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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Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Starting out as a Primary Care Physician, Dr. Jenny Weyler branched out to aesthetics, exclusively practicing the field since 2010 in our interview with the Physician.

Dr. Jenny Weyler - Aponi Aesthetics, Massachusetts

Name: Dr. Jenny Weyler
Clinic: Aponi Aesthetics
Location: Worcester, MA
Website: http://aponiaesthetics.com/

Brief Bio:

I am a Board Certified family practice doctor, who graduated in 1992 from the Medical College of Pennsylvania (now part of Drexel University) in Philadelphia, PA. I completed my family practice residency in 1995 at the University of Massachusetts in Worcester, MA. I practiced as a primary care physician from 1994-2004, and then worked in an Urgent Care clinic from 2004-2010. In 2010 I started taking classes to learn aesthetic injections, and I opened my own business in December 2010. Initially we did some primary care here, but I loved doing aesthetics so much, and that part of the practice grew so quickly that we became exclusively aesthetic providers in 2014 and changed our name to Aponi Aesthetics.

How did Aesthetics interest you and it influence your practice?

When I was doing primary care I always loved doing procedures: stitches, mole removals, biopsies and any minor surgical procedure. Learning aesthetic injections was a great way to incorporate my love of procedures with the excitement of learning a whole new field of medicine. The results are so obvious, amazing and gratifying. People love the results, so the clients are enthusiastic and how could I not love making people look and feel better? As I honed my skills in injections, I started to learn more about lasers and skin care products and we added that to our repertoire as we went along. I have logged well over 100 hours of direct hands-on training in injectables and laser safety and use, as well as many more hours of lectures on the same subjects. Aesthetics is constantly evolving and advancing, and I love...

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Dr. Jennifer Trent - American Dermatology Associates, Florida

With more than 10 years of experience under her belt, Dr. Jennifer Trent practices medicine and writes journal articles and text books in Dermatology, in our interview with the Florida-based Dermatologist.

Dr. Jennifer Trent - American Dermatology Associates, Inc., FloridaName: Dr. Jennifer Trent
Clinic: American Dermatology Associates, Inc.
Location: Sarasota, FL
Website: http://www.americandermatology.net/

Brief Bio:

Jennifer Trent, MD FAAD completed a 6 year combined BS-MD at the University of Miami with an undergraduate major in biology and a minor in chemistry. While in medical school, she interrupted her formal course to participate in a 2 year research fellowship in Dermatology at the University of Miami. The focus of her work was hos-pital care of dermatology patients, toxic epidermal necrolysis, and wound care. Dr. Trent graduated from Medical School with research distinction as well as the Univer-sity of Miami Department of Dermatology’s medical student of the year award.

She completed her internship in internal medicine and her residency in Dermatology and Cutaneous Surgery at the University of Miami/Jackson Memorial Hospital. Dr. Trent has presented her research on toxic epidermal necrolysis and methicillin re-sistance staphylococcus aureus several times at the Society of Investigative Dermatol-ogy and the annual American Academy of Dermatology meetings. She was recipient of the Celia and Samuel Resnik Award for dermatology research from the University of Miami Department of Dermatology and the prestigious Young Investigators award for research from the American Academy of Dermatology for her work on toxic epider-mal necrolysis. Dr. Trent has also received several awards for teaching from the Uni-versity of Miami Department of Dermatology.

At what point in your life did you discover your interest in cosmetic medicine?

Ever since I started medical school, I was also fascinated by the skin. How it exists as this beautiful intermediary between the harsh environment and our delicate bodies. It is a strong but vulnerable gatekeeper. During my residency at the prestigious University of Miami Department of Dermatology, I learned that dermatologists are artists. We can “re-sculpt”...

Dr. Jennifer Trent - American Dermatology Associates, Inc., Florida
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Dr. Bertha Baum - Hollywood Dermatology, Florida

Dr. Baum shares how she got into cosmetic dermatology and some management and marketing tips for fellow physicians in our interview.

Dr. Bertha Baum - Hollywood Dermatology, Florida

Name: Dr. Bertha Baum
Clinic: Hollywood Dermatology
Location: Florida 
Website: www.drbaum.com, www.hollywooddermatology.com

Brief Bio:

Dr. Bertha Baum is a Florida based board certified dermatologist & cosmetic surgeon, considered a skin care expert who provides her patients with the most current and advanced treatments for all conditions which affect the skin, hair, and nails. Throughout her career, Dr. Baum has built a reputation as a top cosmetic dermatologist by providing leading-edge treatments, dedicated and personalized patient care, and excellent aesthetic results.

What can you tell us about Hollywood Dermatology?

We do a lot of internal marketing, for example once or twice a month we run an event and a promotion for our loyal or VIP patients. Also we offer our patients the benefits of the Brilliant Distinctions program or the Galderma Aspire rewards. We have done some marketing on local magazines but we truly believe in word of mouth because our patients are satisfied and they send more patients and thats our success. We have Instagram and Facebook and try to be as active as we can promoting new procedures or the latest in skin care products.

Dr. Bertha Baum - Hollywood Dermatology, Florida

We do a lot of Botox, Dysport and some Xeomin; also all the fillers available in the market. Laser can be a big source of profit once the machine is paid because you are able to charge and not pay for the product. Plasma PRP is also another great source of income with excellent results

We still do clinical dermatology in our office so it was a very busy day at the office and I told one MA that was not with me in the rooms at that moment to get blood from a patient for plasma. After 5 minutes I go back into a clinical derm patient it was actually a full body exam and their first visit and I see the patient had a band aid on her arm freshly placed and as soon as I introduced myself she says “wow I’ve been to a lot of Dermatologist and they have never done bloodwork on my first visit, you are very thorough.” I realized that the MA had done in on the wrong patient and explained to the patient there had been a mistake, thank God the patient understood the situation and then told the MA she had gone to the wrong room to get bloodwork for plasma. I’m grateful this was not a big mistake but we definitely learn from...

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Dr. Alison Brooks - The Mirabel Clinic in Swindon, England

Located in Swindon, England, Dr. Alison Brooks made the switch from general practice dealing with Britan's NHS to focus entirely on cosmetic medicine.

Name: Dr Alison Brooks
Cosmetic Clinic: The Mirabel Clinic, Swindon, Wiltshire, England
Website: www.mirabelclinic.co.uk

Brief Bio:Dr. Alison Brooks - The Mirabel Clinic in Swindon England

I qualified as a doctor in London in 1989 and spent the next few years working as a junior hospital doctor and then became a General Practitioner (GP) in 1996. I worked as a GP in various locations in the South of England and then became a salaried partner in Swindon in the early 2000s. I established The Mirabel Clinic in 2006 and left General Practice in 2014 in order to concentrate entirely on cosmetic medicine

Let us know more about your journey to cosmetic medicine.

I have a lot to thank my sister for as it was her who got me started! She got divorced in 2005 and was back out on the dating game so decided to get some botox and fillers to help boost her confidence. When she told me about the experience saying that the person who administered her treatment was a General Practitioner this got me thinking and stimulated me into considering training to do this work. Almost immediately I looked up on the internet how to get trained in toxin and filler administration and I booked on a course with Adrian Richards – a plastic surgeon in Buckinghamshire. I spent a day training. I then came home and contacted two local beauty salons to ask if I could use their premises on a fee per patient basis. I started advertising in a local magazine and set up a website. For the next two years I gradually built up a small practice in the two salons, which was in addition to my usual work as a General Practitioner. In 2008 I bought a second hand laser/IPL machine from a local colleague, which precipitated a change in premises as I had to register my clinic with the Health Care Commission and I would never have been able to do that whilst working out of the two salons. So I approached The Shalbourne Suite, which is the private wing of the local NHS Hospital and asked if I could hire a room for a few hours a week. They agreed to this and I then spent the next 8 years working there, gradually building up to two really busy days a week. I gave up General Practice finally at the end of 2014 and haven’t looked back since. I have just moved into high street premises in Swindon, having taken a 10 year lease on a old property above a shop and completed a complete refurbishment on it. It has 3 clinic rooms, an office, reception room and a waiting room and is just about perfect!

What could you tell about your clinic?

Currently the clinic consists of me and my clinic manager, Debbie. She has worked for me for 6 years and now does all her back office work whilst sitting in the reception room greeting patients and answering the phone. We are in the process of taking on two other new aesthetic doctors to do half a day per week, as well as a receptionist and a laser trained beauty therapist. We open 4 days per week with two late evening till 8pm every week. We are located on a lovely street In Wood Street, Old Town, Swindon with a number of cafes, delis, restaurants etc. Wood Street is the most prestigious street in Swindon and is definitely the best location for a high end Medical Cosmetic Clinic such as Mirabel. We offer the usual toxin and filler injections, Laser and IPL for skin and hair as well as tattoo removal. I also do chemical peels, diathermy for minor skin lesions, Dermapen for scarring as well as Sculptra and Silhouette Soft thread lifting. We have a new Lipomed cryolipolysis machine that is waiting for a therapist to operate it! We have a database of about 2000 and I usually see about 40 to 50 patients per week but these numbers are expanding rapidly. Our patient demographic is mainly female with an age range of about 35-65.

Tell us about your staff also.

I have been very fortunate in finding a very good friend who has now become my irreplaceable Clinic Manager. I remember asking Debbie about seven years ago if she could spread the word about my need to find someone to do my back office work of filing and accounts. She suggested herself and I laughed saying that I thought she was overqualified for the role. She persuaded me to take her on and it has been the most amazing journey for her and me. She is one of the most organised and reliable people I know and is an incredible manager. I genuinely could not have developed the clinic into what it is now without her. We are now taking the next step of hiring staff and I am very aware (from other doctors in this business) of the pitfalls. Watch this space…..!

Which technologies do you use in your practice?

I have a Lumenis Quantum IPL and Laser multiplatform machine which I bought second hand in 2008 which I am very fond of and use a lot. I do IPL for hair removal and skin rejuvenation and it has an ND Yag head which I used for deeper thread veins and a Q-switched ND Yag head which I used for blue/black tattoo fading. I bought a second hand Alma Soprano Hair Removal diode laser for hair removal in sensitive areas and on darker skin types. I love this machine but use it less at the moment and will hand this one on to a laser therapist to administer treatments shortly. I also bought a new Lipomed machine last year but have yet to get going properly with this as it will be a therapist administered treatment. I am constantly on the look out for new machines and have considered getting a radiofrequency machine for skin tightening and more recently have looked at the new plasma soft surgery devices for non-surgical blepharoplasty and removal of benign skin lesions such as seborrheic warts. That said, buying new machines is a bit of a minefield. The reps will tell you that you will recoup your money in six months and that never happens! I find getting truthful advice about expensive machines is very difficult. I mainly take advice from other medical colleagues in the cosmetic medicine world.

Any marketing strategies that work for you?

I think marketing is a very difficult thing to get right. I and all my friends in this business have, at some point in our careers, been sold advertising in magazine and locals papers (at great expense) which have made absolutely no difference to our turnover! At The Mirabel Clinic do a little advertising in a free local paper and have a good website with some online selling. We don’t do much in the way of social media marketing and know that we should focus more on that area. The one single thing that made the biggest difference was investing in a radio ad on a local radio station. We have used this for the last 4 years and it constantly brings more custom into the clinic and has paid for itself several times over in terms of new customers and repeat business.

Which procedures do most of your patients undertake?

Without a doubt toxin treatment is the most profitable treatment I do, followed by dermal fillers and then IPL treatments. My least profitable treatment is in fact laser tattoo fading which is almost a non-profit making enterprise. I had to replace my Q-switched laser head last year and had a good long think about whether it was worthwhile, from a commercial perspective, to carry on doing tattoo fading. In the end I felt that I could not let my patients down and bought another head! It is a pro bono treatment but it makes me feel better about myself. I have just started Silhouette Soft Thread Lifting and am really enjoying the new technique. It definitely helps with the lower half of the face and I sell it as the only treatment I have in my armoury of non-surgical treatments that will do much for the jowls. The next step is really plastic surgery, and that is not for everyone.

Any stories you would like to share as a physician in cosmetic medicine?

I definitely have some stories of strange characters who have turned up in my clinic asking for unusual hair removal treatments and I remember one particular time early on when my children were very small and I was still taking calls for appointments on my personal mobile. I was in the changing room of a local swimming pool getting the children dressed when I took a call from a rather breathless man asking if I performed certain unmentionable services. I was so flustered that I almost dropped the phone and a baby too! I said “No!” and put the phone down feeling very shaken but I did have a good laugh about it later.

What is your advice to your fellow physicians?

Be brave. It is quite terrifying stepping out into the big commercial world – especially in the UK where most doctors are NHS employees. The rewards from growing a successful business can be huge, both financially, and in terms of your own personal self-esteem. Take a big breath and do it. Dig deep and you will surprise yourself.

About Dr. Brooks

Dr Brooks set up Mirabel Clinic in 2006 after completing advanced training in cosmetic injection and filler therapies at an expert training course run by a team of Consultant Plastic Surgeons. She completed her laser training in 2009.

Dr Brooks is a member of the British College of Aesthetic Medicine, regularly attending conferences and training updates to learn about the latest advances in cosmetic medicine and laser treatments.

Dr Brooks always offers free initial consultations as she feels that it is very important to advise you on the most suitable treatments, tailored to your individual requirements, before any committment is made by you.

Juvederm Ultra XC: Year-Long Lip Fillers

The US FDA has approved Allergan's JUVEDERM® ULTRA XC for the injection into the lips and perioral area for lip augmentation in adults over the age of 21.

Allergan's trials show that results last up to a year in the lips, but as always, there are two sides to the coin.

Juvederm Ultra Plus XC

Since 2006, Juvederm formulations were already FDA approved for correction of moderation to severe facial wrinkles and folds such as parentheses lines around the nose and mouth. Then in 2013, the Juvederm XC for age-related mid-face volume loss was introduced.

Clinical trials for Juvederm revealed that 79% of subjects showed an improvement in lip fullness three months following the treatment. More than 78% of the subjects reported an improvement in their overall satisfaction with the smooth and natural look and feel of their lips at one year after treatment.

Executive Vice President & President, Allergan Medical Philippe Schaison said that:

As the leader in medical aesthetics, Allergan is committed to continued research and development in this area. Providing physicians and patients with premium products that allow them to achieve the aesthetic results they want is always our goal. Understanding that the desire with lip augmentation is to achieve a natural-looking and lasting result, we continued our research of JUVEDERM® ULTRA XC for the lips. With this approval, JUVEDERM®ULTRA XC is now the only filler that is approved to last up to one year in the lips while providing natural-looking results.

Juvederm Ultra XC contains a smooth gel formulation of modified form of hyaluronic acid (HA) and a small amount of lidocaine. The hyaluronic acid helps the skin to maintain its moisture and softness and the lidocaine acts as a local anesthetic to improve the comfort of the injection.

While the increase in the time between injections is going to be welcomed by patients, there are some physicians and clinics that might lose income since patients are not coming in as frequently. Additionally, these longer fillers might not be appropriate as a "first-time" filler for patients who are unsure if thy're going to love the effect. There's a big psychological difference between living with a change for a few months and an entire year. Still, the general increase in lenght is a good thing for clincs and patients who are familiar with the effects.

Radiesse: FDA Approved For Hand Rejuvenation

Radiesse is now FDA approved for "hand rejuvenation".

Radiesse is an FDA approved dermal filler for smoothening out facial wrinkles and facial contouring. Recently, Radiesse got its FDA approval, making it the only FDA-approved filler for the hands although hyaluronic acid has been used by physicans for years.

The product, according to its website, can hide visible bones and tendons, making the hands look more youthful and smooth. Radiesse utilizes a safe gel formula that contains calcium microspheres (CaHA). These can immediately create added volume and then stimulate the body to produce collagen which results in volume augmentation that can last for around a year.

According to board-certified plastic surgeon Dr. Brent Moelleken, MD FACS:

Radiesse is a great option as a filler for hands. It’s safe for all skin types, and leaves no obvious line between the hand and wrist. The hands are the last frontier, so-to-speak, and often give away the true age of a woman.

Depending on the severity of the volume loss, patients should expect to pay for about one to two syringes of Radiesse at an average cost of $800 - $1,200 per syringe for their hands.

Dr. Moelleken adds that because of the product's pliability and softness, it is a great filler which may also be used for deep filling in the face.

Patients are cautioned to seek out experienced and board-certified plastic surgeon in using the Radiesse hand filler because of the many veins, nerves, and arteries in the hand. During the clinical trials, patients showed swelling, redness, bruising and pain in injection sites.

Because of this recent development, cosmetic doctors may now offer enhancement and rejuvenation for both the hands and faces of their patients.

For more information, you may visit:


Filler Injections: Achieving the Ideal Lip Shape

Our lips provide competence to the oral cavity when we chew our food. They may also affect sounds and facilitate facial expression which help us communicate what we feel. Lips also have their own aesthetic value.

Earlier this year, the Kylie Jenner Lip Challenge went viral on the internet. People who took the challenge sucked the air out of a glass to create fuller lips that is said to be more attractive. Of course, everything did not go well for others because many attempts ended in painful bruisings and trips to hospitals.

Sucking glass cyclinders did not make Kylie's lips look plump - it was cosmetic enhancement that did it. In an interview with Cosmopolitan magazine, she admitted using a filler and advised others who want a similar look to try a filler that lasts about two to four months, in case they change their mind and want to give it up.

For dermatologists and Medspa owners who work with patients desiring for plump lips, giving advice to patients during patient consultation may boost patient satisfaction rate.

A study in Germany was conducted "to clarify what it is that makes lips attractive - and whether there are gender-related differences of an attractive lip and lower third of the face".

After patients' lip and chin regions were photographed and evaluated by voluntary judges through a Likert scaling system, the results showed that there were certain parameters of the lips that add attractivity of both male and female individuals. Further, gender-related differences were manifested in the form and shape of an attractive lower third of the face.


  • There is a significant higher ratio of upper vermillion height/mouth-nose distance in frontal-view images of attractive compared to unattractive female (p < 0.001) and male (p < 0.05) perioral regions.
  • Furthermore, the ratio of upper vermillion height/chin-nose distance was significantly higher in attractive than in unattractive female (p < 0.005) and male (p < 0.05) lip and chin regions.
  • The nasolabial angle was significantly sharper in attractive compared to unattractive female perioral regions (p < 0.001).
  • Attractive female lip and chin regions showed a wider mentolabial angle compared to unattractive female lip and chin regions (p < 0.05).
  •  Comparing men and women, we found that attractive female perioral regions showed a higher ratio of lower vermillion height/chin-mouth distance (p < 0.05) and lower vermillion height/chin-nose distance than attractive male perioral regions (p < 0.05).

Read more on: http://www.jprasurg.com/article/S1748-6815(15)00137-0/abstract

Dr. Yoel Moyal: The Clinique Revolution du Plateau In Montreal

Dr. Yoel Moyal: The Clinique Revolution du Plateau In Montreal

Dr. Moyal is at the cutting edge of new injection techniques to offer a variety of treatment choices for his patients.

Name: Yoel Moyal MD CCFP EM
Clinic: Clinique Revolution du Plateau
Location: Montreal, Quebec, Canada
Website: clinicrevolution.com

Can you tell us more about your career transition from specializing in Family Medicine to Emergency Medicine to Aesthetics?

I have worked in Emergency Medicine and Family Medicine since graduating and recently became interested in esthetics as a means of doing more procedures and fine techniques. I also use my esthetic practice to balance out the often hectic environment of the Emergency Department with the quiet, serene environment of my office.

How do you market yourselves to patients and what do you do that your competitors aren't doing? 

Marketing medical esthetic services to clients is tricky as our ethical code in Quebec does not allow for the solicitation of a client/patient by a physician. We can inform people of the services we offer but can not incite patients to have a procedure done.

This applies to injections of Botox, dermal fillers and other medical-surgical procedures. Treatments such as laser hair removal, IPL and other esthetic services not performed by a doctor can be marketed. Doctors may not sell, endorse or associate any product or brand  to their name in Quebec.

Canadian Cosmetic Medicine Dr. Yoel Moyal

Are there any treatments or technologies that you're especially excited about that haven't hit the market yet? What do you think about new therapies like stem cells or others? 

I am excited about autologous fat transfers for restoration or augmentation and hair cloning for hair transplantation.

As a physician it is wiser to offer services that are exclusive to our profession such as injections or surgical procedures. It is difficult to compete in a market where anyone can offer the same services. For example in Quebec anyone can offer IPL , laser hair removal or tattoo removal but only doctors can inject. A doctor offering laser hair removal in his clinic can not compete with an esthetician doing so in her basement.

That being said, at our clinic we offer Laser hair removal as some people want to go to a clinic where there is medical supervision but the majority do not place much value on that. The majority of our practice revolves around  minimally invasive procedures such as injections of Botox and dermal fillers.

I do not encourage physicians to invest heavily in machinery as the technologies are often overpriced and often underdeliver in terms of results. Many estheticians can obtain similar results (in most cases) with mechanical (low cost) treatments with less risky side effects compared to  new technologies.

Technology has its place but not as much as savvy salespeople would have you believe.

The way to add new technologies is to introduce them into your practice based on the foreseeable demand from your own established clientele and the clienetele that you wish to attract. For example, your current clientele is between 45 to 65 years old doing BOTOX and dermal fillers regularly , the majority of your clients have sun damaged skin or pigmented lesions , they often ask if there is anything to be done. You should consider adding resurfacing technology or IPL at this point.

If you are considering adding a new service then careful market research in the territory you serve is vital- do not take the salesman’s word for it that  there will be people will be breaking down your door to try your newest machine and spend significant amounts of money.

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Dr. Donald Rainone At Smoothskin In Londonderry, NH

Londonderry, NH Cosmetic Physician Dr. Donald Rainone

The business of cosmetic medicine has its ups and downs according to Dr Rainone.

Name: Donald P. Rainone, M.D.
Clinic: Smoothskin Cosmetic Laser Center
Location: Londonderry, NH
Website: smoothskinnh.com

Tell us a little bit about your clinic.

The clinic is co-owned by me and an RN. I provide leadership and direction, and perform all laser and injection procedures. The RN oversees HR, risk management, and customer service issues, and maintains vendor relations. The esthetics manager directs the esthetician team, and performs quality control over esthetics procedures and equipment. 

I offer medical injectables, laser tattoo removal, laser rejuvenation, microdermabrasion, chemical peels, IPL hair removal, and IPL brown spots and facial vessels. I pared down my services, especially when the recession hit from 2008 – 2011, omitting massage, laser leg veins, lipodissolve, and liposuction. Focusing on fewer services has heightened my expertise level and made me busier.

My patient population covers all ages, both sexes, and a broad socioeconomic distribution. Tattoo removal brings in more lower income, young males, while medical injectables bring in higher income, older females.

I am located about 50 minutes north of Boston, MA, 15 minutes over the New Hampshire border.

I have only about 1,000 SF and every inch gets used to the max: 4 treatment rooms total. One thing I stay on top of is how much revenue per square foot, per hour, is generated by the rooms. This helps me when deciding what to expand or cut.

Can you give us some insight into how you hire, manage, and motivate your staff? 

Hiring is a challenging event and we apply some rigor to avoid getting the wrong person. We usually post on Craig’s List and weed out the obvious poor fits prior to an interview. We then do several return interviews with the RN and Esthetics Manager. We have esthetician candidates do a sample facial on the esthetics manager to test how caring they are in the touch/handling aspect of a client. I have found that anyone can be trained, but you cannot teach “nice.” Kindness goes a long way in this field. 

Yes, I have lots of horror stories. We address problems in real-time, document the discussion in the employee’s record, and promptly terminate any gross violations. One employee was not completing her tasks because she was spending the day logged onto dating sites. She did not even bother to erase the browser history.

Unfortunately, I suffered a great financial loss by an employee who turned out to be a professional white collar criminal, embezzling the total cash equivalent of one quarter’s gross revenues. I was able to recover 20% of that through legal action.

I now run a criminal background check on every potential new hire. I also tightened the password access to transactions in the point-of-sale software, hindering the ability for employees to hide evidence of cash skimming. As a final precaution, I now make all my own bank runs for cash deposits. 

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Jean M. Casello MD, Medical Director Of Renovo MD In Shrewsbury, MA

Dr. Jean M. Casello entered the world of the cosmetic industry with uncertainty, which paved the way for a flourishing practice.

Jean M. Cassello MD Shrewsbury, MA Renovo MD Medical Director

Massachusetts Medical Spa Physician Dr. Jean M. Cassello Name: Jean M. Casello,MD
Clinic: Renovo MD
Location: Shrewsbury, MA
Website: RenovoMD.com

Can you tell us more about the daily operations of your clinic?

Our clinic is composed of an office manager, receptionist and a part time in-house marketing director. The office manager takes care of the day to day running of the office. On the clinical side, I am on site full time and I have a full time esthetician. We are in the process of hiring another esthetician and a nurse to do the injectables.

We offer comprehensive services: fillers, Botox, IPL, LED treatments, fraxel resurfacing, electrology, skin tightening, sclerotherapy, permanent makeup, chemical peels and pharmaceutical grade products. We have recently added tattoo removal.

Our patient population is mostly women from 40-70 years old. We also have a fairly large population of teenagers with acne. About 20% of our patients are men.

We are located in Shrewsbury, Massachusetts. We are in a small town about 40 miles outside of Boston. We see patients 4 days a week in this office and one day a week at our off site off

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Brian Buinewicz MD, Plastic Surgeon At Le MedSpa In New Jersey

Juggling tasks at the medspa, at a hospital and at the university is no easy task. Let's see how Dr. Buinewicz handle multiple responsibilities and manage priorities.

Name: Dr. Brian Buinewicz
Clinic: Le MedSpa of Buckingham and Flemington
Location: Doylestown, PA and Flemington, NJ
Website: lemedspabucks.com

Your clinic basically offers a holistic approach in a sense that it covers everything from face, to body and even health and nutrition. How did you grow your business? How is your clinic organized? 

Our practice is a dual physician based practice covering all of the patient’s needs from nutrition, exercise, primary health care, weight management in addition to our full service medical spa and plastic surgery services. The business grew naturally by constantly offering the best and newest treatments for our patients. We evolved over the years to have a “tool chest” full of options to offer our patients, not just surgical intervention, for example. When the only tool you have is a hammer, the whole world becomes a nail.

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Dr. Michael J. Brown, Plastic Surgeon In Virginia & Maryland

Dr. Michael Brown's practice includes three offices across Virginia and Maryland.

Name: Michael J. Brown MD
Clinic: The Loudoun Center for Plastic Surgery
Locations: Ashburn & Richmond VA, Bethesda MD
Website: rejuven8u.com

About: Dr. Michael J. Brown has been voted a Top Plastic Surgeon in Virginia and Top Doctors in Virginia by Northern Virginia Magazine and Best Cosmetic Surgeon in Virginia by Virginia Living Magazine in 2012. Dr. Brown has also served on the editorial board of a cosmetic surgery magazine. He is an active committee member for the The American Society for Aesthetic Plastic Surgery.

As a clinic that is primarily focused on plastic surgery but offers nonsurgical treatments, how is your clinic organized?

The Center is organized with 4 components. There is the medical office that's devoted to plastic surgery. The Center has a nurse who is trained and provides assistance with injectable treatments like Botox, Restylane, Juvederm, Dysport

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Using Artefill

Are you using Artefill? How do you like it?

There have been a few chapters in the story of this filler, and I know that many doctors are not using it due to fears of permanent fillers and fears of longterm complications. Also, it went off the market for a while as Artes Medical went bankrupt, but came back from a new company called Suneva.

I am a fan of the product and have used it quite a bit in my practice for the last 6 years. I have seen no concerning longterm issues. No granulomas, no migration, no product lumps. In Europe it sounds like doctors encountered quite a few serious problems with the Artecoll and Arteplast iterations of the product, including granulomas and lumps. It was so much so that a fairly strident call went out to never use permanent fillers. This boycott was enthusiastically supported here in the states by many plastic surgeons and dermatologists (most notably Arnie Klein). Even now, it seems that doctors who use Artefill are considered somewhat fringe by the core group of physicians.

I think that this is a shame. I have used the product on over 1000 patients without a single adverse event and I find it to be soft, natural appearing and forgiving. My main issue is that when the collagen component gets absorbed it is often not fully replaced by the patient's tissue. The result is that I frequently have to do several sessions in order to get good results and this can get costly. I inject in the deep as well as the superficial planes, but i try to have most of the product stay superficial. Because the product is so soft, I have found that if I inject it deep I do not see great results.

What is your experience?

Italian Plastic Surgeon, Dr. Egidio Riggio's "Zenith System" For Breast Augmentation

Dr. Egidio Riggio focuses on innovation and research related to plastic surgery, both aesthetic and reconstructive. 

Name: Egidio Riggio, M.D.
Location: Milan, Italy
Website: chirurgiaplastica.mi.it/it/home/

That's interesting: Dr. Egidio Riggio is the creator of an innovative philosophy and aesthetics of an original surgical approach to breast augmentation he calls the "Zenith System" which he claims lead to more natural breast augmentation results. He has performed mor than 100 cases and published this proceedure in the international journal of cosmetic surgery most authoritative, Aesthetic Plastic Surgery August 2012.

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