Fox News reports that an enterprising Arizona cosmetic surgeon, Dr. Semone Rochlin is offering layaway payment plans to patients to enable them to afford the aesthetic treatments they desire.

"I call it a savings account for my patients," said Rochlin, 42. "Offering a payment solution where no credit is needed is a financially sensible alternative in today's market. It's my answer to the economic recession."

To read the complete article, click here.

In the article, the president of the American Society of Plastic Surgeons (ASPS), Richard D'Amico is quoted saying "It appears more consumers are choosing the less invasive cosmetic procedures because of the economic downturn".

While the article reports using layaway plans for cosmetic surgery, it could be expanded for package treatments such as laser hair removal or combination skin rejuvenation packages (chemical peels, Pearl Fractional, IPL such as LimeLight and/or Laser Genesis). 

It's time to get really creative!  Your patients will appreciate it.

Advance for Healthy Aging has an interesting article on aesthetic marketing.  It's not enough to do what you did in the past (run a yellow pages ad) and wait for the phone to ring.  You have to be creative and advertise more.

Having an effective call to action is vital - as you can see in the article:

"Your offer. In today's world, you cannot expect much of a response if you don't give your audience a compelling reason to respond and a deadline in which to do it. So many physicians pay for "Name Recognition" promotional efforts that are all about them. That's fine if you're not expecting anything more than a few patients telling you they saw your ad. But if you want new patients to come through your doors, it won't work. A well thought-out call to action will prompt the aesthetic patient to do just that-take action.

Consider adding a special offer if they respond by a certain day. This doesn't have to be a discount off your procedures. It can be a value-added benefit, such as a free skin care product, with the purchase of a service. The reality is everyone likes a good deal, and your aesthetic patients are no different." 

A time-sensitive offer works wonders - creates a sense of urgency.  So if you are having a special on skin tightening packages or procedures, then ensure your offer indicates that if the package is purchased by a specific date, then another benefit (say Laser Genesis treatments or microdermabrasion) will be included gratis.  Action-Benefit offers work very well!

Happy Holidays to all of you from Cutera!

Skin changes that progress with age

Advanced Skin Care starts with basic skin care on a daily basis. Daily skin care is necessary In order the achieve optimal results from chemical peels and Light Based Technology for skin rejuvenation.

It's not just your face that can show your age. Skin changes are also noticeable on your neck, shoulders and hands. These areas are frequently exposed to the sun, wind, changing temperatures and pollution, so they need to be moisturized and protected as well, especially from the sun's harmful UV rays.

Aging Skin

As presented by Antonio Campo Voegeli, MD at the American Society for Laser Medicine and Surgery

Twenty-Fifth Annual Meeting in Orlando, Florida, April 2005

 

Background and Objective:

The 1064 nm Nd:YAG laser has proved to be one of the most useful light sources for the treatment of deep vascular lesions. A deeper penetration and a lower absorption by haemoglobin makes this wavelength more useful for the treatment of deep or thick vascular lesions than the traditionally used shorter wavelengths (KTP, pulsed dye, IPL, diode) (Figure 1). However, problems with previously used Nd:YAG devices such as limited parameter combinations and pulse durations, non-optimal cooling systems, and uneven fluence distribution made them of limited value for the treatment of superficial or facial vascular lesions, as pain or risk of burning were common events. Since adequate absorption of this wavelength is achieved by haemoglobin, a system able to control depth of penetration through appropriate spot selection (Figure 2), with variable pulse duration to adjust to different vessel diameters, high fluences and optimal cooling systems to avoid pain or burning, should theoretically be able to treat any vascular lesion both superficial and deep or thick. An Nd:YAG laser with variable spot sizes (3, 5, 7 and 10 mm), highly-variable pulse duration (0.1-300 ms) and high fluences (up to 300J/cm2) (CoolGlide Vantage, Cutera) was evaluated for the treatment of a wide spectrum of vascular lesions.

A New Way To Treat Difficult Vascular Lesions

Special considerations: Exacerbating factors mandate acne treatments for ethnic skin

Acne vulgaris ranks as the most common dermatologic disease, regardless of skin type, and its pathophysiology is the same in light and ethnic skin. "However, there are special considerations for acne management in ethnic skin that must be taken into account to optimize outcomes," says Dr. Callender, clinical assistant professor of dermatology, Howard University College of Medicine, and a private practitioner in Mitchellville, Md.

The use of lasers in ethnic skin can pose a therapeutic challenge due to significant risks of post-inflammatory pigment alteration in this patient population. The greatest risk occurs in lasers with wavelengths in the range of the absorption spectrum on melanin due to the epidermal melanin absorption and resultant thermal injury in richly pigmented skin. In this article we will review lasers that have been studied in ethnic skin and will offer a practical approach to the safe use of lasers in ethnic skin.

The long pulsed Nd:YAG is the safest for laser hair removal in darker skin types.

A short pulsed nonablative Nd:YAG (Laser Genesis, Cutera, Inc., Brisbane, CA) has been studied in skin types I-V for the treatment of acne scars

Laser based technology and IPL technology may be used for a vascular treatment and skin rejuvenation. Clients often present with both pigmented lesions and facial veins caused by actinic damage.

Telangiectasias are small dilated blood vessels near the surface of the skin or mucous membranes measuring between 0.5mm and 1mm millimeters in diameter^.
They can develop anywhere on the body but are commonly seen on the face around the nose, cheeks, and chin.

Causes of Telangiectasia

Rosacea, acne rosacea, and actinic telangiectasia

Causes of Varicose Veins and Spider Veins

Varicose Veins and Spider Veins

Patient eye protection is imperative to prevent permanent eye damage from Laser based technology. It can difficult to perform a laser vein treatment, Laser Genesis or a Limelight facial if the patient safety goggles are not adjustable.

Download the PDF file for patient laser goggle

For further information, contact:

Bio2 Cosmeceuticals treatment products are designed to enhance healing time by reducing the patient's recovery time and redness (erythema) from chemical peels and ablative laser treatments.

Clients seek advice for advanced skin care for Acne, Melasma and skin rejuvenation. It is important to identify the root cause of the condition in order to recommend an appropriate and effective treatment.

Three main factors contribute to the formation of acne: androgenic hormones, plugging of the hair follicle, and bacteria.   7 Acne Myths

Melasma is hyperpigmentation in sun exposed areas. The skin care treatment plan for melasma may include topical medications, chemical peels and Laser based technology.

Laser Genesis has been found to be helpful as a part of skin care treatment plan for treating Melasma. However, it should be noted that anything you use to treat Melasma may make it worse. A treatment protocol that is very effective for one client will not work on a different client and may even make their symptoms worse.
R. Lierly, RN

Advanced skin care and Laser based technology has become increasingly popular and growing field of study for many health care professionals. Clients are requesting a number of diverse procedures when they seek our assistance. It is not uncommon to have a client who requests "Skin Rejuvenation". The skin care treatment plan may consist of skin tightening, Laser Genesis and a Limelight facial for a vascular treatment or pigmented lesions. It is quite possible that this same client may later request a chemical peel, Botox or fillers and even Laser hair removal. The diversity of the procedures requires the treatment provider to have a wide range of knowledge in order to adequately meet the client's needs. Some resources I have found to be easy to read and a very valuable resource are listed below. Of course, there are many specialized books that are available and can be found at the links listed below.

Cosmetic Laser Books

Laser and Lights Volume 2

Cosmetic Laser Surgery

R. Lierly, RN

Many factors contribute to the development of telangiectatic facial veins and leg veins. Age, heredity, pathological conditions, occupations that require long periods of standing and pregnancy can all contribute to development venous disease. A successfull vascular treatment is dependent upon comprehensive history including presenting complaint, active symptoms, history of vascular disease, and general health and occupation history. Varicose vein treatment may require a combination of Laser based technology and sclerotherapy to adequately address the client's needs. Any successful vascular treatment is dependent on the treatment provider being able to successfully locate facial veins, legs veins and any reticular feeder veins that are often associated with the superficial telangiectasias.

There are several tools that can aid the visualization of the superficial venous system:

Syris V600 headlamp uses cross polarization technology allows the user
to see approximately 1mm below the skin's surface. 

The new Venoscope^® II transilluminator utilizes an array of high intensity LED lights to transilluminate the patient’s subcutaneous tissue thereby highlighting the veins which absorb the light rather that reflecting it.

The VeinViewer by Luminetx® uses a combination of near-infrared light and patented technologies to image vascular structures, thus allowing physicians, nurses and other healthcare professionals to clearly see accessible vasculature

directly on the surface of the skin.

It's really important to correctly communicate the length of procedure downtime as well as the type of downtime; i.e. is it social downtown (redness) or clinical (i.e wounds with dressings) downtime.

If you set your patient's expectations correctly, and their downtime matches those expectations, then you have a much easier time and a happier patient. 

Using chemical peels as an example, the length of downtime for a chemical peel can vary based on the type of chemical used.  A mild peel is dramatically different than a deep chemical peel.  Trichloracetic Acid (TCA) is a common solution for medium to deep chemical peels. The depth of penetration varies depending on the concentration and amount of solution applied, therefore the downtime can vary.

Setting expectations correctly on downtime, follow up care, residual redness/dryness and expected results will help ensure that your patients are informed, compliant, and happy with their procedures - and so they refer their friends, family and colleagues to you. 

Skin of Color can present with unique conditions that must be taken into consideration when developing a skin care treatment plan.
Skin of Color is highly susceptible to Post-Inflammatory Hyperpigmentation and requires special care whether performing a chemical peel or using Laser based technology to treat pigmented lesions, performing Laser hair removal, Skin Rejuvenation or a Vascular Treatment.
The Fitzpatrick Skin Type Test is very important to help determine skin type. The FitzpatrickSkin Type Test takes into consideration an individual's genetic predisposition that may not be reflected in the color of the skin but can highly influence the individual's ability to form hyperpigmentation in response to trauma or the use of an Aesthetic Laser System.

--Renee Lierly, RN

PSP-Online has another great article about tracking your patients (not letting them disappear or move on to competitors).

"Focus on your current patient database. You could be sitting on a gold mine and don't even know it. 

Good-quality patient tracking will allow you to do the following:

• Welcome back long-lost patients who would return to you if given a chance;
• Motivate current patients to refer their friends, family, and colleagues; and,
• Encourage your patients to visit more often and to purchase products, procedures, and treatments."

Are you now offering the LimeLight Facial or Pearl Laser Skin Rejuvenation for pigmented lesion or wrinkle reduction?  Let your patients know. 

Do you have patients who now want to have laser hair removal after you  treated their vascular issues?  Remind them you can offer these services.

Do your patients have friends, co-workers, extended family members who have admired the results of your treatments?  Market your referral programs.

Put your gold mine to work for you.

Allied Health Association offers medical malpractice insurance for physicians working in the spa environment. This insurance was developed in response to an expanding need for liability insurance for the growing medspa industry. This insurance covers advanced skin care procedures and Laser based technology. The skin care treatments covered are skin rejuvenation procedures such as resurfacing, vascular treatment, chemical peel, Botox, fillers and much more.

Source: Modern Medicine Publish date: Jul 1, 2008

Renee Lierly, RN

Skin care treatment and skin rejuvenation plans may include chemical peels, microdermabrasion and Laser resurfacing in order to reduce pigmented lesions and produce skin tightening. Post operative care is imperative to successful results and favorable client experiences. biO2 Cosmeceuticals is a product line that has demonstrated the ability to reduce client discomfort, reduce post operative erthema and reduce healing time which improves patient perception of the procedure. This post operative skin care regime can be used after Laser resurfacing, microdermabrasion, chemical peels or burn wound care.

Renee Lierly, RN

Skin care treatment plans start with washing the face. Skin rejuvenation and improvement in the overall texture and quality of the skin can be achieved by combining Laser based technology and cosmeceuticals together in an advanced skin care program. It is important to wash the face with something clean in order to prevent introducing bacteria into the skin. One simple way to achieve this is by the use of disposable daily cleansing pads, such as Aveeno Positively Radiant Daily Cleansing Pads  These dual-textured cleansing pads are smooth on one side to lift away dirt, oil and makeup and textured on the other side to gently exfoliate and smooth away dry patches. Gentle enough for everyday use and even for sensitive skin. Additional Product Benefits Include: soap-free, oil-free, hypoallergenic, noncomedogenic.

Travel tip: Count out the number of pads needed for your trip, add a small amount of your favorite facial wash, place in zip lock bag. They do not count as a liquid or a gel. You can always wash your face with a clean, soft pad or use the textured side for a mild exfoliation.
 
How to wash your face 

Renee Lierly, RN

Less text is better.  You do not need to list every special you can offer on laser hair removal, chemical peels, facial veins, leg veins, Pearl or Titan.  

Include your branding (images, logos, colors, other branding elements) and choose a model who is attractive but who is also age-appropriate.

Cutera's advertising has usually included age-appropriate models.  They are attractive women and men but they are not perfect.  They have smile lines around their mouths and eyes, they have imperfections and they look real because they are real. 

They are not 17 year-olds who are then airbrushed to impossible perfection.  Who can possibly identify with someone who looks impossibly perfect?  You want your patients to identify with your model.  Your model should remind your patients of themselves or take them in a direction they wish to go which is NOT looking perfect or looking 16 again - but looking attractive, confident and happy.

GCI magazine has a great article with tips on creating beauty ads.  While it's written towards the beauty industry (Dove and L'Oreal are mentioned), the tips are true for aesthetic practices trying to attract new patients.

The brilliant folks at Laser Skin Solutions came up with a great promotion for Mother's Day.

Teaming up with the number one station in Palm Beach County (with whom they advertise), Karen Lederman and her team are offering an aesthetic treatment package valued at over $5,000.

The station, in conjunction with this contest, is also giving away a $200 laser facial at Laser Skin Solutions during a popular day segment where they promote the contest.  They are asking listeners to nominate a mother in need of a makeover for this contest and directing them to their web site where the contest is featured.  The contest was also part of an eblast to a 30,000 opt-in email list of listeners.  

This is great exposure for Laser Skin Solutions!  Lots of station listeners are hearing their clinic name and learning what types of aesthetic services they offer (BOTOX, fillers, laser hair removal, skin rejuvenation, microdermabrasion, advanced skin care such as Obagi, etc.).

In the first five days of the promotion, the station received over 40 submissions (photos plus a 50 word story on why that mother needs a makeover).  

Think about contests you could create yourself with the support of a local media outlet (radio, TV, newspaper).  Ideas might include Mother's Day, Father's Day, Valentine's Day or the seasons (Spring, Weddings, Swimsuit season, Summer vacation, Back-to-School...).   

Bravo on a very clever promotion - highlighting an important day for women, donating services to help a mommy-in-need and successfully promoting your practice.  This is a win-win idea.