Trained as a GP in the UK, Dr Shuba Dharmana runs three clinics in India and has become well-known among a celebrity clientele.

In this interview, Dr. Dharmana discusses her cosmetic clincis, staffing, marketing and working on darker skin types with IPL and lasers.

Name: Dr. Shuba Dharmana MBBS, DFFP, DPD (UK) Associate member of ISHRS (International society of Hair Restoration Surgeons)
Clinic: Le Jeune MedSpa
Location: Hyderabad, Bangalore, and Visag India
Website: www.lejeunemedspa.com

Brief Bio:

I trained and worked as a General Practitioner in the UK for several years for the NHS and in the private sector as an Aesthetic and a slimming specialist.

I worked for the National Slimming and Cosmetic Clinics in the UK in Northampton and Coventry and for several other aesthetic clinics as an injector for Botox and Fillers. I also ran my own clinic ‘Cosmesthetic’ in North London for 2 years before relocating to India. Whilst in the UK I trained under some eminent cosmetic surgeons and got certified to perform various basic and advanced procedures in cosmetology. In 2011, I undertook Hair Transplant training under one of Europe’s most eminent Hair Transplant Surgeons, Dr. Marwan Saifi, in Poland and also completed my post graduate diploma in Clinical dermatology from the university of Cardiff, UK.

I then relocated to India in June 2011 and after working briefly at a hospital heading a dermatology department, branched out on my own and set up my first clinic in Hyderabad. This clinic quickly became very popular with celebrities and socialites with operational break even from first month. Its been 2 years since that I further relocated to another city in India and quickly opened a second clinic in Bangalore and now the third in Vizag. I am an associate member of International Society of Hair Restoration Surgeons and also an ambassador for an NGO that aims to improve education levels in government schools called “Teach for Change’ in Bangalore.

Currently I am working on a unique style of liquid facelift that I call the V3 Lift with fillers that is popular with my celebrity clientele

What made you decide to pursue cosmetic medicine?

I suffered from eczema as a teenager and it prevented me from going into modelling which I had always wanted to do. I was selected as a finalist for Miss India competition but couldn’t compete because of medical exam commitments. I quickly saw how physical appearances matter a lot in this world. It gives you a world of confidence, grows your self esteem and opens up a lot of opportunities. My background in modelling and my skin problem made me realize the value of good skin and beauty.

Throughout my tenure as a GP also I gravitated and favoured to treat skin problems because I could relate to the psychological issues attached with them. When one of my GP colleagues told me about a Botox course I enrolled immediately and once there I realized just how quickly and amazingly medical technology had been advancing. For me there was no looking back since then. One after the other I did all the courses that were advertised in the UK in aesthetic medicine. All the money I kept earning through general practice went into funding my aesthetic training. I got my first job as an aesthetic doctor and slimming specialist at the NSCC and soon offers poured in from all around the country in UK.

Could you tell us more about your clinics?

I am running 3 clinics today in different parts of south India, in Bangalore, in Hyderabad and in Vizag. Since I live in Bangalore, its easier to manage here. The appointments are booked through a practice management software and I get to know about my appointments early in the morning. I have a digital marketing team that assist with Google adwords and social media marketing on twitter, instagram & facebook to get us leads, a PR team that help publish various news articles on latest trends, procedures, etc, a manager and counselor who follows up on the leads, makes appointments, mediates to negotiates payments and essentially helps to convert the lead. In my other centres I have employed doctors and dermatologists who are trained or are being trained by me. They consult all cases and do procedures such as Peels, Prp for hair loss and acne scars, lasers and other procedures they are competent at. Few skilled procedures such as botox, fillers and hair transplants are lined up for me once in 2 -3 weeks and they assist me with these procedures as well. 4-5 days before my arrival the clients are all informed about my dates and clients that particularly want to see me make their appointments with me during those dates.

The services we offer are : Peels, Dermaroller, Vampire facelifts, laser hair removal, Fractional CO2, Fractional RF, Skin brightening and toning with q switched ND Yag, Hydrafcial, O2 Intraceutical facial, RF refirme, Ultherapy, UltraLipo for body contouring, Cool Sculpting, Microdermabrasion, snake venom facial, sheep placenta facial, Scalp micropigmentation, PRP for Hair loss, eyebrow tattooing, Botox, Dermal Fillers, Lipodissolve PPC injections, weight loss programme with nutrition counseling and FUE hair Transplantation.

We see an affluent population as well as a middle class aspirational crowd for most procedures these days. Men want these procedures today as much as women do. Botox and Fillers are taken up quite a lot by the actresses followed by socialites and an expat crowd.

WE have grown into 3 clinics now, in Hyderabad, Bangalore and Vizag , all in the south of India

How do you manage your staff?

The manager who counsels and helps to convert a lead works on a salary and gets an incentive or a commission. If they demand a higher salary they do not get other incentives. We prefer they take a salary along with a commission on the sales so that they retain interest. If it’s a doctor we give them 3 different slabs of salaries with or without commissions. For eg: high salary with no more commissions and lower, basic salary slab with highest commission percentage and something in between with a lesser commission on treatments. I find this plan easiest to use as it gives the member the choice of how they want to work and when they choose to work for salary and commission they feel like this is their own business. The more work they put it the more they get out of it and it works best for everyone. They feel very involved in the business.

What available technologies do you use for your patients?

Most Indians have skin type IV so we invest in diodes. I have 2 of Syneron’s elase with elos technology that uses RF and diode energies. The diode is therefore kept low to avoid burns on dark skinned patients. Its is therefore very safe and very effective. The risk of burns is low but is mainly from the RF aspect when the handpiece is not kept in contact with the skin hence a little operator dependant. I am quite happy with the technology and results but cannot say anything positive about the service issues. You never get the support you are promised after purchasing the laser.

We have Soprano Accord from Alma Laser another diode system for laser hair removal. It is painless and quite effective like the elase but unlike elase’s RF component that can cause burns, this does not cause burns unless you are using grossly wrong settings. It is easier to train a technician on Alma Accord than Syneron’s elase. With regard to results I find Syneron’s superior because the RF component can be increased during the final sittings to target finer hair.

In the Fractional devices I have Fractional Co2 and Fractional RF. Fractional RF allows me to treat skin type IV and above with no risks but with fractional Co2 on skin type IV and above, esp if I want to use higher settings, I prep the skin with a demelanising cream for few weeks before treatment.

For Skin tightening I can try and compare my Ultherapy with RF Refirme. RF refirme does show results but several sittings are needed and then maintanence and results are nowhere as drastic as ultherapy. Ultherapy uses focused Ultrasound technology to lift and induce collagen and I have seen some amazing results. It requires only one sitting and hence Ultherapy treatment can be expensive. RF refirme on the other hand is not expensive and clients can easily afford several sessions. I have had the opportunity to work with Alma’s Clearlift also and I am quite impressed with the results. It falls somewhere in between RF Refirme and Ultherapy.

Alma promises to entice me with some upcoming great powerful lasers and user support but that is something I will have to wait and see. I like Ultherapy, the technology, the results and since they have been very supportive with marketing and training I would like to be associated with them forever. I am not happy with the support Syneron has given me despite buying several of their lasers including 2 elase and 1 e2 system and for this very reason I refuse to buy any more from them.

What are your marketing strategies?

We have a digital marketing team who are working on Google adwords, SEO and social media posts on facebook, twitter and instagram. In this digital age we live in digital marketing is extremely important, much more than traditional newspaper, radio or TV marketing. Everyone I know is hanging out on Instagram or facebook!

Our PR team helps with brand building activities, speaker opportunities, magazine and newspaper publications. I realize PR is very important but it helps in building your brand not in getting you immediate business. Do not expect leads or increase in business immediately from PR activities , it takes time and you should start this later if you cannot afford to do it right away.

Traditional marketing is not working for us anymore. There was a time newspaper advertising worked but not anymore. Radio marketing is also for brand building which did not get us any leads. TV marketing can get very expensive and depending on the area you live in, it may or may not work. If there is too much competition in your area and there are too many clinics advertising on a channel, it gets very expensive. If you are the only one of your kind and from a small town, then you have better chances of getting your audience’s attention.

I support causes that I am passionate about like education for kids in government schools through the NGO ‘Teach for Change’, and sporting and fitness events. Being a fitness enthusiast I get my clinic involved in fitness events like 8K, 10 run events, zumba or Yoga sessions with healthy breakfast, and also conduct beauty, nutrition and skin care workshops to educate groups of interested people. Involving yourself in such activities like charities, social events make people look upto you and notice you. It helps to pick an interest and develop it parallely. It helps to avoid a burn out and boredom. In the process you get to meet many potential clients.

Cconducting workshops, educating people, writing articles, writing books and speaking at events and on TV, radio etc helps people to recognize you as an expert in the field

What are the most sought after treatments or procedures in your clinics?

Hair Transplantation: The investment isn’t much and returns are good even thought t maybe labour extensive. Its also something that needs a lot of skill and hence the justification of profits. Its also highly satisfying to see their face transform. Its something that gives me a lot of joy.

Laser Hair Removal: Here in India dark hair on a darker skin tone makes one look even darker which isn’t liked by anyone. There is a big market for treatments for unwanted hair and this earns us our bread and butter. Ofcourse the investment in a laser is huge but because majority of the population seek this this can me something that is paying your rent and salaries.

PRP: PRP for hair loss is really picking pace. Hair loss issues are many in both women and men and PRP is showing excellent results. Investment is minimal and earns a good revenue

Peels: India has a big market for skin brightening and Peels really sell. Peels are for acne, for lifting Tan, spots, pigmentation, melasma, rejuvenation and they are used by one and all. Minimal investment and good returns

Botox and Fillers: can be good if you have a good celebrity /socialite clientele. In Bangalore I have an expat and socialite crowd that ask for it and in Hyderabad I have actresses, celebrities and socialites

Fractional Treatments: Investment is big in the machine and returns aren’t great. Most people do not want any downtime and they find the treatments expensive. If given a choice they choose dermaroller treatment

Hydrafacial: Good revenue can be generated by acne clientele. Has good scope for marketing with all existing clientele

O2 intraceutical : not really worth the investment but when it is clubbed with other treatments such as microdermabrasion or fractional it can be a luxury experience. So good to give some in a package

Ultherapy: cosumable cost is too high but there is a decent profit to be made if marketed well

Ultralipo: we haven’t done any marketing for it so its not really earning its money. I regret the purchase

E2 system: ematrix sublative fractional RF is good technology with good results but consumable cost is too high hence people find it expensive. We are not using the RF refirme as much as we’d have liked to. I regret the purchase

I am looking to add a Q switched ND yag . we are already working with Alma’s Clearlift and I like it. Investment is huge again but I am positive it will work for us because at large the population here suffers from pigmentation and colour issues and this should be a good source of revenue

Have you had any interesting episodes that you can share with us?

I have not had horrible situations in my clinic thankfully. The time I did have one not so horrible situation was because of a miscommunication as is usually what happens in these scenarios. What I clearly told her would happen and marked and showed was not understood and she expected something else. Although her tear trough area looked great after injecting she wanted it dissolved after few days because she felt it made her eyes look smaller. She was counseled for hyaluronidase injections and the hyaluronidase used that is known to cause allergic reactions caused a reaction. Throughout her treatment and post whilst she suffered the allergic reaction, I kept in touch with her to reassure and support. The reaction took 5 days to subside and she panicked initially but I was there for her. She told me after that how grateful she felt for everything and she even came back twice after that for further filler injections. She is still a good client of mine. When something goes wrong in cosmetic medicine , which maybe your fault or not but its important to not let communication be affected. If I have to put in extra work because of their misunderstanding I do it mostly even if its costing me additional money because for me its not about money. Its about giving them satisfaction and a good experience.

As an experienced physician, what can you share to your fellow physicians?

Good communication skills are key to set treatment goals and keep expectations in check. Showing them some of the before and after pics of treatments you have done allows them to see what they can expect. All concerns should be addressed before they sign a consent form. Get into the habit of taking before and after pictures for their own medical records. Document the procedure well and look for a history of mental health issues and depression. Document post care, hand them some post care instructions with clinic numbers to call in case of any concerns and do not ever neglect someone calling about a concern. The sooner the problem is dealt with the better their options to find a solution. An unhappy client is something you never want and an unhappy client landing in your competitor’s clinic is far worse. Writing bad reviews online and filing law suits are some others you don’t want to face.

About Dr. Dharmana

Dr. Shuba Dharmana is a renowned and experienced Cosmetic Dermatologist & Hair Transplant Surgeon with tremendous international exposure. In March 2012, she established her presence in India with Dr.Shuba Skin & Laser Clinic in Madhapur, Hyderabad.

'Dr. Shuba then founded LEJEUNE Medspa which in a short period of time' has gained tremendous popularity with locals and celebrities alike. Her celebrity clientele consists of several top socialites and famous personalities from the Tollywood and fashion industry.

She trained at several internationally famous cosmetic clinics in London and Ascot under the guidance of world renowned pioneers of Aesthetic medicine. She regularly and religiously attended various seminars, workshops and conferences conducted in UK like 'Faces' and in Monte Carlo 'Anti-Ageing Medicine World Congress'. She became a laser specialist after undergoing several laser training courses in London.

Whilst in United Kingdom, she established and successfully ran 2 clinics - 'The Ultimate Beauty' in Luton and 'Cosmesthetic' in West London. She worked for several private cosmetic clinics including NSCC (National Slimming and Cosmetic Clinics) in Northampton and Coventry for 4 years as a Cosmetic and weight Loss specialist and for 'Novo London' for over a year in Berkhamstead.

Dr. Shuba writes columns and articles regularly for leading magazines and newspapers such as - 'Aesthetic Life'- Pakistan's no.1 aesthetic magazine, 'You & I' magazine, 'Times of India', 'Postnoon', 'AndhraJyothi', 'Deccan Chronicle', 'Deccan Herald', 'Diabetic Living', 'Health India Portal' etc.