More Army Recruits to Seek Laser Tattoo Removal

Tougher standards for tattoos in the Army.

Those of you who perform laser tattoo removal will want to be aware of recent changes to tattoo restrictions in the Department of the Army.

Eminent changes to AR 670-1 will now PROHIBIT TATTOOS:

• Below the elbow
• Below the knee
• Above uniform neckline

The uniform neckline is Class A but also includes the physical fitness uniform.  The physical fitness uniform is being interpreted as the V-neck cut T-shirt.  I have seen 3 disqualified recruits in the past 2 weeks seeking partial removal of tattoo ink showing in the mid upper chest at the sternal notch.

I maintain a relationship with all my neighboring recruitment centers of all branches offering a discount for laser tattoo removal necessary a s a result of disqualification.

Managing Patient Expectations

Are you making patients more attractive, or just making them think that they are?

In a recent small study, 50 people were asked to rate the appearance of people who had undergone facial surgery. The bottom-line: Surgical intervention shaved a few years off perceived age but did almost nothing to boost patients’ overall attractiveness.  

What’s at issue is patients’ expectations, said study lead author Dr. Joshua Zimm, an attending surgeon at Lenox Hill Hospital and Manhattan Eye, Ear and Throat Institute of North Shore-LIJ Health System in New York City.

“When we’re doing this kind of surgery I’m telling patients that they’ll look fresher, more energetic and less tired, and we have some data in the literature that indicates you will look younger, as we found,” Zimm said. “But clearly I cannot say that they will look more attractive.”

Clarifying why someone elects to have cosmetic surgery is as important for the physician as it is for the patient. “The best motivation for cosmetic surgery is a healthy sense of vanity—emphasis on the word healthy,” says Timothy A. Miller, M.D., chief of the Division of Plastic and Reconstructive Surgery at UCLA. “There is nothing wrong with vanity, but when it becomes obsessive or the patient sees it as an avenue to changing the direction of his or her life, it can be a problem.” 

What patient doesn’t want to look their best? Most patients have very realistic expectations. But some patient expectations can stretch beyond reason. “If you expect cosmetic surgery to turn you into a movie star, you’re bound to be disappointed,” Dr. Miller says. “Also don’t count on surgery to save a rocky relationship, gain a promotion or improve your social life.” 

Maybe physicians in this space should refer to the hairstylists adage, “We use scissors, not magic wands.”

Non-conformists, Dissenters & Rebels

“Talent, I believe, is most likely to be found among non-conformists, dissenters, and rebels. Think different—the best thinkers often do.” --David Ogilvy

If you're seen by your market as an also-ran, your clinic is going to be among those that are fighting for the scraps left over by the market leaders and you'll be forced to compete on price... not where you want to be.

To set yourself (and your clinic) apart, the first thing you have to do is be something of a non-conformist.

Non-conformity is what allows businesses to break out of the pack to become extraordinary. Non-conformity means that while everyone is following the rules, you are in your garage building Microsoft or out flying a kite in an electrical storm, or floating across the “Big Pond” to “discover” a new world.

Apple, famous for its “Think different” approach to problem solving, famously defied the conventional wisdom that compters had to be big and complicated to run, thus creating the first personal computers. Brilliant problem solvers often do more than find answers to existing problems. They create entire new industries. 

And that’s when things get interesting. The medical spa market is no longer new and novel. It may be that the med spa buzz has died down a bit, but with technology advancing faster than ever, the med spa industry is becoming more mature, and the competition will only grow for the forseeable future with the expansion of the new medical technologies that rely on tech over specific physician knowledge and skill.

Marketdata estimates that revenues of the 2,100 U.S. medical spas reached $1.94 billion in 2012, and will hit $3.6 billion by 2016. Average revenues per facility are $924,000—with about 80% coming from procedures and 20% form retail product sales. The market is forecast to grow 18% per year. Fully 58% of med spas expected sales to grow more than 5% last year.

How do you define non-conformity in business? Being a non-conformist isn’t limited to what you do; non-conformity might be displayed in how you answer the phone (value chain), how you build and market your products (positioning), your manufacturing (cost advantage, sustainability), your technology (speed and efficiency = cost)or any number of metrics. 

If you’re a non-conformist, a dissenter, or even a rebel, how have you broken away from the pack? What makes your business extraordinary?

The New Medical Spa MD Guide To Aesthetic Laser Platforms Is Out!

The Comparative Guide to Aesthetic Laser Platforms is now available for free to all Medical Spa MD Members.

Choosing which aesthetic platform you're going to build your clinic or medical spa around is one of the most important, and expensive, decisions that you're going to make. Switching costs are high and if you make a mistake, you're going to be regretting it for a long, long time.

Included Laser Platforms:

• Alma Harmony
• Palomar Icon
• Syneron elos Plus
• Cutera Xeo
• Sciton Joule
• Syneron Emax

This first edition guide offers a starting point for physicians and clinics who are just beginning to research the purchase of a platform, or as a resource for dotors who are in the market but want to know what else might be available. We've done much of the preliminary leg work for you by taking six popular platfroms from Palomar, Sciton, Alma, Cutera and Syneron and comparing them across a number of treatment modalities.

We've also included links throughout the guide to the discussion forums on each platform for deeper investigation that allows you to ask questions directly from other physicians who own that specific laser, as well as discuss other important purchasing decisions around consumables (which can be a significant cost) and support (which can be critical).

Download this free aesthetic lasers report >

Medical Spa MD Guide to Aesthetic Laser Platforms

Note: While there are dozens of laser and IPL systems that might have been included, we started with thise six since they're all "multi-purpose" platforms with wide utility, widely available around the world, and are generally well known. If you represent a cosmetic laser company and would like to be included in future reports, please contact us.

Do you have a suggestion to improve our services or an idea for as research project you think we should be doing? Would you like to be interviewed, or sponsor a report? Please contact us.

Our contributing physician list is growing fast. Thank you to the physicians and clinics who have contributed to this report.

Also: Please feel free to distribute, email, link to, tweet, post or send this report to anyone who may be interested as long as you do not modify or change the report in any way.

Brotox...Botox For Men? Don't Bet Your Clinic On It.

Yet more stories about men getting Botox... now it's "Brotox", but don't bet your medical spa on your male clientele.

Plumbers and wall street bankers alike are increasingly turning to Botox to turn back the years? There's more on what's touted as a growing population of men that are turning to cosmetic medicine, Botox in particular.

It Britain, they call it the “Simon Cowell” effect. What do Simon Cowell, Gordon Ramsay and David Hasselhoff have in common? They’ve all confessed to having Botox. Turn out, men care about their appearance just as much as women do, they just haven’t wanted to talk about it.

Once relegated to the female population, Botox has gained popularity among men today – particularly those with what are considered “stressful” careers. Dermatologist Dendy Engleman said that Wall Street men are “the fastest growing segment of my patient population,” because they’re looking to smooth out the stress lines caused by the European crisis abroad and weak economy at home. 

Men feel pressured to maintain a more youthful and attractive appearance to compete in the job market. There’s also less of a stigma now for men to turn to cosmetic procedures. Think of it as a continuation of the metrosexual movement. Guys taking charge of their appearance, and owning it.

And it’s not just Botox. Injectable dermal fillers have now become the second most popular nonsurgical treatment for men. Evidently 29% of men get manicures, 24% have facials, and 13% get eyebrow waxing appointments.

Tom Ford and Marc Jacobs have both launched men’s cosmetic lines. With guyliner and murses out there, it’s no real surprise this is a growing trend. 

Most of the above is complete bullshit. 29% of men get manicures? Bullshit. 13% have eybrow waxing? Bullshit.

Don't listen to what you hear in the press about stuff like this. It's written by a twenty something who's just rewriting a press release that's designed to get attention.

My opinion is that the number of males who look at some form of cosmetic medicine is going to vary somewhere around 5-5% of your clinic, a little more in some areas but that's pretty much it. It's generally a waste of time to try to cater to men in the same way that you cater to your female patients unless you're just doing it for some sort of marketing. There may be some growth, but that just represents the growth of the market in general, and since males make up such a small percentage, it's not hard to see those numbers as skewed. Don't take the bait.

And while we're at it, let's take a moment to share a story about my brother-in-law. Last week he had a business meeting out of town. He packed his bags, han an uneventful flight, checked into his hotel and slept well. In the morning, while dressing for his meeting, he realized that the black pants he had packed to wear with his black suit jacket were actually, his wife's skinny black pants. Ever the problem solver, he decided to give them a quick try on anyway. Surprisingly, they fit... poorly, but still. He even claims they perfectly matched his suit jacket. So, the point I make, perhaps I'm wrong.

Yep, There's An App For That

Botox marketing via the iPad?

Allergan has just released an app that markets Botox directly ot patients with an app that digitally modifies what they will look like after Botox. (Who knows if it actually works at all.)

It’s pretty simple. You can either upload your photo to the iVisualizer Tool on the Botox site, or you can use the free iPad app, and watch the results emerge. Voila, a wrinkle-free face.

Those of you who are familiar with photo retouching programs, like photoshop, can see that the “after” effect is pretty much just a bit of softening and blur where the facial lines were, but, perhaps it does give patients a better idea of where the wrinkles will be diminished. 

I'm guessing that you'd have to be a pretty hard core Botox researcher to download an app just to blur your face so I'm guessing that the real driver of apps like this is to extend Allergan's marketing reach to physicians and give the sales reps someting to trot out when they visit your office to show you how much traffic Botox is driving to your clinic. That, and keeping Botox's copetitors (Myosport, Xeomin) chasing them.

Anyone have thoughts on how well this really works?

Why Blackberry Failed, And Why Traditional Medicine (And Your Medical Spa) Will Too

The Globe and Mail has an article on the fall of BlackBerry which actually has three authors and takes a deep-dive into the Canadian phone makers woes.... but there's information in there for physicians.

The overarching explanation of what happened is something that we already know: RIM (Blackberry's maker) failed to iterate/change/evleove at anywhere near the speed that the market demanded in the post-iPhone era, but the article, which includes quotes from an interview with RIM founder Mike Lazaridis really puts touches the main point with the tip of a pin. Here's the quote:

“The problem wasn’t that we stopped listening to customers,” said one former RIM insider. “We believed we knew better what customers needed long term than they did. Consumers would say, ‘I want a faster browser.’ We might say, ‘You might think you want a faster browser, but you don’t want to pay overage on your bill.’ ‘Well, I want a super big very responsive touchscreen.’ ‘Well, you might think you want that, but you don’t want your phone to die at 2 p.m.’ “We would say, ‘We know better, and they’ll eventually figure it out.’ ”

Hubris is the fall of many frontrunners and works on every business scale, including individual small business.

You may know better than your patients, but if you don't listen to them and execute what they want, they'll go somewhere else eventually; just ask the droves of plastic surgeons how have lost patients to the familiy practice guys who aren't constantly pushing their patients into surgical proceedures.

20% Of All Medical Spa Yelp Reviews (Including Yours) Are Fake?

What's this? Fake reviews that you've posted about your own clinic? Say it ain't so...

Now, more than ever, social media plays an integral part of businesses marketing strategies. Savvy consumers turn to Yelp and a host of similar sites to read reviws, and in turn make buying desicions based on what they’ve read. 

The problem is, some businesses (insert medical spas, dermatologists, and plastic surgeons here) are paying freelance writers to create “fake” positive reviews... or they're just writing them themselves.

Writers from Eastern Europe or Asia are paid a few dollars to write glowing reviews... because they work. Businesses are highly motivated to obtain positive reviews, as according to a 2011 study by Michael Luca, assistant professor at Harvard Business School, a one star rating hike on Yelp can mean a 5% to 9% rise in restauraunt revenue.

The number of fraudulent reviews on Yelp rose from 5% in 2006 to 20% in 2013, according to “Fake It Till You Make It: Reputation, Competition, and Yelp Review Fraud,” a report by Luca that was co-written by Georgios Zervas, an assistant professor of marketing at Boston University. Analyzing an additional 316,415 Yelp reviews of Boston restaurants, 16% were filtered and identified as fake, Luca says.

This is a problem that is only beginning to be addressed. Five or six years ago anyone could post phony reviews from their own computer, without ever calling attention to themselves. Things have become a bit more comlicated since then. Now, fake reviewers must submit fake email addresses, and write reviews from multiple locations. Fake reviewers and the companies that hire them are now beginning to face fines. The office of New York’s Attorney General announced this week that it fined businesses (including on physician if I remember correctly) more than $350,000 for publishing fake reviews.

Additionally, false praise online is expected to become more and more widespread. Fake reviews are expected to grow between 10 and 15% by 2014, predicts Gartner, an online research firm.

What’s Yelp’s response? Yelp’s automated software looks at every review published, and ultimately deemphasizes about 20% of the more than 39 million reviews onto a secondary “Filtered reviews” page linked at the bottom of business listings. 

Meanwhile, Google is moving away from anonymous reviews, requiring reviewers to be logged in to Google Plus to write one. Yelp could require a Facebook login to help guarantee identities, but of course options like these may scare off or, just plain annoy potential reviewers.

We all know buying and selling reviews is wrong. And, now, it’s against the law. Yelp’s final word? “But don’t worry, we’ll keep watching out for consumers behind the scenes, too. Just in case.”

Of course we've seen this here, and we've outed a number of equipment vendors and physicians who got caught posting fake reviews here. That's one of the reasons that we don't allow vendors or salespeople into the Medical Spa MD LinkedIn Group.

Has anyone out there got a sneaking suspicion (and an example or two) that the medical spa or clinic down the street is doing this?

The Power Of Single Message Marketing

The first rule of advertising for anyone (including your medical spa): Present one, clear, single minded message.

Your ad will be stronger. Your message will carry more weight. You’ll create breakthrough in a world filled with cluttered, muddled messages, that simply go unseen.

Research suggests that you only have 3 seconds to communicate the message to your audience. Take longer and you could lose potential prospects. 

Think about the bed of nails analogy.

It appears to the spectator that anyone lying on this “bed” would be injured by the nails, but this is not what happens. Assuming the nails are numerous enough, the weight is distributed between them such that the pressure exerted by each nail is not enough to break the person’s skin. 

What if we replace the thousands of nails with just one nail? You know what happens. A person can’t successfully lie on just one nail. The pressure exerted by just one nail is much too strong.

How do you determine your single message? It could be the unique selling point of the product or service or even the biggest benefit gained by using the product or service.

But are times changing? 

We haven’t done studies directly comparing the effects of multiple messages in an ad or commercial vs. single messages, but we’ve studied how people deal with what used to be considered a bombardment of stimuli. They handle it just fine.

The Internet of course has led the way. Watch how even the less skilled with this medium use it – not just skipping from site to site, page to page, item to item at blazing speed. They absorb multiple images and information elements simultaneously. Watch the more adept moving their fingers across their keyboards like the fingers of a virtuoso violinist moving across the strings of their instruments. And the minds of those Internet users are moving even more quickly.

If we move multiple messages into fast forward, will advertisers risk losing their audience? Or will the viewers be less bored and watch or read the advertising. 

Trying to fit 'everything you do' into your advertising is common, but it's also amaturish, and less effective. I understand that you don't want to miss that one patient who's looking for something you offer, but you're tripping over your real purpose which is to drive a single idea home.

Do yourself (and your clinic) a favor and be harsh. If it's not supporting a single point, let it go.

Botox For Plantar Fasciitis

I've seen Botox used for stress headaches, but until now I was unfamiliar with the fact that Botox can also be used to treat Plantar Fasciitis.

The article below detalis some of the new reasearch, but I'm wondering if anyone is using / has used Botox in this way and what the results were? (Leave a comment.)

Botulinum toxin (BTX)A may be more effective than steroids for the treatment of plantar fasciitis.

The 19 patients given a total of 250 U of BTX-A split between two medial and lateral calf muscle sites and the soleus had significantly faster and greater improvement than the 17 patients treated with intralesional dexamethasone (8 mg) plus 2% lidocaine (2 mL).

Although there was no significant difference between the BTX-A and steroid treatment groups at baseline for the visual analog scale (VAS) for pain (7.1 vs 7.7), patients given BTX-A had a significantly lower average score than steroid-treated patients at the 1-month check up (1.9 vs 3.4 points). Scores were also significantly lower at 2 (1.6 vs 3.6 ), 4 (1.5 vs 3.7 ), and 6 (1.1 vs 3.8) months.

Similarly, despite comparable Maryland Foot and Ankle scores at baseline, the BTX-A-treated patients had significantly greater improvement over the whole study than steroid-treated patients.

Although both patient groups experienced significant improvements of American Orthopaedic Foot and Ankle Society scores and Foot and Ankle Disability Index scores at 15 days after treatment, BTX-A was associated with a faster and more sustained treatment response than steroids.

The researchers note that all patients were shown dorsiflexion and plantarflexion stretching exercises to begin within a week of treatment.

“It is important to note that patients must perform plantar fascia stretching exercises to obtain a rapid and sustained improvement of plantar fasciitis,” say Carlos Acosta-Olivo (Hospital Universitario “Dr Jose E Gonzalez,” Universidad Autonomade Nuevo Leon, Monterrey, Mexico) and co-workers.

Read the entire article here.

Additional articles on the same subject:
http://www.methodistorthopedics.com/plantar-fasciitis-heel-pain
http://www.eurekalert.org/pub_releases/2013-01/sp-bbs011713.php
http://www.sciencedaily.com/releases/2013/01/130117152009.htm
>http://connection.sagepub.com/blog/2013/01/30/botox-beats-steroids-for-painful-foot-condition-plantar-fasciitis/