According to PR Newswire, in 2016 Aesthetic Medicine was an 8.6 billion dollar market. By 2023 it’s expected to reach 19.4 billion dollars. Now at the half way point, 2019, we’re finding it may even exceed those figures. What’s driving that kind of growth?
Primarily there are two product categories. Botulinum toxin injectables and dermal fillers. There is a third one on the horizon however, insertable threads. More about that later… When used properly, botulinum toxin injectables give temporary wrinkle relief. Dermal fillers can smooth skin, fill shallow areas, and in some cases even grow new collagen. As a side benefit, we’re finding Aesthetic Medicine patients not only see an improvement in appearance, but an enhanced sense of self. This state of mind “uplift” results in satisfied patients and happy return visits.
I truly love Aesthetic Medicine. The rewards received not only from treating my own patients but also from training others are both monumental and grounding. However these benefits came with some uncomfortable moments.
I remember the first time a professional acquaintance asked me “How well are you really doing with this stuff?” I was taken aback, but had the presence of mind to realize their real question was, “Is it worth my time and trouble to learn facial aesthetics?” To answer that, one first has to look back at the first paragraph. Then consider that it is a cash business. No one needs to be dedicated to collecting insurance payments or coding. And once you are trained and proficient at providing predictable outcomes, the main source of new patients will be existing patients referring others. Getting to that point as quickly as possible is one of the goals of my training business.
Just hearing a prospective patient ask “When could Dr. Bonnie fit me in?”, instead of, “How much do you charge for_____” is such a blessing.
Would you like to make this happen in your practice?
The first crucial element is learning the secrets of creating a fresher and more rested look for your patients. That renewed appearance is the Golden Key to looking younger naturally. This look is not about freezing facial movement or giving lips an overstuffed “trout pout”. It’s about giving someone an indefinable “You just look more attractive” appearance. I’ll show you techniques and solutions learned from over 20 years of practice and tens of thousands of patients. Most importantly, my training is designed for challenges you’ll face and giving you all the confidence you need. Also, you will be able to contact me after the training for questions.
Please look through the topics below. They’re based on actual questions I’ve been asked. Your question may be similar. If not, just contact me, I’ll be glad to help!
Q. There’s a lot of fillers and neuromodulator products on the market. Which ones would you recommend?
A. I can only give you my experience and perspective on products available. That said, the internet should be your first stop if you are new to Aesthetic Medicine. Research both dermal fillers and neuromodulators. Make a list, go over all the indications, and read all you can about their abilities, strengths, and weaknesses. Reviews help too, but you can get a lot of conflicting opinions from people with varying skill levels. This research will help you be better prepared to talk to reps about their products.
Regarding fillers, there are several differences but the most important is consistency. Some are for fine lines; others are more robust and used to fill hollow areas. Some encourage collagen growth, some don’t. And some are permanent, which I never recommend.
You can’t go wrong with products from major companies like Allergan and Galderma. Galderma’s product, Sculptra®, is unbeatable for filling facial waste due to aging. It has the benefit of greatly stimulating collagen growth in the offending area. It can also be used for so-called “butt lifts”, a treatment procedure that is growing in popularity. Additionally, wherever you have skin, adding Sculptra® can make it younger and healthier appearing. Also, when purchasing products, go directly to the actual companies. Whatever you do, don’t get involved with overseas, or even out-of-country purchases. Importing products is illegal and you risk losing your professional license. Aside from the fact that you’ll receive no back-up if you have an issue.
Then there are neuromodulators. BOTOX ®Cosmetic (onabotulinumtoxinA injection) is a great product, made by Allergan. Its name has become synonymous with facial aesthetics. Dysport® is another tried and true muscle relaxer, made by Galderma. I use both and get amazing results. Xeomin® is another, produced by Merz. Jeuveau™ is the newest on the block by the relative newcomer Evolus.
Threads are another fast growing segment of Aesthetic Medicine. They are great for support of sagging skin and falling regions provided there is not too much laxity. Although I get terrific results, the learning curve is a bit steep. I would advise staying away from threads until you are totally comfortable with other procedures and products.
It’s very important to know and understand the facial structure and anatomy. While everyone has a different face, with proper training you’ll be amazed how many similarities you see that you can build on and improve.
Q. I am giving consults and advice, but not getting appointments. Is it common to waste so much time on consultations?
A. Short answer: You will spend more time doing consults in Aesthetic Medicine than in “normal” medicine. This time is NOT wasted because a good percentage of them will become happy patients.
That being said, since you say prospective patients are not booking or returning, I can only suspect you, or something else in your office, is causing the problem. I see you have a derm practice. Do you have the same problem with your derm patients? If not, then we’re left with your consult as the problem. Unfortunately I can only speculate, but you say that you “advise them what to do”. I suspect your advice is the culprit. While you may be hearing everything the prospective patient says, after you have attentively listened, try to tactfully re-direct them to what you see as their actual problem. For example, many people will c/o naso-labial folds when the real issue is lack of cheek volume.
So just tell them exactly how you can help. If you address those initial concerns, while adding a few more things you may notice, you and your new patient can create a plan. And, you’ll have a “forever” patient.
I can’t say for sure my assessment is 100% correct about your consult to booking ratio problem, but I’ve used this consultation system for years and it works. Just make sure you convey genuine empathy (not faked) and deal with THEIR issues first. One of the biggest challenges “normal practice” practitioners have is adapting to this new paradigm of consulting as opposed to the medical practice model of diagnosing & prescribing then on the next patient.
Q. How can you judge proportions of a face? Are there any specific guidelines?
A. Yes there are. All beautiful objects from buildings to art (and faces) are designed around Phi, which is not only the 21st letter of the Greek alphabet, but more importantly is named after the sculptor Phidias. He ascertained the human head, and more specifically its face, is perfectly sized in proportion when the width times 1.618 would result in the measurement of the perfect height. The midpoint position of the eyes is computed, then the mouth and nose locations are also figured in the 1.618 ratio. While you may never see a “perfectly” shaped face, you can use this technique to get an idea of what is necessary to give your patients face a sense of balance, equilibrium, and what we call beauty. There are many articles on the internet with examples of the face and all its features evaluated using Phi.
Q. Are there any specific patient behaviors that would stop you from treating a patient?
A. Yes. And choosing your patients wisely can save you many sleepless nights. I developed some personal guidelines that have kept me from getting involved with patients I’d rather not touch.
Here are three major points you might want to use in the initial consult before even touching an individual. First of all, ask questions and listen far more than offer opinions. What are their expectations? If they are unrealistic, and can’t be brought to reality, then simply tell them you cannot really achieve what they want. For instance you can’t erase 40 years of smoking and sun damage with any treatment I am aware of. A properly trained practitioner can improve their appearance, but not totally erase the damage of poor choices.
Also, if they tell me a bunch of horror stories they’ve had with other Practitioners, I let them go somewhere else rather than include me in their next “tell all” with another Provider.
Lastly, if they exhibit Body Dysmorphic Disorder symptoms, I steer clear. Unfortunately, you will meet some individuals with this deep seated problem. It’s a sad situation but they need help Aesthetic Medicine cannot give.
In essence, your goal should be no different than any other Medical Provider. Create happy and loyal patients by doing great work so they will refer their friends. Then those referrals become happy and loyal patients that refer friends. One thing I have found to be 100% true: If you have a pleasant person that is a happy patient, the friends they refer will also be pleasant. Life works that way.
Q. Do you take pictures of patients before treatment?
A. Absolutely. No exception. And I download them from my camera to a secure location. Each time they come in I take another photo before I touch them. Occasionally full face and profile both, depending on treatment. This protects me and my practice. Also, sometimes a patient will come in and say that they just can’t see any real change. That’s when I take another quick shot of them while they are there and put it side by side on my computer with the original, doing a quick “before and after”. It’s amazing to watch their reaction. Some even ask for a print. The reality is, you can see the difference, and so can their friends, but they can’t until they can see the comparison. It’s not really their fault. When you look at yourself every day, it’s easy to forget what you used to look like. Anyway, the look on their faces when they see their before and after is priceless fun!
Q. How important is facial anatomy in Medical Aesthetics?
A. Anatomy is very important. Patients can be harmed by improperly placed injections. It’s quite possible to cause necrosis of tissue or even blindness without a good sense of anatomy. There are many books and trainings that cover this issue, as do my own trainings. Also remember that no technique is 100% safe. Some feel that utilizing a cannula makes injections fool proof. However, bruising, occlusions, and even blindness have happened with blunt-tipped cannulas.
Anatomy is also important from an Aesthetic perspective because knowledge of facial changes with aging is crucial to great results. Natural loss of bone, collagen, and fat, sun and smoking damage, plus the law of gravity will all take their toll. Unfortunately, facial anatomy, unless that was your specialty, is barely mentioned in a medical education. You will probably need some study to get up to speed.
Q. How much do your trainings cost?
A. My most frequent question….. So let’s start with the answer you never thought you would hear. Don’t hire me as soon as you decide to try
Aesthetic Medicine. I would first get the training every major company in this industry offers at no cost. But you need to understand how pharma training works.
If you are considering a product, first get on the internet and read the indications (or “on label”) uses for that product. You will be surprised how narrow some indications can be. For example, BOTOX® Cosmetic, by Allergan, was first released in 1977 to treat Strabismus, an eye muscle problem. So, lets say in 1977 you wanted Allergan to send a trainer to your office. That trainer, paid by Allergan, could only address Strabismus. No other use could even be mentioned in the training because Strabismus was the only on label indication.
It was not until 2002 that BOTOX® Cosmetic was approved for wrinkle relaxer, and then only in one area between the eyebrows. So, in 2002 you could ask for a trainer, but they would only be able to show you injection techniques for wrinkle relaxer between the eyebrows, and naturally Strabismus. If you wanted to put BOTOX® Cosmetic anywhere else, and of course you would, it would be up to you as the medical professional to decide to use BOTOX® Cosmetic “off label” and to have the proper training to inject whatever site that might be.
BOTOX® Cosmetic now has many more indications, but not nearly as many as you, as the medical professional, may need to prescribe off label for your wide variety of patient needs.
So, before you call me, contact one of the major pharmas and ask to meet with your rep. Read all you can about the product ahead of time and prepare a list of questions. They are busy people, so it may not happen in a day or two. Be patient. They are in a high growth industry. When you meet, ask them about training and any other questions you have.
Now to answer your question about training cost- It depends a great deal on your needs and your location. While my office is in South Florida, I often do training programs out of state. Naturally, if your office is in Southeast Florida there is less time and travel involved. Please contact me personally and we will discuss your offices individual needs and how I can help you. I will then provide you with a written agreement detailing what we’ve discussed including the exact investment.