Part 1 of our interview with Audubon Dermatology in New Orleans: Dr. Jackson tackles the medical technologies used in their practice and her experiences as a Dermatologist.

Name: Dr. Sarah Cenac Jackson
Location: New Orleans, LA
Website: http://audubondermatology.com/

Of Interest: Dr. Jackson is a member of the Annenberg Circle of the Dermatology Foundation, the largest foundation of dermatologic research in the country. She lives in New Orleans, LA with her husband Konrad and their 3 children Adelaide, Henry, and Charles.

What sparked your interest in offering cosmetic medicine?

Botox and Restylane were FDA approved for cosmetic use when we were in training at a program that had an established cosmetic training clinic and education in place. It was a natural fit for us to continue using and perfecting our techniques with injections.

We have several leaders and mentors within the cosmetic field in New Orleans and we were inspired to stay at the cutting edge of this exciting time in dermatology. What keeps us in cosmetics is the high level of patient satisfaction with these procedures. People love looking better and it translates positively to other areas of their lives. The constant positive feedback stimulates a desire to continue training and offering our patients the best services possible.

What are the IPL and lasers you use? And how do you select the medical devices in your practice?

We use many lasers and energy devices. We started out by renting a hair removal, vascular, and resurfacing devices. As we became more booked up on the days we rented the lasers, we made business decisions to purchase devices. IPL and laser hair removal were our first purchases and remain very profitable.

We determine devices to purchase based on 1) demand 2) data on the device's success 3) profitability.

Consumables and warranties can become very expensive so we are sure to factor that in as we make purchase decisions. We calculate ROI per hour on devices including the time required for one of the doctors or aestheticians to operate it, including numbing and consents. More complicated and painful procedures have a cost to us in time!

Our Palomar IPL, Exilis radio frequency, and Cutera Hair Removal systems are fantastic because they require no numbing and have no consumable. Cool Sculpting is very popular as well. We do research to see how much competition we have locally with a particular technology, but we have found that our patients are very loyal and respect our expertise, so it has not been a big problem for us to compete with med spas or group-on type pricing.

Clear and Brilliant and Fraxel Dual are also very popular, but difficult to use in New Orleans in the summer as we have so many tanned and skin of color patients. We are starting to use Cutera's picosecond laser for pigment as it is more color-blind.

Our tattoo removal business has not been as busy as we had initially thought, but it is growing and we love having the picosecond technology as indications for that device grow.

Over the years we have become savvier about negotiating. We usually decide what technology we want (skin tightening, resurfacing, etc.) and then research which device by talking to other KOLs and peers. At meetings, we try to have meetings with laser companies and get to know their personality. We always, always demo the devices before purchasing. Prices are negotiable and we discuss extra warranty years, extra consumables, and what to do if the device is upgraded before ever signing.

What anecdotes can you share about your patients?

I think some of the worst patient situations that happened involved syncope secondary to patient anxiety about needles. As a physician injecting all day long, we need to be skilled in recognizing syncope and pre-syncope and be able to best treat our patients. We have had several episodes in the office of seizure-like activity as part of syncope. We have had patients jerk with these convulsions while a needle is near the globe and even fall off the exam table. One patient even had lateral nystagmus. After consulting with our Neurology colleagues, we learned these symptoms can be seen with syncope. We have found it very helpful to know the proper recovery for syncope. Most importantly to lay the patient flat and let the blood flow back to the brain. We keep juice and ice on hand and everyone in the office is ready and prepared in case it happens. People are not allowed to leave until fully recovered. We have had a young male patient try to leave to early and face plant the copy machine on his way out! So, we triage for this as part of the patient intake. “Have you ever passed out with needles?” We are always prepared with guarding the needle and stabilizing our hand in case the patient jerks. We have our staff prepared so the patient recovers fully and can have confidence in our care.

Bio: Dr. Jackson received her medical degree from Louisiana State University School of Medicine, where she was a member of AOA honor Medical Society. She also fulfilled her residency training at Louisiana State University Health Science Center where she served as Chief Resident in Dermatology. She received her undergraduate degree in Zoology from Louisiana State University, where she graduated cum laude. She is a board-certified Dermatologist with special interest and training in medical dermatology, dermatologic surgery, cosmetic dermatology and laser surgery. Dr. Jackson is a former President of the Louisiana Dermatological Society. Additionally, she served for several years as the Louisiana State Chair of the Dermatology Foundation. Dr. Jackson is a member of the American Academy of Dermatology, the American Society for Dermatologic Surgery and the Women’s Dermatologic Society.