According to a Dove survey of 8,000 men between the ages of 30 and 55 in seven countries, it appears that men are bothered by how they're portrayed in advertising.  According to Michael Kaufman, Dove gender expert consultant, "These are bad news about what our standards of men's bodies should look like, they're impossible images. Men can't live up to that."

Dove launched an ad campaign during the NFL's Super Bowl for its new line of men's skin care products.  What Dove's new ads convey and what their survey reveals is that reak men are not the fit, toned and buffed male models we see in ads.  Men are just as frustrated by those portrayals as women are annoyed by fashion images suggesting all women should looked like photoshopped-to-perfection super models.

Sharon MacLeod, a director at Unilever which owns the Dove brand reports "What our campaign does is look to celebrate men who have different responsibilities in life and are comfortable in their own skin," Ms. MacLeod says. "These are not guys who are ladies men or heroes or power-hungry. These are real men with real lives" -- film directors, business people -- and the campaign is "about their definition of success."


 

Of note:  Dove's survey found 65% of Canadian men are comfortable using women's skincare products but only 24% are prepared to admit to using women's products to their friends.

Outside of toiletries; other articles indicate that male demand for fillers, injectibles, liposection, laser hair removal and other cosmetic procedures are on the rise.  Does this indicate that it is time of use promotional marketing materials (brochures, posters, countertop displays, DVDs) which show men - in and around your practice?  Should your web site and advertisments appeal to your male patients?  Should your practice offer product lines for retail with a focus on male concerns?  Are male patients the new demographic?  It's an equal opportunity world of aesthetics!

Aesthetic practices should give extra attention to customer service — everything from the reception area to staff interaction with patients.

One area often overlooked is the impression given to patients over the telephone. 

Some helpful tips:
 

• Pick up the phone by the 3rd ring - make this policy clear with all of your staff
• Ask permission before putting caller on hold (and wait to receive that permission)
• Have On-Hold messaging that is up-to-date and details your services and current specials
• Smile when on the phone; it shows in your voice
• Introduce your practice and provide your name, then request the callers name and use it throughout the call
• Remember that the caller cannot see anything about your practice; they can only hear the receptionist's voice and interpret their tone and words
• Ensure the receptionist can answer questions enthusiastically and correctly on services such as laser hair removal, BOTOX, skin tightening, etc.
• Use professional terms (discomfort vs pain, underarm vs armpit)
• Thank the caller at the end of the call and obtain an action (schedule an appointment, request email address to send info, phone number for follow-up)

Providing a positive experience for the caller will help ensure they become (or remain) a patient.

 

Wendy Lewis, acclaimed author and expert in aesthetic consultancy, has a helpful article on "Instilling Loyalty in Cosmetic Patients" in the October 2009 issue of Plastic Surgery Products. 

Wendy recommends offering your loyal clients a reward program to encourage repeat business and referrals. 

Customer Loyalty Programs may include:
 

• courtesy vouchers
• offer of extra service
• complementary product
• volume discount
• refer-a-friend bonus
• discount on particular treatment
• trial of a new product or technology

Even offering a "thank you - using personal notes, calls or emails can be enough to make them feel special.  I highly recommend saying thank you after any aesthetic laser treatment such as laser hair removal or skin rejuvenation or injectible; and keep them coming back for more. 

Read Wendy's article to learn more.



 

Pigmentation Revisited

By: Peter T. Pugliese, MD

Skin-lightening Challenges

By: Zoe Diana Draelos, MD

• Going to happy hour events at local restaurants, bars and clubs to network
• Frequenting businesses near her location and introducing themselves to other professionals, merchents and employees of local business (examples include grocery stores, book stores, nail salons, hair salons, other medical professionals)
• Hosting open-houses or events monthly
• Thinking out of the box - all the time

Posted: June 2, 2009, from the June 2009 issue of Skin Inc. Magazine.

During a conversation with Dr. Jill Lezaic with Laser Skin Solutions Jacksonville, she used the term "e-myth" which stumped me.  What was an e-myth?  Dr. Lezaic explained it as a business term for companies whose founders are very good at creating products but not necessarily good at running a business to sell those products.

How would an e-myth work in aesthetic practices?  Physicians are trained to perfom medicine.  They are not trained in medical school how to operate a business and market their services. 

Physicians must learn the skill sets needed to be an entrepreneur.  It's not intuitive to know how to advertise laser hair removal or to differentiate their ability to treat vascular conditions on all skin types, safely.  For tips on jump starting your aesthetic practice, consider registering for Dr. Lezaic's webinar on practice marketing.  It's taking place live on July 28, 2009 from 4-5pm PDT but afterwards will be available on demand for your convenience.

I heard from a colleague who recently attended a customer event at an aesthetic practice.  The event was sponsored by Allergan and primarily promoted Latisse to their event attendees. 

The physician was offering a discount on Latisse to any attendee who purchased that evening or within a few days. 

I thought it was interesting that the physician did not promote her other services or products.  She sold ~10 units of Latisse at the event and of course, there will be a great opportunity to market additional services to those buyers going forward but I think it would have been a more profitable event had the physician enlisted additional vendors for support and opened up her event to more promotion.  She could have promoted laser hair removal (which can be safely performed year-round with CoolGlide Nd:YAG, even on tanned patients), non-invasive skin rejuvation (Laser Genesis, again, safe on all skin types, year-round), Titan, fillers and BOTOX. 

Open houses and customer events are a great way to have current customers (patients) bring friends and family, enjoy some wine and hors d'oeuvres while learning about new products and services and enjoying special attention (receiving goodie bags, being offered special discounts for packages paid for that evening or within 48 hours, referral $ or points if their friends/family buy product or sign up for packages). 


Customer events are great marketing tools - just be sure to leverage the event for all it is worth!

"Aesthetic medicine is an evolving field in both the medical and business arena. Commonly referenced business strategies and tactics used in retail and health care industries may not fit as well into our world. 

Retailicine is an approach that embraces the luxuries of retail while never compromising on our primary responsibility—doing the right thing medically for our patients." 

This quote is from Steven H. Dayan, MD, FACS and Tracy L. Drumm who co-wrote an interesting article, featured on Plastic Surgery Products. 

Their MICE principles are especially intriguing (MICE = Messaging, Information, Customer service and Efficiency).

Are you following these principles to successfully market your aesthetic laser and light-based services?



 

The reason for selecting YSGG over CO₂ is only strengthened when comparing YSGG to low power CO₂ lasers. Low Power CO₂ lasers (typically 30 watts and below) exaggerate the problems of CO₂ and have several independent problems as well. Histology obtained from data sheets for Deka’s SmartXide DOT and Alma’s Pixel CO₂ are included to illustrate the problems with devices that do not have sufficient power and energy density in each spot. 

Many people believe wavelength determines depth. For ablative lasers, this is not true. Wavelength determines the thermal characteristics of the laser, but depth of ablation is determined by power and energy density. With the right amount of power, all ablative wavelengths can ablate equally deep. Their thermal damage zones, however, vary significantly across devices.

A first typical problem of lower power CO₂ lasers is ablation depth. To ablate deep, lasers must have high energy densities delivered in short time periods. This requires high power. Depth of ablation is directly proportional to treatment results up to about 400-800 µm deep. Beyond this depth, there are two schools of thought. One thought is that greater depth is better, the other is that greater density is better. There is likely some truth to both. Either way, however, device should be able to treat at least 400-800 microns deep. 

In the histology image below, the image on the left shows a lesion from a single laser pulse. The ablation depth in this image is ~200µm (based on epidermal thickness of ~70µm). The histology image on the right shows a deeper treatment, but as can be seen, this required stacking 3 pulses (i.e. firing three pulses in the same location). Stacking pulses is challenging as even minor movements by the patient or practitioner can misalign the treatment holes as each spot is only several hundred microns in diameter. Further, it takes 3X longer to perform a treatment if stacked pulses are required. This means the patient experiences 3X as many shots per pass, which can reduce the tolerability of the treatment.

The second problem with low powered CO₂ devices is pulse duration. The primary problem with any CO₂ laser is excessive thermal damage. This thermal damage leads to increased potential for pigmentary complications and slows wound healing time. This is the reason all low power CO2 units were long ago abandoned for full resurfacing. This thermal damage is also a limiting factor or fractional CO₂ devices and can lead to the same complications as observed with full resurfacing CO₂ lasers if greater depth or density treatments are attempted. To properly perform a resurfacing procedure with a CO₂ laser total exposure time should be less than ~600µs to confine thermal damage. 

·        This is documented in the text “Cutaneous Laser Surgery” Chapter 6, Carbon Dioxide Laser Surgery.  In this text, it states that the thermal relaxation time for the volume of ablated tissue during CO₂ resurfacing is about 695 us and pulse durations of less than 950 us (0.95 ms) are sufficient to prevent clinically significant thermal damage

Because the laser is low powered, long pulse durations must be used to deliver sufficient energy to ablate tissue. In fact, many pulse durations as much as 100X longer than was experimentally and clinically proven optimal for CO₂ lasers.

The long pulse durations used with low power CO₂ lasers can be seen histologically in the two images above. In both cases, the coagulation / thermally damaged tissue zone is ~250-300 microns wide and deep. This means the treatment diameter of the laser is not just the spot size, but the spot size plus ~250 µm on each side of thermally damaged tissue, meaning the spot size is ~500µm wider than stated – leading to greater downtimes if treatments are performed to equivalent depths for equivalent treatment results.

The end result of minimized ablation depth, excessive thermal damage, and large effective spot sizes is that treatments are predominately thermal (not ablative), and are not very deep. Fractional non-ablative devices were completely thermal, and deeper, but required 4-6 treatments. Low powered CO₂ lasers do have maximized ablation (the only difference between ablative and non-ablative fractional lasers) meaning these treatments and results are closer to fractional non-ablative devices. Further, it is often necessary to perform multiple treatments to provide equivalent end results as highly ablative fractional devices (like Pearl Fractional). Many before and after pictures actually show results pre and post 3 treatments each spaced roughly 1 month apart.

Pearl Fractional was designed to reproducibly deliver deep fractional ablation with variable density to provide single-treatment results with maximum results and consistency. Accomplishing this and limiting downtime and complication risks required a wavelength capable of providing controlled thermal coagulation in a pulse-duration that is thermally confined. Pearl fractional was designed with sufficient power to ablate to necessary depths (typically 600-800 microns, which is ½ of maximum power). See comparison histology images below – image sizes are scaled to maintain approximately equal magnification. Histology images for the SmartXide DOT and the Alma Pixel CO₂ were obtained from product brochures from each company.

In a simple answer, Cutera selected YSGG (Pearl and Pearl Fractional) for thermal control with the desire to maximize ablation and control, but not eliminate coagulation (thermal damage). A little thermal damage during ablative procedures is a benefit, but too much can be a liability. Laser wavelength is the primary determinant of thermal damage. Power determines how deep an ablative laser vaporizes – and necessary power is determined by water absorption. At the edges of the ablation column though (sides and bottom) there is not sufficient power to continue ablating tissue. From this point outward, the zone of thermal damage is determined by how far sub-ablative intensity light penetrates through tissue – creating a coagulation zone. Cutera selected YSGG because this zone is 40-60 microns thick. Conversely, Er:YAG is about 10-20 microns and CO₂ is about 75-150 microns.

The coagulation zone (thermally denatured tissue) with YSGG is thick enough to coagulate normal microvasculature in dermal tissue, thus preventing significant operative bleeding. It is small enough though to be able to maximize ablation area without unduly increasing the size of the lesion. Note: thermally denatured tissue is dead / necrotic tissue that the body must also clear for the wound to heal. Additionally, excess thermal damage is associated with increased risks of pigmentary complications. With the thermal control of YSGG, Pearl fractional can maximize treated area and tissue vaporization beyond that of CO₂, yet still provide coagulation and thermal stimulation that is lacking with Er:YAG.

1. Don't drop prices (much) - instead concentrate on package deals, being very mindful of consumer price sensitivity
2. Leverage existing patients - reward them well for referrals
3. Market internally - use brochures, email newsletters, posters, dvds, photo frames, before and after books, countertop signage
4. Work social media - encourage patients to post positive reviews on as many review sites as possible such as Yelp, RealSelf.com, CitySearch.com...