Dr. Paul Cronin - Eternal Youth Clinic in Cheshire, England

Eternal Youth Clinic uses updated aesthetic technologies and sees returning and loyal patients in our interview with Dr. Paul Cronin.

Dr. Paul Cronin - Eternal Youth Clinic

Name: Dr Paul A C Cronin
Clinic: Eternal Youth, Cheshire
Website: www.eternalyouth.co.uk

Brief Bio:

A one time family doctor who branched out into aesthetic medicine over sixteen years ago. He has extensive experience in injectables, radio-frequency skin tightening, micro needling and laser resurfacing. He opened Eternal Youth clinic over ten years ago and offers Fraxel, Thermage, Ulthera, INTRAcel, ULTRAcel and VASER liposelection.

What made you pursue cosmetic medicine?

I blame it on my mum really. She rang me up very excited one day and said ‘you have to go and learn Botox.’ When I asked why she said that she had just had some treatment by a young doctor who used to be a GP and now does this. She thought it would be good for me and I might be good for it. It seems that she was right

Mind telling us a background about your clinic?

My clinic is a small and very personal run affair. We used to have a large clinic in Alderley Edge with several staff, but now we work from purpose built premises in our garden. My wife is in charge really and makes sure I know who is coming next and what for. we have a varied patient base from quite long distances in some cases. Our patients appreciate the discretion and the very personal services we offer.

What are your insights about your staff?

To be honest when we had more staff I didn’t think I was a very good picker. I think it is hard to find someone who will work as hard for your business as you will. That might say more about me than the staff I suppose…

Enlighten us with the technologies you're using for your practice.

We offer Fraxel Restore at EYC and have done for over ten years. I am always impressed that it is still doing a great job. So many pieces of kit cost so much money and become redundant when a newer/better one comes out. Fractal has definitely been my best investment. We have recently purchased ULTRAcel which is an excellent device offering three modalities of skin tightening and rejuvenation in a single platform.

What are your marketing strategies for your clinic?

I am not sure I am very good at this. I have spent a ton of money over the years on Cheshire Life magazine, radio ads and stacks of other stuff and I still think most of my new patients arrive through word of mouth. I really think you have to care about your patients and do the best you can and then over the years the list will grow. Probably slower than you would like but patients who come from personal referrals are usually patients for life. Adverts tend to produce more ‘tire kickers’ who come to suss you out. Personal referrals come with money in their pocket. They trust you already as much as they trust the friend who referred them.

Which treatments and procedures are popular in your clinic?

Botox and fillers always provide the ‘bread and butter’ but I love the results that the Fraxel and ULTRAcel can provide. They obviously cost more money but some of the before and afters are amazing. I would like to promote my cosmetics more as some of my colleagues seem to do better with products than I do. Maybe I’m just not ‘pushy’ enough?

Any stories about your career in cosmetic medicine?

My favourite bit is the fact that some of my patients have been coming to see me for 15 plus years. These patients see me three or four times a year and trust me implicitly. Knowing that if I recommend something new its not because I need the money and is because I think it will help them look better. It is this personal relationship which is the corner stone of my practice. Recently I had a consultation with one of my longer standing patients and just for fun we looked back at her original photos from over ten years before. We both agreed that the before photos today looked better than the after photos from ten years ago. That is priceless.

Share what you would like to tell fellow physicians.

Don’t worry so much about kit. You can waste a lot of money on devices which eventually sit lost and lonely in the corner of the room. There are however some technologies which do stand the test of time.

Care deeply about your result. Make sure the patient knows you care. The actual outcome of the treatment is really less important than whether the patient thinks you tried hard and really wanted to do your best. This may sound off but I do believe it is true.

Be particularly vigilant for patient expectations. It is always a whole load cheaper to ‘not take the money’ and ‘not do the treatment’ than pay for the litigation….

Get to know your patients. You don’t need thousands of patients to make a very good living in this business. A few loyal repeat customers will be a lot less work for the same money.

Don’t work too hard. Life is for fun too.

About Dr. Cronin

Dr Paul Cronin was once a local GP and has been in the medical profession since 1985. He has specialized in Cosmetic Medicine for many years and last year alone he performed over 1500 treatments to brighten up the lives and faces of the ladies and gentlemen of Cheshire including some very “well known” faces!

Now Dr Cronin has relocated Eternal Youth Clinic onto the outskirts of Congleton in Cheshire. Nestled into the hills overlooking the Derbyshire peaks, bringing the tried and trusted benefits of muscle relaxing treatments and fillers now combined with several new cutting edge treatments.

Michael A. Persky, MD, FACS In Encino, CA

Dr. Persky considers his work to be as much an art form rather as a medical procedure.

Name: Dr. Michael A. Persky
Clinic: Persky Sunder Facial Plastic Surgery
Location: Encino, CA
Website: drpersky.com

What IPL or laser technologies are you using? What technologies do you like? Which do you dislike and why?

We have used the complete line of Fraxel lasers since their inception. Initially, many colleagues were skeptical about the results we were seeing, now Fraxel lasers have become the gold standard for laser skin rejuvenation and resurfacing. We do not use IPL in our practice, but feel that our Fraxel Dual laser treats brown spots like “an IPL on steroids”.  We currently are using Ulthera to non-invasively lift and tighten the face, neck, and eyebrows as well as treating fine lines around the mouth and eyes. We find that when combined with Sculptra and other facial fillers, results are quite satisfying for both patient and physician.

Technology companies may tell the physician anything to sell them the item. Physicians must do their “due diligence”, and not believe everything that they are told. Technologies such as Thermage have not lived up to their hype, and others like Zerona are just plain “snake oil”. The latest technology that we are most excited about is Cellulaze, a minimally invasive one time treatment that effectively treats cellulite.

What treatments have you observed to be the most profitable? Have you dropped any treatments?

Surgical treatments are most profitable. Next come non-invasive treatments such as Ulthera, Fraxel, and CoolSculpting. Injectables are profitable as well, including Sculptra, Botox, Dysport, Juvederm, Restylane, and Radiesse. The use of cannulas for injection has revolutionized our use of Radiesse for “quick” facial volumization. We have dropped laser hair removal and radiofrequency skin tightening treatments.

Read More

Pioneer Of Non-Surgical Rhinoplasty, Dr. Alexander Rivkin In LA

Dr. Alexander Rivkin is an international authority on non-surgical cosmetic treatments who provides non-invasive and non-ablative treatments in Southern California.

Name: Alexander Rivkin, MD
Clinic: Westside Aesthetics
Location: Los Angeles, CA 
Website: Westside Aesthetics

That's Interesting: After several years of being an Allergan Clinical Educator, Dr. Rivkin was recently honored with Diamond level status: recognition that he is among the top 1% of Botox providers in the nation

He is a prominent member of the national teaching faculties for Allergan, Contura, Johnson and Johnson, Medicis and Bioform. He is also a member of the physician advisory board for Contura and serves on the boards of a number of charities including the Lynne Cohen Foundation for Breast and Ovarian Cancer Research.

I first met Dr. Rivkin somewhere around 2002 when I was attending a "medical spa conference" and Westside Aesthetics was on the tour. At the time, Westside Aesthetics was located above a salon but now Westside Medical Spa is tucked away on Gayley Avenue near UCLA. 

Dr. Rivkin is renowned for non-surgical alternatives to commonly performed cosmetic procedures. He was the first physician in the country to offer the Non-Surgical Nose Job, his signature method for non-invasive correction of cosmetic nasal irregularities.

Read More

Dr. George Sanders, Encino CA Plastic Surgeon

Dr. George Sanders, Encino CA Plastic Surgeon

Despite of the emergence of noninvasive treatments, Dr. George Sanders keeps himself abreast with the current trends.

Name: George Sanders, M.D.
Location: Encino, CA
Website: drsanders.com

The Sciton Erbium laser was purchased several years ago and remains a stellar performer for full face laser ablative therapy when the patient has 9 days to recover to the point that they can wear makeup and go out and look very good. I do many facelifts and this recovery time frame makes sense in that the remainder of the face is recovering at about the same pace. When I purchased the Sciton, other erbium lasers were available, but the dual head configuration and other factors made it more appealing. It has paid for itself many times over and remains a very reliable piece of equipment that provides a consistently excellent result with minimal complications. 

The Fraxel laser is used by my nurse in those patients who do not need as much of a result as the Sciton produces and who do not have as much time for recovery. These patients have at most one or two days of downtime.

Eventually we will need to replace our Sciton, and it may be that a fractionated CO2 laser may be the answer. I am also looking with interest at the nonsurgical fat sculpting devices as well as the nonsurgical skin tightening devices. Reliability, cost effectiveness, efficacy, and a usefulness that will last years are all things that I look at when deciding upon what to purchase. I am also not interested in a device that requires multiple patient visits to accomplish the desired result because of inherent limitations in office space and personnel time.

Read More

Brian Howard MD FACS, North Fulton Plastic Surgery

Dr. Brian Howard FACS

Dr. Brian Howard runs his solo-practice in Roswell, just outside of Atlanta, Georgia.

Dr. Brian Howard is boarded in both plastic surgery and otolaryngology. In this interview we got together to find out what he thinks of his practice, cosmetic technologies and staff compensation.

Name: Brian Howard, MD, FACS
Location: Roswell, GA
Website: drbrianhoward.com

That's interesting: Dr. Howard is a recipient of the Outstanding Research Award given by the American Academy of Facial Plastic and Reconstructive Surgery and was recognized by the Consumer Research Council of America as a Top Physician.

Read More

An Interview With Dr. Mary Lupo Of Lupo Center For Aesthetic Dermatology

Mary Lupo MD, FAAD Board Certified Dermatologist New OrleansSince 1983, Dr. Mary Lupo has been at the forefront of non-surgical skin rejuvenation.

As the founder of Tulane University's resident's cosmetic clinic, a Platinum plus Botox and Juvederm provider, and a clinical instructor for Allergan, Dr. Mary Lupo knows her way around injectables. In fact, she launched Botox to physicians in Austrailia in 2007. We wanted to hear what Dr. Lupo has to say about how she manages her dermatology clinic and her lifestyle as a physician.

Name: Mary P. Lupo MD FAAD
Location: New Orleans, LA
Website: drmarylupo.com/index.html

That's interesting: Dr. Lupo received the Peterkin Award for original research in skin lipids and inflammation in patients with atopic dermatitis. Author of over 50 publications and presentor of over 230 presentations. Researcher, author, lecturer, teacher. Founding co-director of the Cosmetic Boot Camp in 2005. Past-president of the Women’s Dermatological Society and former member of the board of directors of the American Society for Dermatologic Surgery.

Read More

Warren Seiler MD, A Laser Center & Medical Spa In Alabama

Warren B. Seiler III, MD, A Board Certified Cosmetic Laser Surgeon in Alabama

Dr. Seiler is a speaker, preceptor and physician trainer for Lumenis Laser Company and injection trainer for Allergan (manufacturer of Botox & Juvederm).

Birmingham Alabama is home to Seiler Skin, Cosmetic Laser Center & Medical Spa, a single-physician clinic run by Dr. Warren Seiler and his wife. We sat down with Dr. Seiler to find out what he thinks of the current crop of cosmetic lasers, how he runs his clinic, and hear what advice he has for other physcians.

Name: Dr. Warren B. Seiler III
Location: Homewood, AL
Website: seilerskin.com

That's interesting: Dr. Seiler is a Board Examiner and the Executive Director of the American Board of Laser Surgery and co-author of the ABLS examination text book and board certification exam.

As a single physician owner, how does your clinic operate?

My practice, Seiler Skin Cosmetic Laser Center, is a single physician driven cosmetic practice. I personally perform the laser and injectable procedures. I have a very good medical aesthetician working directly under me who helps patients with skincare programs, Hydrafacial, chemical peels, and laser hair removal. My wife is our marketing and website director and she is co-owner with me in the practice. We run the practice together, but we have an office manager that helps.  I perform fractional CO2, Fraxel, Thermage, Laser Hair Removal, Laser Spider Vein treatments, IPL, and others. Botox and Juvederm are the only injectables, although I have tried many others, I feel they are the best. Our practice is really the only one in Birmingham in which the physician specializes entirely in cosmetic laser procedures and nothing else, which really helps to offer the experience that I provide.  

Read More

Interview: Lila Bratani MD, Plastic Surgeon In Germany

AA look at plastic surgery in Germany with Dr. Lila Bratani.

Physician:  Dr. Lila Bratani
Location: Karlsruhe, Germany
Website: www.drbratani.com, http://www.estheticon.de/chirurgen/dr-lila-bratani

That's interesting: Dr. Lila Bratani is recognized as a member of Stanford's Who's Who for having demonstrated outstanding leadership and achievement in her field.

How did your cosmetic medicine training kick off?

Back when I was a teenager, I was attracted to aesthetic medicine and of course beauty and anti-aging. My first step in Plastic Surgery was when I got a good training by my teacher, Prof. Muehlbauer, one of the leading aesthetic surgeons in Germany and recognized worldwide. I also completed a fellowship in advanced aesthetic medicine and got trained in cadaver courses in Brazil (Sao Paulo and in Brasilia). I was working with great colleagues and I am still learning a lot of new techniques in the aesthetic medicine field. The art of this profession gives the ultimate satisfaction.

Can you tell us more about your surgical clinic and how it's organized?

I’m the chief of the Plastic and Aesthetic Department in a private clinic. The owners are dermatologists and it works perfectly. We offer plastic surgery, hand surgery as well as non invasive treatments such as laser. We also have 3 cosmeticians in our skin cosmetic center. The clinic consists of: 1 plastic surgeon (me), 6 dermatologists, 3 cosmeticians, 1 practice manager, 1 PR and clinic manager, 1 OR nurse, 3 frontdesk assistants and 8 physician assistants. We serve to a mix of private and state health care patients.

The requirements for hiring staff in our plastic and aesthetic surgery clinic are very high. PA’s and nurses have to understand that they need to have this extra “service” for extraordinary plastic surgery patients. We like them to have a corporate identity that represents our clinic well and of course a fabulous attitude and behavior.

We use commission on the cosmetic sales.

What laser technologies are you using? What are your thoughts about the technologies you’re using now?

We don’t use IPL, but we are using Alexandrite, Ruby, NdYag laser and Fraxel, CO2-Laser. I like most of the Fraxel  and new devices of Radiofrequency (Thermage and BodyTite). I have a lot of experience on the smooth liposuction with radiofrequency using the BodyTite device and so far, I'm seeing great results with skin tightening.

Where do you spend money on advertising? What works best for your practice?

We have websites, social media as Facebook, publications on newspapers and  journals such as Vogue. We also distribute e-newsletters for existing patients via email. In the waiting rooms, we showcase programs with different techniques of aesthetic procedures. This kind of advertising works much better than handing out external flyers or ads. 

(Sponsored: See Frontdesk waiting room videos for plastic surgeons and dermatologists.)

What are the in demand treatments in your clinic? Are you planning to add something new?

All kind of aesthetic surgery procedures like breast augmentation, facelifts, liposuction and face skin rejuvenation with radiofrequency as well the small procedures as fillers such as Botulinum toxin therapy.  I will be adding more fat grafting and liposculpturing techniques soon.

What have you learned about practicing cosmetic medicine? What stories can you tell?

I have learned to offer what I think is good for the patients and not to please the unrealistic demands of someone. Sometimes patients bring their own drawings of unrealistic body parts. I’m aware of dysmorphophobic patients and refuse to do anything on those. 

What advice would you give to other physicians based upon your experiences?

Working hand in hand with other colleagues is a benefit for starting into aesthetic medicine. You may share the cosmetic lasers and IPLs (which are very expensive) when starting your own clinic. Never underestimate the non-invasive procedures, even we plastic surgeons love it than being in the operating room with the scalpel in the hand.  Set your own “branding” so that patients will be pleased with your work and aura and will bring you more patients via word of mouth, which is also a great marketing tool.

About: Dr. Lila Bratani completed her Craniofacial and Plastic Surgery fellowship in Nova Southeastern University. With over 10 years of experience in Plastic, Aesthetic, Reconstructive, Laser and Hand Surgery, she is a university lecturer, medical manager and an esteemed health care consultant in New York,USA. She specializes in burn surgery and tissue engineering. Other than that, she is an active member of the Society of Plastic Surgeons of Germany DGPRAEC, WOSAAM (World Society of Anti Aging Medicine), IPRAS (International Society of Plastic Reconstructive and Aesthetic Surgeons) and DGBT (German Society for Aesthetic Botulinum Toxin Therapy.

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.

Interview: Dr. Samir Ibrahim Abu Ghoush, Plastic Surgery In Poland

Mandala Plastic Surgery Clinic

Dr. Samir Ibrahim Abu Ghoush, Plastic Surgeon


Plastic surgeon and hair transplant physician Samir Ibrahim Abu Goush who practices in both Poland and the Middle East.

Physician: Dr. Samir Ibrahim Abu Ghoush
Plastic Surgery Clinic: Mandala Beauty Clinic
Location: Poznań, Poland
Website: www.mandalaclinic.pl

That’s interesting: Dr. Ghoush is a trainer for Cool Lipo in the Middle East and Central Europe and a pioneer of LVR (Laser Vaginal Rejuvenation) in the Middle East and Poland.

Profile: Dr. Ibrahim was awarded twice by the International Society of Hair Restoration Surgery for presenting the best clinical case and poster. Aside from that he is recognized worldwide for planting facial hair, moustaches and beards. He is a distinguished Faculty member and Chairperson of many live workshops in HAIRCON and OLSW (Orlando Live Surgery Workshop). Dr. Samir has performed thousands of Aesthetic, Plastic Surgery, Reconstructive and Hair Restoration Procedures in a career spanning for more than 15 years. His patients are women and men from different countries, from all facets of society, many celebrities. Dr. Samir trained and worked with world renowned specialists in their fields.

We hadn't really thought of Poland as a hotbed for cosmetic medicine, until we met plastic surgeon and hair transplant specialist Dr. Samir Ibrahim Abu Goush.

Can you tell us more about your clinic? What are the services available?

Mandala Beauty Clinic is located in the heart of Poznan, Poland. It is very modern, with an integrated operating room with inpatient services. We offer a wide spectrum of innovative methods of treatment, and lasers that include: Vaser Hi def. Liposculpture, Laser Assisted Liposuction, Laser Vaginal Rejuvenation and Aesthetic Gynecology, CTEV Endovenous Laser, Aesthetic Plastic Surgery, Facial Surgery, Breast Surgery, Body Procedures, Hair Transplants, and Dermatology & Aesthetic Medicine 

How is your clinic organized? How do you manage your staff’s salary?

Physicians are working with us as partners on the (win/win) basis. We have at least 25 medical spa staff. The permanent staff is paid a monthly salary while the rest are paid on a per case/per hour basis.

What IPL or laser technologies are you using? What are your thoughts about the technologies you’re using now?

I use a German made IPL (smart plus). I have the Vaser machine from Sound Surgical Technologies, the Cool Lipo Laser and the CTEV Endovenous Laser from Cool Touch, a Laser for LVR (laser vaginal rejuvenation) from Innogyn.

I am very happy and much satisfied with these technologies. I use the Vaser all the time.

How do you market your clinic?

First of all, we have our website that has great medical spa SEO and generates a lot of traffic. We also get featured in both print magazine and TV shows and we always look for ways to make our practice more visible through interviews or PR. However, I still believe that the most important way of spreading word about our clinic is word of mouth. Patients are the most valuable asset you will ever have. If they are happy with your services, there’s a higher probability that they will recommend you to their friends and family and we take every effort to provide both the best medical services, and the best patient care..

What treatments attract the majority of your patients?

The Vaser body sculpturing remains to be the most profitable treatment in my clinic, which delivers amazing results and achieves a high patient satisfaction. Hair transplants are in demand as well. I am always looking into adding new services and innovations to my practice. I am planning to purchase a Fraxel Laser soon.

Can you share your thoughts on what you have learned in the cosmetic industry?

I believe that practicing this profession requires continuous learning. I never stop learning new things, new technologies and how others do the same procedures. If you are in doubt, ask your physician colleagues in the industry and share what you know! Attend workshops, seminars and webinars to keep your self updated.

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be considered for an interview, just contact us.

Interview: Stephen Weber MD, PhD of Lone Tree Plastic Surgery

Sitting down with Dr. Stephen Weber of Lone Tree Facial Plastic & Cosmetic Surgery Center outside of Denver, Colorado.

Physician: Stephen Weber MD, PhD
Location: Lone Tree, CO
Website: http://www.lonetreefacial.com

That's interesting: Dr. Weber has participated in the "Face to Face" program where local plastic surgeons donate their services to the victims of domestic violence and has participated in the annual humanitarian mission surgical trips providing free care to medically isolated, indigent patients.

Profile: I am a double board-certified Facial Plastic and Reconstructive Surgeon practicing at Lone Tree Facial Plastic & Cosmetic Surgery Center in the Denver metro area. My practice involves all aspects of facial cosmetic surgery including facelift, browlift, blepharoplasty, rhinoplasty, otoplasty, facial implants, facial resurfacing and scar revision. Our office also provides comprehensive treatments for facial aging including Botox and Dysport to reduce facial wrinkles, dermal fillers to minimize facial lines and folds as well as fractional laser (Fraxel and MiXto) resurfacing.

Can you tell us a little bit about you and how you got started in cosmetic medicine?

I became a Facial Plastic & Reconstructive Surgeon by a very circuitous route. In medical school, I planned to become an Infectious Disease specialist and even obtained a Ph.D. in Immunology and Microbiology in pursuit of that goal. However, my first rotation after successfully defending my thesis was in head and neck surgery. I knew that first day that I wanted to become an Otolaryngologist (Head & Neck Surgeon, ENT). During my residency training in Otolaryngology and Head & Neck Surgery I realized that my goals of performing a diversity of procedures in a technically demanding sub-specialty made Facial Plastic Surgery a very well suited specialty. I trained as Dr. Shan Baker’s fellow in Facial Plastic Surgery at the University of Michigan and then entered practice.

Can you tell us more about your clinic and the services available? 

My practice is a single specialty clinic. We have two plastic surgeons here at the practice, myself and Dr. Rick Schaler who is my partner and practice owner. We have eight other staff including one nurse, five estheticians, one front desk staff member and a billing manager. We offer the full range of facial reconstructive and cosmetic surgery. Our office has a fully functional operating room in which we perform all of our cosmetic procedures under IV sedation. On the medical spa side, we offer all of the available injectable treatments including Botox, Dysport, Xeomin, Restylane, Perlane, Juvederm, Radiesse and Sculptra. We perform laser services including Fraxel and MiXto (fractional CO2) resurfacing, vascular laser and laser hair removal treatments. We also perform a full complement of facial peels and facial treatments. Our patient population comes from the surrounding suburbs of Lone Tree, Highlands Ranch, Littleton, Parker as well as Denver proper.

How are you dealing with staff in your clinic?

Fortunately, we have not had the need to fire staff. The reason for this is that we’re very careful with the hiring process. The communication between members of our office is very clear. When we set out to hire a new member of the office we have a clear, articulated goal regarding our needs and the type of person we want to hire. Everybody in the office has a chance to veto a potential new member of the office staff. Each member of the office also has the opportunity to veto that potential candidate. We tend to hire from a pool of people already familiar to the office or from strong referrals from friends of the practice. We have avoided print advertising of open positions of late as this always leads to a huge response with relatively low yield of the type of candidate that we need.

For the front desk staff, compensation is hourly. For procedure or treatment oriented members of the office, including physicians, compensation is heavily weighted toward production. This is the most fair compensation method and encourages productivity. The formula is simple, clearly articulated and fair. Employees are paid a percentage of net collections. An employee can review their production at the end of each month, if requested. I review my own production at the end of every pay period and encourage the rest of our staff to do the same.

What laser technologies are you using now? How do you decide on new purchases?

We perform laser treatments including Fraxel and MiXto (fractional CO2) resurfacing, vascular laser and laser hair removal treatment. In terms of new purchases, laser companies really need to show us a substantial improvement in results before we will purchase new technology. We are marketed to by phone, mail, email and at conferences. I am interested in new radiofrequency technologies but I think the jury is still out and we’re holding out on making that purchase.

How do you market your clinic?

In terms of social media, we market on Facebook , Twitter, as well as LinkedIn. We’re trying to determine whether Pinterest can be leveraged with pre- and post-op photos and other images. We use social media to communicate with current and prospective patients with informational posts and product samples/ give-aways. Our email list of current patients is our most valuable marketing tool. Providing current patients with updates that they can forward to friends is invaluable. We also put on open houses and seminars that allow us to provide education, meet new patients and learn more about our current clients.

In the pay-per-click arena, we use Google AdWords with a relatively conservative budget. That has drawn a lot of traffic to our website and helped generate surgical cases. We have been testing the waters of direct mail and print advertising. Direct mail has had moderate result. Print advertising has been disappointing. We do not currently take part in Groupon, Living Social or any other daily deal sites. The main reason for this is cost and questionable ability to develop lasting relationships with users of these services.

What are the most coveted treatments/services in your practice? Have you tried removing some of your services?

The sun and dry air in Denver are the reason why people flock to this area. However, they wreak havoc on facial skin. As a result the demand for lasers and peels here is tremendous. On a volume basis, Fraxel skin resurfacing and Botox are the most common services in our office. However, the fixed cost associated with these services is significant. From a revenue perspective, surgery provides the greatest revenue and greatest profit for the practice. About 75% of our cases are elective in nature. We have not dropped any procedures recently. When I joined the practice, I introduced Sculptra facial injections and Radiesse hand rejuvenation and we’ve seen high demand for these treatments. 

What have you learned about practicing cosmetic medicine?

I’ve developed a thicker skin and learned not to take things personally. In the past, when a patient booked surgery with a competitor I assumed that I had erred in some way or not provided excellent photos of patient results or …. I’m noticing today more and more patients that will meet multiple surgeons and come back to book surgery with me. When I’ve asked why, the answers that patients provide are incredibly vague. It really is a gut feeling that people have that you are or are not the surgeon that will provide what they’re looking for. All we can do is provide as much information and education, quality photos of surgery results, a top notch facility and a warm, caring environment to convince patients that we’re the right team for them.

Any last thoughts on advice for your physician colleagues in the cosmetic industry?

I would urge physicians, especially in the plastic surgery realm, to compete by providing exceptional service. With Groupon and other daily deal sites, there is increasing pressure to compete on cost. Some of these deals will temporarily drive patients into the practice. However, few are likely to be loyal patients when the practice down the road runs an even cheaper deal. The daily deal trend has provided consumers with cheap (not necessarily quality) services. However, this has come at the expense of sustainability for practices that jumped in without doing enough research. The bottom line is that daily deals will lead to a spike in volume composed of largely price-oriented patients. Further, the deal seeking crowd is unlikely to see the value in your services. Continuing to drive down prices when our costs are fixed is not only unsustainable but diverts your attention from providing services, such as surgery, that are the profit engine for the practice. When you offer services at cost, you CANNOT "make it up on volume."

This interview is part of a series of interviews of physicians running medical spas, laser clinics and cosmetic surgery centers. If you'd like to be interviewed, just contact us.

Fractional Laser Resurfacing Chat

Wednesday March 11, 2009.

9 - 10 PM EST

To join this live fractional laser resurfacing chat, just click this button (at the right time).

Chat Room

Participate in the conversation as Fraxel, Lumenis, MiXto, Juvia, Dot, Lutronic and others (even a PreOwned Laser Dealer) try to convince MAPA Man to purchase their Fractional CO2 Laser. Fractional Erbium and Cutera Pearl Fractional will also be invited.

Wednesday's Chat is going to be about all the Fractional Technology.

  • CO2, Glass Erbium, Erbium, Pearl
  • How deep, What Percent of Surface Area
  • Ablation vs Coagulation
  • Dwell Time, Spot Size

We are going to discuss it all! Everyone is Welcome. We will have experts on the Sciton ProFractional, Lumenis UltraPulse, Juvia, Fraxel and others

Discussions include treatment perameters, effectivness, cost, the technolgies and anything else of interest. All interested parties are invited. Reps who identify themselves and are willing to engage in open discusion are also welcome.

To participate: Click the launch window button above at the scheduled time.
Looking forward to seeing you.

Read Previous Chat Transcripts

Next Live Chat: Fractional CO2 Lasers

Fractional CO2 Laser Disccusion:

Wednesday March 11, 2009.

9 - 10 PM EST

Participate in the conversation as Fraxel, Lumenis, MiXto, Juvia, Dot, Lutronic and others (even a PreOwned Laser Dealer) try to convince MAPA Man to purchase their Fractional CO2 Laser. Fractional Erbium and Cutera Pearl Fractional will also be invited.

Chat Room

Discussions include treatment perameters, effectivness, cost, the technolgies and anything else of interest. All interested parties are invited. Reps who identify themselves and are willing to engage in open discusion are also welcome.

To participate: Click the launch window button above at the scheduled time.
Looking forward to seeing you.

Read Previous Chat Transcripts

Fraxel 1500: Rashes, reactions and treatment protocols.

More from the Fraxel 1500 crew here at Medical Spa MD Forums; Fraxel 1500 treatment protocols, rashes, and reactions.

In response to a complaint of redness after a treatment with the Fraxel 1500:

Maybe this can help...

I have seen rashes like this occuring after thedoctor (chiropractor) at my office performs a fraxel treatment. He is known to not wipe the numbing cream off thoroughly and then puts the gliding gel on directly after. After performing the treatment he does not thoroughly clean the skin and immediately puts aloe on the skin. Clients usually come in days later complaining of a rash and itchiness, especially on the cheeks and chin. Im guessing the rash is from a combination of the heat and multiple substances still being on the skin. It is very important to make sure that the skin is very clean before, during and after the treatment. The topical we use is a 7/7 lidocaine/tetracaine combo and most clients that I've treated come out pretty good without any complications after aside from the swelling.

After the treatment I let the client sit with cold aloe vera along with the simmer chiller blasting cold air onthe face for about 15 mins. Then I have them rinse the skin and I immediately apply the Neocutis BioRestorative Gel that is very light in texture and great for post op care. The Neocutis line is great for burns, scars, rashes, irritations and is best for after fraxel treatments for the first week. It helps the skin get back to a normal state. i usually sell these products along with the Fraxel package so that the client can use the products at home and continue caring for the skin properly. Using anything thick like a vaseline base, bacitracin, heavy creams immediately after the treatment and during the first week post op will irritate and clog the skin and cause more complications.


Fraxel 1500: Pain control when performing fractional treatments.

There are some new comment threads of interest in the Physician to Physicain Forums including this one on the Fraxel 1500 and pain control when performing treatments.

What is the strongest numbing cream that you can order from a compounding pharmacy?

I currently get a combination of lidocaine/prilocaine that the pharmacy will not tell me how and what concentration it is. It is better than Emla, but is there anything else out there? Currently we are getting people through the CO2 first pass with my cream, a 10 mg of Vicodin and 2 mg of Ativan, all PO, but when it comes to the dynamic phase where I blend, they start squirming. I am at the point, I may start to do conscious sedation with Fentyl and Versed. If anyone is using the Lutronic CO2, my settings are 100-160 mJ and 100-150 spots/cm2(density is automatically calculated for you)...

Fraxel, Thermage, and CO2 Laser Physician Chat

You'll want to make you take advantage of the newest feature on Medical Spa MD, MAPAs live discussions and chat archive.

Last Chat: Tuesday, Jan 27 at 8PM EST
Thermage, Fraxel, and CO2 Laser Ablation

The discussion will include treatment perameters, effectivness, cost, the technolgies and anything else of interest. Physicians with experience are invited but the chat is open to any interested parties. Fraxel, Thermage or other reps who identify themselves and are willing to engage in open discusion are also welcome.

The transcripts of previous chats on Marketing and Fraxel are already available on the new MAPA Chat Archive along with a new area for reviews of medical spa technologies.