PermaTox: Botox results that are permanent?

PermaTox? I was sent a link to this page by a patient who was asking my opinion about this treatment.

Has anyone heard of this Permatox proceedure? The last line of this pitch discloses that it was developed by prominent cosmetic surgeon named Guillermo Blugerman. In looking up Guillermo Blugerman on Google it seems that he's a surgeon from Argentina.

Any plastic surgeons on the boards here heard of PermaTox or have an opinion on it?

Here's the pitch for PermaTox from a medical spa web site:

PermaTox – A Brand New Procedure That Promises Botox-Like Results That Are Permanent

Tired of frequent Botox injection visits? PermaTox might be the long-term wrinkle solution for you! A new procedure that promises to give you longer lasting results without the needles!

PermaTox - has been tipped as a possible future anti-wrinkle remedy that uses a thin surgical thread to sever the specific nerves that cause frowning, which results in less movement and fewer lines.

While PermaTox patients might still receive periodic Botox® injections in other forehead areas, sometimes keeping the glabella (frowning nerves between the eyes that makes that annoying furrow between the brows) relaxed can, over time, soften wrinkles in other forehead areas, as well.

An observed effect of this treatment has been that eyebrows gradually tend to become more elevated and horizontal forehead lines reduced, potentially eliminating the need for elective surgery or Botox injections entirely for some patients.

PermaTox , is safe and quick, taking only 30 minutes in the office to perform.

Dr. B_____ is the only one performing this procedure and trained by the prominent cosmetic surgeon Guillermo Blugerman, who developed this technique.

Interestingly, all of the Google search results for PermaTox are for pest control.

Surface Clinics in the South East: Gettin our groove on.

Midwest sent me an email calling out these other Surface clinics in Nashville who are opening clinics in the South East. Turns out that they are us and we are them. If you're a physician and think that you'd like to work in/on/with Surface in the new SE clinics, drop me an email. But be warned, if you're a doc just looking for a job don't bother. The docs we're looking for are smart and motivated. This is not a franchise.

Getting the Wrinkle Out...Of the Business Plan

 

Maren Scoggins is the vice president of strategic development at Surface Skin and Facial Rejuvenation, a new medical clinic in Nashville specializing in non-surgical cosmetic procedures.

Founded in November 2006, the facility functions as Surface's beta site where the business plan can be modified to accommodate an aggressive expansion plan that calls for five to 10 new sites to be developed throughout the Southeast within the next five years. Plans are already underway to acquire real estate in Naples, Fla., with further expansion planned in Orlando, Fla., Atlanta and Charlotte, N.C.

While this may seem like an ambitious business plan, the market for Surface's products and procedures is expanding rapidly, especially as a result of an entire generation of aging Baby Boomers that wants to continue to feel - and look - young.

Improvements in technology are also helping to draw customers who might otherwise be intimidated by invasive surgical procedures that usually involve a lengthy recovery period.

"People are going for things that are minimally invasive and more natural," says Scoggins. "The products in aesthetic medicine are growing very fast. Aesthetic procedures have grown by about 500 percent in the last five years."

Scoggins estimates the initial investment necessary to start a clinic at around $1 million, adding Surface hopes to balance its budget in its first fiscal year. The beta site in Nashville has 10 employees, but future facilities will be staffed with about half a dozen - including physicians, aestheticians and administrative personnel.

"Most medical spas don't have physicians on site," explains Scoggins, "We differentiate ourselves by offering services that other spas don't have."

The services include Botox, Thermage, facials, chemical peels, Intense Pulsed Light (IPL) photo facials and hair removal and the Natural Lift, a nonsurgical face lift that is reversible, involves only local anesthetics and leaves no visible scarring.

Pricing for the procedures varies from a few hundred to a few thousand dollars - no single procedure offered by Surface is listed at more than $5,000 - with financing options available. Costs are kept to a minimum by avoiding expensive hospital stays and anesthesia.

"Youth is hard to hang on to, but beauty you can have at any age," says Dr. Deborah Kondis, a Surface physician. "What we're after here are natural looking results."

Surface's office at 2020 21st Ave. S. appears and even smells more like a day spa than a state-of-the-art medical facility. A scented candle burns while soothing music plays from a flat-screen TV with ambient lighting. The walls are painted in gentle pastels meant to create a calm and inviting atmosphere.

The staff and the environment are not the only features meant to distinguish Surface from the competition. To educate and attract customers, the facility maintains a detailed Web site with frequently asked questions and comprehensive information about each procedure.

The site's goal - along with e-mail updates, educational seminars and free consultations - is to keep clients informed. Surface also offers gift certificates, which are helping to develop new business trends.

"In fact, a lot of people do this together," Scoggins says. "They want to stay young together. That's becoming more popular."

Scoggins, who developed the operational plan for Surface, was formerly senior operations analyst at BH1 - Private Equity Healthcare, Surface's parent company. Aside from Surface, BH1 owns and operates Baptist Women's Treatment Centers and Middle Tennessee Medical Center, located in Nashville and Murfreesboro respectively.

Aside from being a graduate of the Owen Graduate School of Management at Vanderbilt University, Scoggins studied in the pharmacology research graduate program at the University of Virginia, has an undergraduate degree in engineering from Vanderbilt and was previously a professional golfer.

In addition to marketing, advertising and staffing Surface, Scoggins is responsible for the real estate acquisitions for the planned out-of-state locations and for fine tuning the business plan as problems arise at the beta site.

"She impresses me every day," says Theresa Fletcher, a Surface aesthetician. "She's on top of it. I think she hardly sleeps."

Surface Medical: Opening in Nashville.

Surface is bringing a new tune to Nashville.

 
Nashville will be the headquarters and jumping off location for a new Surface company who's developing new medical cosmetic centers in the South East.

Surface SE, a new company formed expressly for this purpose, has built out the Beta site in an upscale suburb of Nashville. My partner at Surface, Dr. Aaron Barson, has been busy training the physicians for this new location.

This marks a change in the wind for the deliver of cosmetic medical services.

Why? Because Surface SE is bringing to bear the operations and scale of major business to the market.

There have been a number of franchises and startups that have tried in a limited way to do this before. There are a number of reasons that they've failed; undercapitalization, poor operational skill, and misunderstanding the market. We think that Surface SE has none of these shortcomings.

Surface South East

This new clinic is the first of a new breed of retail medical businesses. (It's the technology stupid.) that are able to compete as real businesses rather than individual physicians. 

Individual physicians will find themselves unable to compete on the same level. I don't mean this to be condescending. It's a fact.

Imagine this: You're a physician with a successful medical practice with loyal patients and great reputation. Your appointment book is overflowing with a host of patient eager for your services. But now a new clinic opens up down the street. It's offering treatments you've never heard and can't get. It's open 20 hours a week more than you. It performs to the highest medical standards and has customer service out the ying yang. It has an advertising budget that's 20 times more than you've ever spent. It has corporate programs, associate programs, affiliates with large businesses. In short, it runs as a professional corporation with it's sights set squarely on you. You find yourself in the position of the small town store whom everyone loves. But when Wal-Mart opens up in the same town it just doesn't matter.

Unlike the current batch of medical spa franchises (What I think of medspa franchises) these new clinics are built entirely around physicians. And not fly-by-night physicians who are there just a a figurehead, physicians who specialize exclusively in this area. Every patient, from upper lip hair removal to whatever, is see by a physician.

What will individual & group physicians do? 

Hey, we're not there yet. For the near future, the market will continue on in the same way with a few subtle changes. There will always be ways to be successful and compete, but it will necessitate changing. The consolidation of the market that will take place over then next 5 years will present opportunity as well as potential problems. Physicians who are able to adapt to the new paradigm will be able to grow, but the key will be to find a niche. 

Medical Spas Online hits 5000... So where's the beef?

It's something of a surprise to see that Medical Spas Online now has more than 5000 unique monthly visitors. I feel somewhat remiss in that I haven't been posting as regularly as I might. While I'm not big on excuses, here's what's been going on and a few things in the pipe.

• Surface inked a deal with a VC firm that's resulted in the creation of a new company, Surface SE (South East). This new company is headquartered in Nashville where the first SurfaceSE Beta site is about to go live. SurfaceSE is charged with a much larger roll out that should include a number of locations in the South East of the country. (There will be more on this as it progresses.)
• Blogging does actually take time and it's common for the occasional break to recharge the batteries.
• I've been devoting some time to two other start-ups that have resulted both from this blog and speaking to physicians:
• A business start-up book for physicians and businesses on how to conceive, open and run a cosmetic practice. The book will be available for download from this site when it's completed.
  
• And a consultation and training program for physicians in the aesthetic market. (You can read more about what I think of most of the current crop of consultants and franchises here.) I receive between 5 and 10 inquires for advice, training or consulting each week and have decided to put my money where my mouth is and build a program that works. I envision this new training program to be much more along the lines of 'mentoring' and consist of 'how to' training in the business, operations and marketing aspects of the business as well as medical training. You can send me an email (jeff 'at' surface-med.com) if you would like to be alerted when this system becomes available.
  
• There are a number of businesses that I'm either starting myself or advising others on. You can read more about these on my blog that deals with business outside of cosmetic medicine. You can read my Nimble business blog here.
  

If you haven't done so already, check out the Physician to Physician and Business Discussion areas. There's some great info.

An anesthesiologist moving into cosmetic medicine.

I had occasion last Friday to be visited by an anesthesiologist from Denver, who is interested in learning more about Surface Medical Spas.

Dr. Nelson is currently a member of a rather large group of anesthesiologists (55). In choosing her residency, she had felt that anesthesiology was a good fit since it was procedure oriented, and a high paid specialty. She has since been slightly disenfranchised, and to be honest - bored. She is also not terribly excited by the fact that she does a lot of pediatric anesthesiology, and is on call as a junior member of her group so that she has interrupted weekends and evenings.

Dr. Nelson called me a few weeks ago to ass about Surfaces cosmetic and business training for physicians. I spoke with her at some length about what we did, and what I thought we might be able to help her with. I suggested she come visit us, if she felt so inclined, to learn more.

(I have found in the past that, speaking on the phone is great, as far as it goes - but, the amount of information that you can convey over the phone during a half-hour or hour-long phone call is just not that great. Whereas, six hours of speaking with sedition's and staff, and treatments performed, and consolations done, and how our office is run, conveys a huge amount of information, and has always been extremely beneficial.)

Dr. Nelson in on a Thursday, and had booked a plane ticket home on Friday at around 2:00 - which didn't give us much time. I met Dr. Nelson for breakfast, and we talked about both where she was as a physician, where she wanted to be, how she might go about getting there (moving from Anesthesia into cosmetic medicine, is still a bit of a stretch) I was impressed with Dr. Nelsons interest and drive. She had already spent a tremendous amount of time researching her options and had looked at several of the current batch of medspa franchises and licensing consultants. She half-jokingly referred to several of them as 'evil'.

Doctor Nelson and Doctor Bergstrom spent a brief period of time just talking and chatting about history and backgrounds before was invited into one of Doctor Bergstrom 's consultations.

(Surface consultations are performed very differently than what is typically done. First of all they are free. Secondly they are an hour long. Our patients are able to spend an hour of physician time discussing anything they want, including how much stuff hurts, how much stuff costs, whatever... )

After the consultation, Doctor Nelson had maybe about another hour that I spent talking to her before she had to catch her plane. She was, I think it is safe to say happy that she came. She expressed to me a number of times during that hour that she felt she had found her new home.  In fact, one of the direct quotes was, "I want to be Doctor Bergstrom," which I found both humorous and flattering.

It will be interesting to find out if or how she pursues both her contacts with Surface as well as any other potential avenues. We left it with her thinking about what her options might be in the near future. Whether she joints Surface in some capacity, or opens up a clinic of her own, I  wish her the best of luck.