surface Medical Spas) has been built or switched to squarespace. Here's the list:

• Simple Curiosity? - Daily posts to tickle your thinking bone.
  
• Medical Spa MD: Information for physicians in retail medicine.
  
• Nimble Theory: My other business blog about technology startups & angel investing.
• Pony tail Club: My daughters blog about her riding academy and horses.
• Kid Agent: My sisters site as a child agent in Hollywood.
• Studio Salon Suites: A business site.
• Fight Club: A networking blog for entrepreneurs. (Since rolled into Nimble Theory)

There are some others that I've helped my friends set up as well but I don't own them.

Why choose Squarespace over a free blog site?

You can get a blog up and running for free as on Wordpress or Blogger. It's a valid solution and I've done just that in the past. (Squarespace also has a 30 day trial period that's free.) There are a number of things to take into account:

1.  I've found the 'free services' to be something of a misnomer since there is either:
   
   • Significant time involved that could better be spent elsewhere so you're, in effect, paying yourself 50cents an hour.
     
   • You end up having to pay someone to do it for you anyway.
2. Starting at $7 a month squarespace is a steal. In most cases if you're really running a site you're going to be responsible for hosting it anyway. (My virtual server for Surface Medical Spas runs about $49 a month.)
   
   
3. Since Squarespace is a paid service, they offer a host of support features and technical support. Since switching all of the blogs I run to Squarespace I've opened up around 35 support tickets. In every case the problem has been resolved and the tech support has been phenomenal with same day turnaround.
   
   
4. Squarespace comes with some really great features standard:
   
   • Search: Where Google's site search works great, Squarespace blows the doors off.
   • FAQ builder: If you've ever tried to build a FAQ (as I first did here: Medspa FAQ) The new FAQ feature stomps any other solution I've seen.
   • Drag & Drop: Moving stuff around on a whim.
   • RSS: No longer any need to configure your RSS feeds. It's already done.
   • SEO: Snap. Everything is valild and optimized so people can find you.
     
   • Build forms and capture information from your visitors. You've truly got to see this in action to believe it.
     
   • I could go on ad nauseum but here's the Squarespace feature set.

Building a dynamic business site that actually works the way it's supposed to.

If you're building a business site these day's it's easier than every. You no longer need to know HTML or CSS or any geek speak. However, and this is important, building a site that no one goes to is a waste of time. There are literally billions of web pages and your tiny spot on the web had better be easy to find.

Perhaps the biggest benefit of using Squarespace is the ease of use. While I'm writing this on the site, I've got spellcheck and the rest of the editing tools that everyone takes for granted. If my front desk needs to offer a special at a certain location, they just log in and do it... The don't have to call me, get the IT guys involved, or shed a tear. It's so easy that my daughters site at Pony Tail Club is run completely by my wife and daughter who have zero, zilch, nada, snake-eyes, by way of geek training. 

If that isn't the tipping point I don't know what is. 

Cosmetic Medicine: The Unhappy Patient

How to ask the patient to stop seeing you.

I shouldn't have even said "unhappy patient." I should have said the forever unsatisfied patient. Thankfully this is a very infrequent situation in our practice, but it happens every once in a while. And it leaves such a mark, that I thought I'd ask how other physicians handle these scenarios in their own practice.

Last year I saw a patient (56 year old woman) and treated her with a little Botox between her brows and some Restylane in her nasolabial folds and the lines above her lip. She came back to see me 2 weeks later and fell into tears in my office. In fact, I was moved to tears since it truly seemed like I had ruined her life (there's where I should have seen the first red flag, but I missed it). She felt like she had all sorts of new wrinkles, her brows had fallen, etc. Unfortunately (and let this be a lesson that some of you might learn from my mistake) I hadn't taken "before" photos of her. And that was unusual since I really do take pictures of almost everything I do. Especially the first time I treat a patient. And now I absolutely do! Anyway, I couldn't see any "lowering of her lids" from the Botox. In fact, the Botox did exactly what I had expected and had informed her beforehand that it would do. I assumed she just didn't like the effect. But in terms of the Restylane, she saw all sorts of new lumps, new horizontal wrinkles and changes to her original appearance.  In her defense, I did seem some minor areas I could fix and so I did so at no charge to her. And this time I took photos. I also added some Botox to her lateral brows hoping we would see a little lift there to alleviate what she saw as "drooping."  But there was no ptosis or any of the potential complications that could occur from Botox.

She returned to see me again in another two weeks and again was still unhappy. I had ruined her "girl's weekend" in Vegas because she couldn't leave her hotel room looking so "horrible." Again more tears. But I managed to take some more photos and compare them to the ones we had taken on the last visit. Her brows were elevated a bit and her lip lines and nasolabial folds looked great. We even zoomed in to take the closest look possible. But she was not swayed.  She was convinced she still looked horrendous and that I was to blame. So now I'm starting to notice a little bit of the flag. But it's still in my peripheral vision  I really listen and try my best to understand where she's coming from, but honestly I think she looks pretty good. Course it doesn't matter what I think, I still have a dissatisfied patient sitting in front of me. But I didn't think adding any more filler or Botox was going to improve the situation. So I ask her what she thinks can be done. And she comes right back, in a very matter of fact tone, and says that she feels the most appropriate next step would be for me to perform a thread lift on her at no charge. So right about now the red flag is waving frantically in front of my face....hopefully hiding the look of shock.  My mind is filling with all sorts of questions...like why would she want something more invasive, more long term? And if I'm the one who has ruined her life, why does she want me to do another procedure on her? 

Right about then I realized that she wanted more procedures done, but she just didn't want to have to pay for them. So in the nicest way I knew how, I simply said that I didn't think that I was going to be able to satisfy her needs.  I was concerned that there was little, including a thread lift, that I thought I could do to meet her expectations. And I wasn't sure whether she had unrealistic expectations or if I had promised the sun, stars, and the moon. But somewhere between what she wanted and what I could deliver, there was a great divide. But knowing that all our office offers are minimally invasive or noninvasive procedures, I routinely spend a great deal of time in the initial consultation. If a patient comes in to see me and has complaints that cannot be adequately treated with the procedures I offer, then I usually refer them to one of the plastic surgeons in the area. I try hard to communicate the strengths and weaknesses of what I can do in my office verses what a surgeon can do in the OR.  So I doubt I had given her the impression that a little Botox and filler were going to make her look like she was 22 again.

And I certainly didn't think it was going to be a good idea for me to be performing any more procedures on her given she already didn't like what I had done. Did I mention she had already spoken to her attorney? I think I forgot to tell you that part of the visit. At the end of my previous visit with her, she told me that her attorney had advised her to stop payment on the check that she had originally written for her initial services. I wasn't sure if that was even legal or not, but needless to say, that put a damper on our relationship. And then when I said I didn't feel it was in either of our best interests to do the thread lift, her tearful eyes quickly changed to scowling ones and she let me have it. I asked my office manager to step into the office with me since I wanted somebody else to witness the exchange. But now she turned from a weepy patient to an angry woman who was yelling and screaming at me.  Since it quickly became apparent that we could no longer communicate in a constructive manner, I let my office manager (who is extremely proficient in all situations) try to diffuse the tension. 

Cosmetic medicine is still medicine and needs to adhere to the regulations governing any practice. But are the terms somewhat different when it comes to patient "abandonment" and how to notify a patient that you no longer wish to be their provider? What happens when a patient wants you to do something that you don't feel comfortable doing? What if it gets ugly? Please share your stories or thoughts on these situations.

To learn more about how to end the Doctor-Patient relationship and the legal aspects or ethics involved, click here