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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Cutera Reviews: Buying Used Lasers & IPLs

Cutera Laser Reviews

Cutera is a major player in the cosmetic space with a number of platforms and systems:Cutera Coolglide, Cutera XEO, Solera Opus, the LimeLight IPL, ProWave Nd:YAG and Solera Titan. So what's Cutera's reputation with physians?

If you read the discussion threads on Cutera there are some positive opinions about the technology but there's a a lot of negative reactions to the company policies around sales and support practices. Much of it mimics these opinions in the comments on this Cutera discussion thread from way back in 2007: Is any Cutera technology work buying?

Many of the comments or reviews fall in to a couple of buckets that are recognizable and are often repeated; problems with the effacacy, pricing and costs too high, buyer felt lied to or misled by the sales rep (oversold and under-delivered), and the companies desire to lock in the buyer and extract every possible dollar. (We're working on series of posts and a guide to address all of these areas.)

Cutera's not the only laser manufacturer facing some negativity of course. All of the cosmetic laser companies have some issues that they deal with all of the time. In some cases it's unrealistic expectations from buyers but there's a lot of sales reps that aren't doing these companies any favors in overselling and promising revenue outcomes that are much more dependent on the buyers business sense and marketing that the IPL or laser they're buying.

Don't Buy New comments:

I'm new to this site and so happy to see that I'm not alone. Recently wooed into purchasing the Cutera Excel V (at a conference) BIG mistake. Free drinks, good salespeople, and me-new to industry, naive and inexperienced with lasers and zero business savvy. I was told by the speaker at the event, who was also a friend of a friend who I thought had my best interest in mind, that I was getting "the best deal the salespeople are allowed to give" for the demo unit at that conference. Paid $125,000, it broke on day of training and then 2 more times over next few months, and I did not see the results I expected. Long story short...after 6 months of minimal use, I am trying to get rid of the laser, have been offered $30,000 by 2 different laser re-sale companies! Called financing company Cutera had me sign with-Heartland (no options given and no discussion of terms) who informed me that my payoff is actually $170,000 with no ability to pay less early! Can't resell on my own because warranty doesn't transfer unless I pay Cutera another $30,000 to transfer ownership.

and from LH

... The only Cutera piece I still use is the 1064. I will never buy new from Cutera again. I may buy a used 1064 for 20 cents on the dollar or less. The secondary market is very crowded with Cutera products which continues to devalue them.

but one anonymous poster (sarah) said this:

As a Cutera owner I am shocked to stumble across this site. I have been working with this system 2 years. I have very satisfied patients, many of them are thrilled with the how much better the 1064 works for hairs than other treatments they have had elsewhere.  There the no equal to the 1064 for safely treating facial veins.
Also, anyone who is not getting great results with the Titan is just not doing right. I have people coming over from Thermage all the time. Just prepare your patients, doing this treatment to get great results comes with a lot of discomfort. 
Anyone complaining about a warranty... should have bought it at the beginning. My sales rep is amazing, we can always count on him to support our events and set up extra training whenever we feel under prepared.

In short, We love our Cutera system! It just took learning how to use it correctly.

My impression in reading Sarah's comment is that she is not the owner of the clinic or buyer of the system. (Just a hunch.) Most buyers are always talking about the business costs vs return rather than the personality of the sales rep.  : |

Notes: We allow anonymous comments on this site for obvious reasons but you might want to judge the voracity of those comments vs commenters who are identifying themselves (which you do when you login and comment.) All comments are individual opinions and don't necessarily reflect the views or opinions of others on the site. Make your own decisions.

Anyone have thoughts on the current state of Cutera's technology or sales practices?

Is ANY Cutera technology worth buying?

My physicians were underwhelmed with the Cutera Xeo.

0m.jpgWe were using the Cutera Titan & ND Yag. The inexperienced physician in the location where we had it thought it worked well, but my more experienced physicians hated it and, in effect, wouldn't use it.

The 'single do everything platform' is also something I generally don't like since I can only have one treatment room going at a time. I guess that Cutera is trying to target individual physicians with a 'this one device will do everything' approach. While you might originally might think this is a good idea it's hard to grow if you have to invest another $100k for each additional treatment room.

LH comments about Cutera:

"At this time, I have very little respect for Cutera. They have over promised and under delivered on many things (Titan, Genesis, etc). The only time they contact my office is when they want to sell me an upgrade. Their webinars are only geared to the new person getting into aesthetics. Their webinars are only made so they can sell you something. I have watched many webinars and have stopped because they are a waste of time.

I also have issues with a company that will sell you a brand new system and will not back it up if you sell it on the secondary market. They will not sell refurbished Titan heads to anyone other than the original owner. They will not train any non-Cutera laser techs. This is so they can charge more for repairs. They will not send parts to any non-Cutera laser techs. Therefore, Cutera has made my used laser worth much less than it should be.

Unless Cutera changes their ways, I will never purchase a Cutera laser again. I will also never purchase an upgrade for my current sysytem."

And Dermadoc says about Cutera:

"My frustration is two-fold: first, Cutera totally overhyped the Titan, despite a few (very few) providers who seem to be getting what they consider good results. Second, how could this coatrack be marketed without a more consistent technique being identified, along with consistent recommendations for patietn selection, expected results, etc. It was sold on a wing and a prayer and like LH, I will find it very hard to purchase anything from Cutera again."

I'd have to agree with LH. The only time I saw the Cutera rep was during sales calls. Cutera's refusal to support their technology outside of the origional purchaser is a mistake and greatly lowers the value of their entire system. I can't see that investing in a system with such a downside when trying to sell is such a good idea.

I'm curious as to everyone elses experience with Cutera technology or dealing with Cutera as a company. (I'm even interested in what the Cutera reps on this site might have to say.)

Thermage is comission. Titan & Fraxel are hourly.

As business models: Thermage is commission, Titan & Fraxel are hourly.

(Thermage + Fraxel discussion threads)

pages2and15_machine.jpgI had lunch with Clint Carnell, Vice President of Domestic Sales for Thermage today. While we were talking about the current state of the medical spa market he referred to the Thermage business model as 'razors and blades' and it triggered the thought that there was an analogy with commission vs. hourly employees.

Physicians seeking to minimize risk will often try to hire staff on commission with the hopes that they'll achieve two things; a motivated employee, and lower cost per treatment since they'll only be paying a percentage of treatments that are being performed. Nice in theory.

Here's the flip side. Commission robs you of success. This is a business that has very high fixed costs, but once those costs are met, there is a large potential profit to be made. As a business, its usually preferable to absorb those fixed costs if possible and keep the profit rather than have it diluted by paying commissions.

(That's why Surface has decided to grow as an entirely company owned business rather than persuing franchising with it's associated problems. If you have the capital, wholy owned businesses offer the most success while franchises offer the ability to grow the business using other peoples money.) 

petit_fraxel_02.jpgThermage made a radical decision to offer the 'box' (razors) for near cost, and focus on selling the disposables (blades). Smart enough. But Thermage is not charging 100% markup. Thermage tips probably cost around $12-$16 dollars to produce (that's a wild guess) but Thermage sells them for $450 or more. That's a helluva markup and it's led to a built in profit potential for anyone who can figure out a way around it as well as being a source of friction with those who have to buy them. (I have yet to hear any physician anywhere think that Thermage tips are a 'great deal'.) Refurbished Thermage tips came on the scene soon after Thermage launched and have even been studied for safety and performance.

Thermage faces a challenge in keeping providers happy with paying a commission on every treatment they perform. If they can, Thermage promises to be the gold standard for the foreseeable future.