Dr. Ahmad Rabb, Cosmetic Medicine At Medical & Cosmetology Centre In Toronto

Connecting with a Canadian physician practicing cosmetic medicine in Toronto, Dr. Ahmad Rabb.

Name: Ahmad Rabb, MD
Clinic: Medical and Cosmetology Centre
Location: Toronto, Canada

That's interesting: Dr. Rabb leads Bio Ethics Seminars for medical Undergraduates at the University of Toronto School of Medicine. He speaks English, Urdu, Punjabi, Sindhi.

You started out in family medicine but then switched to cosmetic medicine. Why did you switch?

It took me couple of years to transition from family medicine into cosmetic medicine. Over the years I realized that non-invasive and non-ablative skin care techniques were becoming increasingly popular and effective in reasonably reversing the adverse affects of different aging types ex. Photo-aging, Intrinsic aging (age related aging) and environmental aging.

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Reputation Management Part 1: Understanding What Not To Do

Physician Reputation ManagementPart 1: What is your reputation online and what can you do that will burn it to the ground?

As a physician or clinic, managing your reputation online can be a tricky task. Online review sites like Rate MD, blogs and social sites like Twitter and Facebook give patients a much louder voice and longer reach than they used to have. Worse, a couple of individuals who really don't like you can have a disproportionately large voice since - unlike your generally happy patients - they're the ones who are really motivated to talk about you. 

There are ways that you can manage and control your reputation successfully, and then there are the most common responses that do much more harm than good. By way of example, here's is an example of exactly what you don't want to do and why people do it anyway.

Case study: IMD Lasers In Toronto

A few months ago, IMD Lasers in Toronto was named in an online discussion thread on Medical Spa MD with patients calling it a "horror" and saying it should be shut down... Not what you want people to be saying but, as those who are literate in the ways of the internet know, to be expected at some point if you're treating hundreds or thousands of patients a year. The problem wasn't really that IMD had some harsh comments posted about them, it was that they were unprepared, unrealistic, and unprofessional in their response to...

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Facebook Advertising For Your Cosmetic Practice - Results From A 3 Day Trial

Facebook marketing for your cosmetic practice: Is it worth advertising your clinic on Facebook?

I've advertised with facebook before and thought it to be somewhat useful.  I liked how it didn't waste paper.  I already think there's too much waste in this world.  But at the same time, these online ads don't sit around for a long time like some advertisements in physical print. This time, I decided I was going to try a 3 day experiment and see if I thought facebook ads were worth the investment.

Advertising format on facebook

The ad format I chose was one of those ads that show up on the side of the screen.  Currently, facebook has rotating ads in this area so that more ads could be shown. One downside to this method of advertising for facebook is that currently these ads don't show up on mobile devices. There are other ways of advertising on facebook which involve getting a status update to show up as sponsored notices - this does show up on mobile devices in the standard newstream (which is essentially the main page of facebook).  The reason I didn't choose this format for myself was that I couldn't customize the audience reach as much as I could if I had chosen one of the ads on the sides.  Thus I chose the side ads. Then I also chose the link to be that of my own facebook page for my practice rather than my own webpage. This means that when they click on the ad, they will be directed to my facebook page.

I made a few ads that were very similar but they would bid through the facebook system via different methods. One was a pay per click and the other was pay per view. Then I also added a few different pictures - one was our logo and the other was the picture of our plastic surgeon (my wife).

Intended audience

I narrowed my audience to women, age 20-50, located within 50 miles of my practice's city, and not associated with my facebook page.

Budget

I assigned a budget of $50 a day to be spent per on all the ads that I had created (pay per click, pay per view, picture of logo, and picture of surgeon), and the ad was to run for 3 days.  Thus I spent $150 on this brief ad campaign with facebook.

What was I advertising?

My wife normally charges $200 for breast related consultations.  She decided for the month of October to charge $25 instead, since October is Breast Cancer Awareness month.

What did I get out of this facebook advertising campaign?

I got 20 more new members on my facebook page.  Sometimes these members are called "fans."  I think these are potentially new patients in the future.

More importantly, I got 3 calls which all turned into consultations. These were 3 calls that could be tracked back to directly seeing this advertisement on facebook. There were other consultations that booked as a result of seeing free status updates on our facebook; these consultations were not counted as part of this experiment. 

Was it worth it?

It was worth it to me. $150 for 20 new facebook members and 3 consultations in 3 days.  The immediate measure of the worth of this advertising campaign would be the conversion rate of our practice. If even one of the 3 consultations turns into a surgery.  It would have covered the $150 expense of the advertisement.  I stopped the advertisement because we didn't have any other spots available in October for any more consultations.

There's so many other strategies one could employ to get more patients. The $50 limit per day x 3 days was my self imposed limit. I can imagine that others could set a $200 per day limit and run the ads for a month. Furthermore, one could advertise via the promoted (non-free) status updates which then would have a broader reach, but I would rather narrow down my audience to women only, age bracket, etc.   I'm sure that facebook would welcome more aggressive strategies. I have advertised several times with Facebook before, but it got somewhat addicting and I found myself being happy to spend more and more money as I saw the clicks roll in. In many respects it felt like tracking stocks with graphs that facebook provides. I thought I'd try a disciplined approach this time and I'm happy to share the experience here.


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Where Does Creating The WOW Factor Begin?

Have you ever been put in the bad situation of believing you need to fill an opening out of need? You post and ad and literally the first few people that respond and can walk and chew gum get the job.  How did that ever work out for you...

There is a real skill set to interviewing & selecting the "A" players that will create the WOW factor even without all the tech behind them. The question I'm most often asked is how to find them, interview them and hire them.  Here are a few tips to consider.

1.  Start with ad itself. Don't flour up the position or your establishment to make it seem like a dream job.  Instead, think of what you specifically need for the position you're trying to fill and use language that will weed out anything other than "A" players. In other words don’t talk about your wonderful environment. Talk about the demands of the position.

2.   Weed through the stacks of resumes and make piles of A & B applicants. All others can be put in a rainy day file for a possible another look. Now send an email to each of your A/B possibilities asking them to describe in specific terms what they can do for your organization. Then sit back and evaluate who you want to bring in for a face to face meeting. In order to hire a WOW employee they need to really impress you in this phase.

3.  At this point you're now meeting the applicants. Remember your job is to find the best "A" level player. Now you have to find out if they can think on their feet and react positively to pressure.  For myself I inform each applicant that regardless of what they are being hired for that every position also has three responsibilities.

   A.  Everyone is in Sales

   B.  Everyone is a Customer Advocate

   C.  Everyone is responsible for outside marketing activities and needs to bring in 5 new patient per month through those efforts.  In short they will need Evangelize how we are and what we do.

Now at this point you will begin to weed out the producers from the pretenders but for me, there is still one more test. I call it my pen test but feel free to create your own. I tell the applicant that I need them to role play for me. I tell them that I want you to sell me a pen and not just any pen. I want you to pretend that there are 3 other pen sales people in the waiting room all trying to sell me the exact same pen you're trying to sell me. I then count down from 5 and it's roll play time. 

What you're looking for is the applicant that can take the heat of the moment and find some way to shine. Funny thing is that I'd estimate that 75% of the over 1,000 people I've interviewed in my life fail this test. Some break down and cry, some stammer then shut down, some freeze and walk out and some hit it out of the park. I submit that if a candidate can't handle selling a pen how the hell are they going to sell aesthetic services?  If they can't handle the pressure of a simple role play how will they handle the irate patient we get from time to time. If that can’t sell you a pen that’s the same as 3 others how can they sell Botox & Laser treatments that are same at other practices in your area.   I’m constantly amazed at how few staff members at other organizations I meet can’t give a simple elevator pitch as to why I should buy from them vs. the competition.  If they lead or bring up price in the first sentence or two I can assure you the organization is floundering on failure.

So, seek out the "A" level players.  They exist but you need to attract them, hire them and retain them.  The last one might be another topic to discuss...

Richard D. Gentile, MD MBA, A Plastic Surgeon In Ohio

Our interview with Dr. Richard Gentile of Gentile Facial Plastic & Aesthetic Laser Center with three locations in Ohio.

Name:  Richard D. Gentile, M.D., M.B.A.
Location: Youngstown, Akron, and Cleveland, OH
Website: www.facialplastics.org

That’s interesting: Dr. Gentile is deemed as one of America’s Top Facial Plastic Surgeons by the Consumer’s Research Council of America. 

Profile: Graduate of Ohio State University, The University of Cincinnati College of Medicine and Baylor College of Medicine Residency Program. International lecturer and author of many publications including the 2011 Textbook “Neck Rejuvenation” published by Thieme. Dr. Gentile is a past member of the Executive Committee of the American Academy of Facial Plastic & Reconstructive Surgery and served as its Treasurer from 2004-2007.

How did you realize you were meant to practice cosmetic medicine?

As an undergraduate student I had the privilege of spending a week externship with a Plastic Surgeon in Columbus Ohio. It was really my first exposure to medicine and I was significantly influenced by the mentoring that occurred. During medical school I was equally influenced by head and neck cancer procedures and elected to pursue postgraduate residency studies encompassing both cosmetic head and neck and reconstructive surgery.

With three different locations in Ohio you must be busy. Can you describe how your clinics operate and how you staff them?

The Facial Plastic & Aesthetic Laser Center is a fully integrated aesthetic practice with a free standing state licensed and nationally accredited surgery center adjacent to it. There are satellite offices in Akron and Cleveland Ohio where consultation and minor surgery is offered. We are privileged to see patients from all regions of Ohio, Western New York, Western Pennsylvania and West Virginia. We also see patients from other states and foreign countries as well. A full service medical spa is located in the Boardman office and one of the largest private laser clinics with 20 different aesthetic lasers.

Our main office is not located in a large metropolitan area so staffing is sometimes a challenge. (Larger metro areas feature more cosmetic practices training staff who then have experience in medical spas or pastic surgery centers when they interview for new positions.)

Unless someone moves into our area we usually do not have the opportunity to hire experienced personnel so we have to train them on site. Another disadvantage is the smaller surgery centers need per diem or part time staffing patterns unless they operate five days a week and frequently it is difficult to find personnel who are interested in more limited schedules. Understanding these special needs allows us to zero in on those candidates who are interested in the employment opportunities we offer. We have several aestheticians, a cosmetic surgery coordinator who also assists our marketing efforts, two RN’s one exclusively dedicated to the surgery center and anesthesia staff who are retained from a national staffing firm. Our front office has a billing director and a receptionist.

What IPL or laser technologies are you using? What are your thoughts about the technologies you’re using now?

We have two Lumenis One platforms one in Boardman and one in Cleveland. They are equipped with IPL, Light Sheer laser hair removal diode laser and Nd:Yag. We also utilize three fractional lasers the Lumenis Ultra Pulse with deep FX , the Cynosure SmartSkin laser, and the Sciton Contour with ProFractional capabilities. We also utilize radiofreqency units for skin tightening with LumenisAluma and Pelleve. We frequently combine these modalities in multi-modality laser skin rejuvenation. The Cynosure Med Lite is one of our most frequently utilized lasers and is used for Tatoo removal, non ablative skin rejuvenation and dermal toning. A 532 nm diode laser is used for non-ablative treatment of vascular and pigmented lesions. Laser Lipolyis is a big part of our practice particularly in the head and neck and we developed many of the facial surgery protocols for laser assisted facelifting procedures or Smartlifting™ procedures.

Have your marketing efforts successfully increased the volume of patients coming in your clinic?

We use or have used virtually all media to market our practice and find particular success with internet based, social media, and seminars to educate the public about the procedures we offer. Being features on the websites of our technology partners also helps to let patients know about the services we offer.

Our favorite referral are those that come from a satisfied and happy patient sending their friends and family members to us and those make up about 50% of our new patients.

Are there particular treatments that have increased your profits dramatically?

Our services are divided about 50-50 between surgical services and the other office based non surgical services including neurotoxins (Botox), dermal fillers and laser procedures. Among our surgical procedures 90% are facial plastic & reconstructive in nature but primarily cosmetic and not as much reconstructive surgery as previously.

A small percentage of our practice revenue comes from skin care products and related sales.

What lessons have you learned in your practice that you can pass on to those who have just started their medical spa?

Listen to your patients. I think it is important that they are not always in your office so that you can give them the result you think they should have. They are there to hear about how you can best help them achieve the result they are interested in. The closer you come to achieving their goals the more satisfied and happy they will be. Learn from the unhappy patients so that it can help you to either modify your approach or better select patients so as to not try to please the difficult to please patients.

It has been a great privilege to practice Facial Plastic & Reconstructive surgery for nearly 25 years and the greatest development from early practice to later practice is the accumulation of wisdom from the early years of practice. When first starting in practice you sometimes carefully walk into the exam rooms of post op patients not quite sure what the result is going to be like or whether there will be complications. 25 years later you pretty much know what to expect and the kinds of results that will be achieved. We are always innovating and trying to add modifications to our techniques that will enhance our patients post- operative results. So while we are getting closer all the time our practice continually strives to obtain the best surgical and non surgical results available anywhere.

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.

Medical Spa MD Report: How Many Years Have You Been Practicing Cosmetic Medicine?

How many years have you been practicing cosmetic medicine full time?

From Medical Spa MD Physician Report Volume 1

The majority of physicians responding to the survey have more than 7 years of experience practicing cosmetic medicine.

For purposes of our survey, it is positive to see that just over 60% of our respondents have been practicing cosmetic medicine for more than 7 years.

This skew towards more experienced physicians may be due to concerns by younger, newer, or more inexperienced physicians that they may be helping a competitor in some way. We expect that this result will flatten as more physicians take part in the survey.

Become a Member to receive the Medical Spa MD Physician Report. You can find the report and more freebies here.

Want to contribute to the next report? Learn more >

Have thoughts on this graph? Leave a comment and let's hug it out.

Medical Spa MD Report: What Is The Total Income Of Your Clinic?

What is the total income of your laser clinic or medical spa per month?

From the Medical Spa MD Physician Report Volume 1According to the respondents to the first Medical Spa MD Physician Report, the largest number of medical spas is making somewhere between $25k and $100k per month.

Another positive note regarding our sample population; there is a nice variety of business sizes, again offering a wide range of perspectives with the highest percentage of the group falling between $10,000 and $100,000 in revenues per month. This, along with the clinic size (next question) appears to indicate that most of the clinics surveyed are operating with a single physician.

What's also interesting is that we have some very large clinics responding with 6% indicating that they're grossing more than half a million dollars a month. These clinics are probably the same ones that have a staff size of 20+.

Become a Member to receive the Medical Spa MD Physician Report. You can find the report and more freebies here.

Want to contribute to the next report? Learn more >

Have thoughts on this graph? Leave a comment and let's hug it out.

Free Medical Spa & Cosmetic Surgeon Directory Listings

Take advantage of these free directory listings for your medical spa or laser clinic.

There are a lot of directories for laser hair removal, cosmetic surgeons or medspas... Here are some that are free and that I know are very good.

Add your clinic to the relevant directories.

Are Groupon Deals Killing Your Medical Spa?

There's a deluge of Groupon offers from Medical Spas who are using cheap laser hair removal treatments to gain new patients... Is it working?

This Groupon tactic is used by skin clinics who are desperately trying to get new clients and don't know how to market effectively or drive perceived value.

Let's take a look at some of these offers and run some numbers on how effective, or ineffective, this will be for your medical spa or laser clinic.

Here's the first of the offers for laser hair removal that I've received from a local laser clinic in the last two weeks. (I think I've received five or six.)

This Groupon offer is from Enlighten Laser Cosmetics of Bountiful, UT.

Enlighten Laser Clinics Bountiful UT

Okay, so let's take a look. Enlighten is offering an 84% discount on laser hair removal from a starting price of $617 for a savings of $518.

The starting price seems about right for what the average cost of most 6 series laser hair removal treatments are in the area so that appears about right. Since they've sold 700 treatments the can't be unhappy about that since it appears that they're getting swarmed with new clients. Let's dig a little deeper.

The selling price is $99. Groupon takes 50% so Enlighten is taking $49.50 for each sale. They may have sold many more than 700 but let's go with that number. So, with 700 sales at $49.50, Enlighten is bringing in a respectable $34,650 from Groupon...

So let's break down that number and see what we find.

With 700 sales at an average of 6 treatments we see that that gross number of $34,650 comes in at a mere $8.25 per treatment. ($34,650 / 700 = $99 / 6 treatments = $8.25 per treatment)

Not so good.

That's $8.25 before any labor, rent, treatment tips, appointment scheduling or anything else. It also ties up around 4,000 or treatment room time that this laser clinic won't be able to use for other treatments. They'll also have to deal with all of the support issues; phone calls, appointment setting, consultations, equipment depreciation and the inevitable complaints and patient issues that arise any time you're treating a patient population of 700 individuals.

If you've ever sold gift certificates you know what I mean. You sell a boat-load in December for the holidays and then starve in January and February as your rooms are booked delivering the services and no money's coming in.

So, what is the most likely scenario?

Enlighten laser clinic is going to skimp on treatment time.

Instead of performing a complete treatment, the staff is going to be under a lot of pressure to get these patients in and out. One likely scenario? They'll cut a 45 minute treatment to 30minutes. They'll perform skip treatments where they're not covering the entire area but treating every other one. They'll have a waiting room stacked six high or schedule patients only on off hours... All of these can lead to exactly the opposite result that Enlighten is looking for, happy repeat clients.

I'll also note that as I've spoken at length about before, the people buying these Groupon deals are coming for price, and they'll leave it just as quickly... Not the patients you're looking for.

Here's another laser hair removal offer from Lisse Laser & Aesthetics Medical Spa in SLC, UT.

Lisse Laser Clinic & Medical Spa SLC UT

This offer arrived in my inbox early this morning so it just started. They have 101 sold deals now but it doesn't end for 24 hours so they'll probably sell many more. (Note: While I wrote this post their sales have climbed to 371 in about 40 minutes.)

Lisse Laser & Aesthetics Medical Spa is taking a much sneakier approach. They're listing their value at $2000 in value.

Here's Lisse's Groupon offer:

...for $145, you get six laser hair-removal treatments on the lower or upper legs (a $1,000 value for women, $1,400 value for men), lower or upper arms (a $700 value), or Brazilian bikini area (a $1,000 value for women, $2,000 value for men)

So again, six treatments but at least they're making an extra $23 per patient. Let's do the math again.

$145 per sale / 6 treatments = $24.16 per treatment.

Lisse is going to have all of the same issues and problems with scheduling, service, appointment setting and the rest as well.

(I'd be interested to hear how those medspas that are using commission (which I personally hate) to pay their staff feel that this kind of discount effects both the level of service and the commission structure. If you have a thought on this please comment.)

And there's another problem.

Selling your services at this type of discount positions you in the marketplace as the cheap player in town. You'll never be able to control your pricing. You'll never be able to create steady, repeat buyers that pay a premium for your services. You'll never be able to bring in the bigger treatments and you'll always have cash flow issues.

Instead, you'll always be scraping along at the bottom of the barrel... if you can survive this type of cut throat slash-and-burn price war.

I can see that Groupon is doing a great job of selling their deal to laser clinics just by the endless stream of deals.

For Groupon this is great. They just made $34,650 from Enlighten by sending out an email... but Enlighten is the one who's stuck delivering all of the services, making all of the appointments, dealing with the customers, and putting their reputation and business on the line, including the potential of any issues that hit their malpractice insurance or medical licensure. (I'm not saying this will happen, just that the risk is entirely on Enlighten and the physician, not Groupon.)

Undoubtedly, there are some occasional successes and I've heard from clinics that claim that they love Groupon, but I've never heard from a physician who was paying the bills that this worked well. It's often the staff that like this since the clinic is now busy, but the physician owner is the one that's not making any money and still paying out.

Here's a quote from a business that ran a Groupon offer.

After three months of Groupons coming through the door, I started to see the results really hurting us financially. There came a time when we literally could not make payroll because at that point in time we had lost nearly $8,000 with our Groupon campaign. We literally had to take $8,000 out of our personal savings to cover payroll and rent that month. It was sickening, especially after our sales had been rising. So the experience jaded me, and the interactions with the few bad Groupon customers we had jaded our staff. After all of this, I find myself not even willing to buy Groupons because I know how it could hurt a business...

This business owner goes on to tell of her experience that the Groupon clients also lambasted her business on Yelp and other review sites with negative reviews.

If you have an opinion on this or experience with Groupon, please leave a comment.

Additional posts on Groupon:

Niche Yourself & Your Medical Spa

If you're not comfortable with creating or finding a niche that your medical spa can dominate... get familiar with it.

Guy Kawasaki is a well known speaker on technology, venture capital and startups. I've seen him give this presentation a number of times and this is dead-on accurate for any business, including your laser clinic or medspa.

If you're just copying everyone and trying to feed on the edges of the marketplace, your medical spa's just an also ran and you'll never experience the ability to control your prices or your income and you'll always be playing second fiddle to those clinics and physicians who understand these principals.

Improving Your Laser Clinics Marketing Funnel

Web users are, for the most part, used to giving out personal information online, especially in exchange for content they want. But certain kinds of information are more sensitive than others.

If you're capturing leads for your laser clinic or medical spa, here's some info from Hubspot that show how asking for certain type of information can reduce the number of contacts or leads that you're able to capture.

Here are some of the findings.

Forms asking for any type of geographic location have lower converstion rates than forms that do not, but mailing addresses seem to be much more sensitive since the perception is that visitors filling out the form will receive mail.

Asking for a telephone number has much the same impact as asking for a mailing address... a decrease in the number of completed forms.

Oddly, at least to me, it seems that asking a visitors age is also sensitive enough to prevent form completions.

So what should you do?

First, don't try to swallow the entire apple, just take a bite and begin to add value. Remember that they're filling out your form in order to receive value from you. If you don't provide any value at all and just spam them with offers, your relationship will sour quickly.

Medical Spa MD Podcast: Dr. Thomas Young & Smartlipo

Dr. Thomas Young

In episode 8 of the Medical Spa MD Podcast, Dr. Thomas Young of Young Medical Spa discusses new Smartlipo techniques and training, choosing cosmetic lasers, and cosmetic stem cell treatments.

We discuss the latest trends and nonsurgical cosmetic technologies including Smartlipo, stem cell treatments, laser liposuction, technology choices and integrating new surgical techniques into your cosmetic practice.

Dr. Young began performing SmartLipo Laser Body Sculpting soon after it's FDA approval and was the first physician to introduce awake tumescent laser liposuction to the Lehigh Valley. He trains other physicians across the country in awake tumescent liposuction and liposculpture procedures and was the first physician to perform Vaser® Lipo, SlimLipo, Body-Jet®, Stem Cell Enriched Fat Transfer Natural Breast Augmentation, Brazilian Butt Lift, ZERONA, VelaShape, and the Soprano XL Pain-free Laser Hair Reduction procedures in the region.

Laser Clinic Tatoo Removal

One of Medical Spa MDs eaders sent me this story on job hunters going to tatoo removal laser clinics in an effort to make them more employable.

The multi-billion dollar business of tattoo removal is enjoying some recession-proof growth — with one LA-based clinic even planning on going public next year to help fund a national expansion plan.

“More than 40 million people have tattoos and about seven million, or 17 percent, are in the process of figuring out how to get rid of them,” said John Keefe, the CEO of Dr. Tatoff, a California tattoo removal clinic, who hopes to use the proceeds from a 2010 initial public offering to grow to a 10-location chain.

“More than 66 percent of those tattooed are between the ages of 25 and 45 and what was cool to them at 18 is an eyesore now that they are a mother with kids,” says Keefe. The executive said revenue per client is about $1,600 — which comes out to $40 per square inch, per laser treatment  with an average of 10 treatments required. The average tattoo is four square inches, he said.

It costs 10 times more to remove a tattoo than to put one on and it takes one year for safe and effective removal,” says Keefe.

The national market is currently fragmented, with dermatologists operating on a one-off basis and usually not dedicating their entire practice to tattoos removal.

The growing unemployment rate is also helping the company ink new business as job hunters feel the need to be competitive. Of course, many look to get rid of their tattoos because of personal taste — they may have simply fallen out of love with their tattoos or out of love with the name of the person indelibly inked on their arm.

I personaly never saw the attraction of getting into laser tatoo removal, but our patient population wasn't really inked-up either.

Is anyome meeting with real success with their tatoo laser removal services? Is tatoo removal cost effective? Is it dependant upon a certain inked demographic? What cosmetic lasers are being used to remove tatoos?

Plastic Surgery Trends For 2010

The Consumer Guide to Plastic Surgery thinks they know what’s in store for cosmetic medicine in 2010, from how the newly proposed “Botax” could affect your self-improvement plans to which new products will come to market. Here's what you might see in 2010:

Even More Botox-Like Products Will Come to Market

First there was Botox Cosmetic; then 2009 brought the Botox alternative Dysport. In 2010, expect to see a few more Botox rivals, including a topical form of the popular wrinkle relaxer and at least one more injectable. A couple of injectable Botox cousins are in development, but PurTox will likely be the next to get a nod from the Food and Drug Administration (FDA). The main difference in these injectables seems to be how long the results last and how quickly the products start to work on your crow’s feet.

Fat Injections to the Breast Will Be Used Cosmetically
After being condemned by plastic surgery associations, fat injections to the breast were deemed OK for "touch-ups" after breast reconstruction in 2008. But these once controversial injections may soon play a role in cosmetic breast augmentation. Taking fat from a part of the body where there is too much (your thighs or butt, for example) and injecting it into your breasts where there is too little, may replace the need for breast implants when done in conjunction with a breast lift. Some kinks still need to be worked out, but fat injections to the breast are likely here to stay.

Surgeons Will Invent – and Perfect – Body Contouring Surgeries to Follow Massive Weight Loss

More and more people are undergoing bariatric surgery to lose weight, only to be left with hanging fat and flab in highly visible areas. As plastic surgeons put on their thinking caps to better address these issues, expect to hear about many new procedures, including the corset trunkplasty. This new surgery targets above-the-belly-button flab, to recreate an hourglass silhouette in formerly obese women and get rid of love handles in men who have lost massive amounts of weight. This area has been ignored by many traditional body contouring procedures that target the lower abs, buttocks and/or thighs. We will hear more about corset trunkplasty and other innovative body contouring procedures in 2010.

Fat Freezing Heats Up in 2010

Fat freezing (or cryolipolysis) may give liposuction a run for its money in the coming years. This technology works by freezing fat cells and breaking them down. Zeltiq is in clinical trials now, and results look promising. Stay tuned.

Cohesive Gel Breast Implants Receive FDA Approval

These so-called "gummy bear implants" have been making their way down the pike for some time, and they just may get the long-awaited FDA nod in 2010. Filled with cohesive silicone gel, these leak-resistant implants – used in Europe and Brazil – are being studied in the United States. Gummy bear implants have the positive attributes of silicone gel, but the gel doesn't migrate. This is a good thing, because if the shell should fail, the gel wouldn’t leak into surrounding tissue.

Lipodissolve Study Results Stun Skeptics

Lipodissolve, an experimental "fat-melting" technology, is being billed as a non-surgical alternative to liposuction. Also called mesotherapy, lipodissolve is performed via injection of a cocktail of chemicals into muffin tops, saddlebags, love handles and other trouble spots to dissolve fat cells. Critics were outspoken, which is why the American Society for Aesthetic Plastic Surgery started a rigorous scientific study of lipodissolve, using standardized ingredients. And while even the trialists were skeptical at first, and the final results have not been tallied, it works. The study results – to be released in 2010 – may encourage many doctors to offer lipodissolve. Still, lipodissolve is only for small areas of localized fat and will never replace liposuction.

“Botax” Will Raise Eyebrows

A health care reform bill will be passed in 2010, and it just may include a five percent tax on all cosmetic surgery procedures (except those deemed medically necessary). Let’s say that breast augmentation with implants costs $10,000 in 2008; add a five percent levy, and the total becomes $10,500 in 2010. With business already down, most plastic surgeons are up in arms about the Botax. There is also fear that taxing cosmetic surgery in the U.S. will encourage many to seek out services abroad or through unskilled providers who offer procedures at cut rates in America, compromising their safety.

Surgery-Free Tummy Tucks Trim Waistlines

Non-invasive body contouring procedures such as Thermage, VelaShape, UltraShape, LipoSonix and Zerona will continue to grow in popularity in 2010. Once reserved for the face,

Thermage also uses radio waves to lift and firm skin on your stomach, knees, arms, legs, hands or butt.
VelaShape employs bipolar radiofrequency energy to reduce the size of the fat cells, along with infrared heat to tighten the skin. And Zerona uses a “cold” laser to painlessly zap the fat cells beneath your skin. These technologies (and more) may give tummy tucks and lower body lifts a run for their money in 2010.

Face Transplants Face Upsurge

Face transplant surgery was once nothing more than fodder for sci-fi thrillers like the movie Face/Off, but they are now becoming a reality. Eight have been performed so far in the United States and abroad, but there will likely be many more as reconstructive facial surgeons further hone their skills and work toward perfecting their highly complicated techniques.

Minimally Invasive Cosmetic Procedures Experience Rebirth

As our economy starts to show signs of life again, more people may opt for cosmetic surgery procedures, reversing the steep decline of the last two years. Don't expect the numbers to reach their record highs anytime soon, though. There will likely be a slight increase in plastic surgery procedures – especially minimally invasive ones such as injectables that allow people to put off more invasive (and expensive) procedures like face lifts until they really need them (and can better afford them).

Consumer Guide to Plastic Surgery is published by Ceatus Media Group LLC, an online provider of health information and physician directories. Consumer Guide to Plastic Surgery is a registered trademark of Ceatus Media Group LLC.
http://www.yourplasticsurgeryguide.com

Cosmetic Surgeons enlist patients to fight the Botox Botax.

Cosmetic surgeons are asking for patient help to fight the Botox Botax. Here's what the ASDS (American Society for Dermatologic Surgery) is giving it's members to solicit the support of Botox consumers: Here's the form.
The U.S. Senate health care reform bill  (Patient Protection and Affordable Care Act) contains a proposed 5 percent tax on "elective cosmetic medical procedures."  While this may look like an attractive option to Senators looking for ways to pay for health care reform, we know that:
  • Cosmetic medical procedures taxes are an unreliable and risky revenue source, which has proved to be a failure at the state level;
  • A tax on cosmetic surgery discriminates against working women;
  • The definition of cosmetic procedures is arbitrary and almost impossible to administer; and
  • enforcement would necessitate review of patient medical records by tax collectors, a clear invasion of privacy.

Please enter your zip code below to be connected to an automatic email system which allows you to send a quick message to your Senator asking him/her to vote against this tax.

I've received an number of emails about this over the last 48 hours. Is anyone worried that this 'Botax' will hurt your medical spa, skin clinic or cosmetic practice?

Medical Spa MD: How to operate effectively in turbulent times.

If you’re involved with or own a medical spa, this question is no doubt on your mind.

In this article, I will give you several tips and tools to evaluate your laser centers culture and operations, so you can successfully navigate any economic downturn… And live to sell another day when the inevitable upturn comes around.

What is the Passion and Purpose of Your Medical Spa?

You reap what you sew. When you engage proactively and passionately in your business you will undoubtedly be successful and see your practice expand. It helps to articulate your passion for your medical spa.

At Assara Laser, our passion is to “help clients look and feel great, not fake.”

Why the Recession Drastically Affects Your Laser Clinics Bottom Line

You’ve probably noticed that generating revenue is not as easy as it once was. There are myriad reasons for this; from the decline in disposable income, to unemployment hitting record highs and tanking real estate valuations. As if these facts were not bleak enough, credit markets are virtually frozen so business owners are finding it nearly impossible to obtain small business loans and lines of credit. Refinancing current loans has become difficult for small businesses.

In short, we're operating in the perfect storm.

Accepting Reality and Responsibility Today

The easy way out is to close up shop and blame the recession. This will not help you going forward, it will not pay your devoted employees their wages, and most of all, it will not help your clients “look and feel great, not fake.”

So, accept responsibility. 

The hardships of the recession create a fact-pattern, problem to be solved; not a reason for failure. To paraphrase Michael Jackson, start, first, with the man in the mirror. Think about the following questions. And pay attention - there will be homework at the end of this article!

Finding Your Medspas Winning Competitive Difference?

Let’s be honest. The quality of your laser clinc's treatments are probably not drastically better than that of your competitors. The proprietary equipment and IPL or laser systems (Thermage, Fraxel, Titan) that you use are, for the most part, available to the competitive skin clinic market at large.

You may believe (and tell clients) that your microdermabrasion treatments are better because you use a diamond-tipped wand or aluminum oxide crystals. You may think that your IPLs or laser hair removal treatments are better because you use cryo-cooling or because you use chilled air cooling, or because you use a diode laser or because you use alexandrite lasers . . .

BUT . . .

Step in to your clients' shoes. To them, the bells and whistles of your Thermage or Fraxel device don't matter. Your clients already expect expert advice and cutting edge cosmetic lasers, IPLs and skin tighening equipment, so merely meeting this fundamental requirement is not a winning competitive difference.

What does matter to your clients are presentation, client interaction, customer service, reliability and consistency. Consider this carefully.

What is each of your medspas clients worth? 

At Assara Laser, one of the most popular packages is our $449 per month Unlimited Laser Hair Removal Program. On average, a client that signs up for this program will remain a member of the Program for 7 months, depending on the results they wish to achieve. How much is a single unlimited client worth to us?  A client in the program for 7 months, making a monthly payment of $449 is worth $3,143. For many laser clinic owners, a single laser hair removal client is worth more than a home mortgage payment!

Do you treat every single potential laser treatment client that contacts your laser clinic as if they’re worth $3,000?

What is your time and effort worth?

Before my partners and I built Assara Laser, I was an attorney. I still practice corporate law as a labor of love, when a friend or business contact has an exciting deal. I normally discount my rate to about $400 per hour, as law isn’t my primary source of income. 

Assume an hour of your time is worth $400.  Assume further that, every time your customers complain, you are willing to give a discount, or a free treatment and that, collectively, free and discounted treatments account for a 20% loss in your revenue. To make up for this lost revenue, how much more work do you have to do? 

Well, let’s add 20% to your 10 hour day, which now makes it a 12 hour day. If your annual sales are say $1,000,000 per year, you’ve lost $200,000. This translates into 500 hours more of work you must do to bring your revenue back to status quo!

Is there a big difference between a day that starts at 9:00 a.m. and ends at 7:00 p.m. versus ending at 9:00 p.m.  You betcha there is!  Is there a big difference between a loss of $200,000 and a loss of zero. You betcha there is!  And these differences drastically affect your quality of life.

How Do You Avoid Mistakes?

Mistakes are costly. A happy client is worth more than $3,000, and will likely refer business, the best and cheapest form of marketing. A single angry client will result in you working 2 hours more per day for the following seven work days, and will possibly diminish your reputation by badmouthing your medspa. 

A lot of people think excellent customer service means free treatments. It doesn’t. Excellent customer service means delivering what you promise. You know the limitations and effectiveness of your treatments so promise only what you can deliver and do it consistently, with a smile on your face!

Your Homework

Write an email to one close friend or business partner (or to me, if you would like to engage in this project with me: wshuman@assaralaser.com), in which you answer the following questions.  Cut and paste the text below into your email, and fill in the blanks with no more than three sentences: 

I wanted to pick your brain for a moment. I’m working on a plan to really blast my medical spa practice off the ground, and I wanted you to use your intuition to judge the quality my sentences below.  What do you think? 

The best way to succeed in business while I make clients feel great is:

The recession has made it harder for my medical spa to operate because:

My medical spa’s winning competitive difference is:

Each of my laser center's potential clients is worth:

I will earn every cent paid to me from a client’s hard earned money by:

The biggest recurring (or systemic failure) affecting my customer service is:

Please let me know your thoughts.

Note: The above is a guest post from Will S. of Assara Laser Centers.  You can find Assara on the web at the following links: Assara Homepage and Assara Blog.

If you would like to write or guest post for Medical Spa MD please contact Medical Spa MD here.