According to Globe Newswire, in 2019 Aesthetic Medicine was an 11.5 billion dollar market, just in the United States. Even more astonishing is it’s expected to grow at a compounded rate of 9.9% from 2021 to 2029. Primarily there are two product categories driving that growth. What are they?
Botulinum toxin injectables and dermal fillers. There is a third one on the horizon however. Insertable threads. More about that later…
So first let’s talk about the products that are said to make up almost 50% of the market share in cosmetic aesthetics, “wrinkle relief”. When used properly, botulinum toxin injectables can give temporary wrinkle relief.
Following these treatments, your patient will probably be wanting to talk about their “too much skin” or “shallow facial areas”. Dermal fillers will be your go-to solution. They 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.
The rewards received not only from treating my own patients but from training others give me tremendous gratitude for those that came before me. 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. However, this came with some uncomfortable moments.
I remember the first time a professional acquaintance asked me “How well are you really doing with this cosmetic 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 only has to look back at my first paragraph. Then consider that cosmetic aesthetic patients pay when they leave. No billing, or chasing for money you’ve already worked for. Better yet, your paid staff can be devoted to making sure you and your patients are happy, and not wasting expensive hours trying to negotiate with insurance companies.
Once you are trained and proficient at providing predictable outcomes, the main source of new patients will be existing patients referring others. Getting you to that point as quickly as possible is one of my goals.
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. More clearly put, a great result is not about freezing facial movement or giving lips an overstuffed “trout pout”. It’s about giving someone an indefinable “You just look younger and more refreshed” 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 everyday and giving you all the confidence you need. Also, you’ll 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 the 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. Your 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 viscosity/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 appear younger and healthier. Also, when you make purchases, 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. And that’s aside from the fact that you’ll receive no help from anyone if you have an issue.
In regards to 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.
Q. I’m 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. But first they will some education rather than just come in for “poke and prescribe”.
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. And take the time to explain why you are suggesting something they did not consider! 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 following that plan will give you a “forever” patient. And one that will bring in their friends!
It’s taken me years to perfect a consultation system that works, and developed friendships with the vast majority of my patients. The key is to 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 & going to the next patient. All Day Long………
Q. What makes a face beautiful? Are there any specific proportions that are used?
A. In a word, yes! 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, named after the sculptor Phidias. He ascertained the human head, and more specifically its face, is perfectly proportioned when the width times 1.618 is the height measurement. The midpoint position of the eyes, 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 patient’s face a sense of balance, equilibrium, and what we call beauty. There are many articles on the internet with examples of the face and with its features evaluated using Phi. It’s a very interesting topic!
Q. Are there any specific patient behaviors that would stop you from treating a patient?
A. Oh 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 look for in the initial consultation 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 back 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 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. First, you need to be a happy and loyal person. Then you can 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. This cycle will repeat itself over and over. One thing I’ve found to be 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 load it on the computer, and put it side by side with the original, creating a quick “before and after”. It’s amazing to watch their reaction. Some even ask for a print. The strange reality is; you can see the difference and so can their friends. But they can’t see it 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!
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.
I know it’s not common for med school to spend a lot of time on anatomy. But it’s very important for you to know and understand the facial structure and anatomy. All my training has facial anatomy as its basic foundation.
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’ll 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, let’s 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, of course, Strabismus. If you wanted to inject BOTOX® Cosmetic anywhere else, it would be up to you as the medical professional to get the proper training. Then based on that training, you would feel comfortable using BOTOX® Cosmetic “off label” successfully.
BOTOX® Cosmetic now has many more indications, but not nearly as many as you, as the medical professional, will need to prescribe off-label for your wide variety of patient needs.
So, before you call me, contact one of the major pharma vendors 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. They are in a high-growth industry. When you meet, ask them about any training they may offer.
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.
I look forward to hearing from you!