This myth might be the cause. 

"8. MYTH: Let winter-ravaged skin hibernate — cut back on pro treatments.

TRUTH:  Actually, winter is one of the best times to start in-office laser treatments like laser hair removal, as pre-laser skin shouldn't be at all tanned, and post-laser skin won't tolerate sun exposure."

To expand on this particular myth, many of Cutera's aesthetic laser and light treatments such as Titan, Laser Genesis, CoolGlide Laser Hair Removal and CoolGlide Excel Laser Vein Therapy are color-blind; they can be performed on all six skin types and can be performed year-round, irregardless of tanned or tanning skin. 

Let your patients know they don't have to wait for Spring or Summer to start laser or light-based cosmetic treatments.  In fact, they will appreciate that they can get a head-start now!

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!

Boom Times Continue for Cosmetic Medicine Specialists

Consumer Demand for Aesthetic Procedures Remains Solid Despite Economic Downturn  (Click on "Featured Articles" ; scroll down page and look for title)

Here is a great way to promote your practice in today's tougher market...

There is a new popular patient / physician web site for cosmetic treatments titled "RealSelf.com". This web site allows patients to review products / procedures. The site then rates each procedure based on reviews. The site is gaining recognition with physicians and consumers. I heard a friend of mine mention it just the other day! It will be nice to encourage your customers and patients to use it to show the value of your Cutera Skin Rejuvenation products like Pearl, Pearl Fractional, Titan, Limelight, Genesis, CoolGlide Hair removal of dark skin types, and leg Vein therapy. This will help drive patients to your door too because there is a physician locator on this site!

If you could have your patients that have had a treatment, go to this site and fill out a real review. Site address is http://www.realself.com/. Please have them fill this in truthfully with their treatment experience. The site specifically states that it does not want "promotional" company pieces and will pull posts that are. If, however, you were treated, you represent a very valid and honest patient perspective.

There are already reviews for Pearl, Titan and Laser Genesis. Do a search for each application in the search bar and you should quickly be able to find reviews. To post a review, select "Write you review" from the bottom right of the home page, or below any procedure review section as "review it". Alternately, follow this link and fill in the form: http://www.realself.com/node/add/treatment-review

Also, please tell any people you work with that have had procedures and ask them to review the product as well. The more reviews and the more positive the reviews, the better for your Cutera technology and hopefully you can gain some new patients. If it was a demo patient that did not pay due to the nature of the treatment (training, demo, etc.) I recommend submitting the price the patient would have paid to be treated by the physician performing the procedure.

Here are the guidelines for posting at http://www.realself.com/community-guidelines

Make sure you sign up for the site for your office. Your practice and location become visible so this is a huge benefit to you if any potential customers in your area are looking at this site for cosmetic treatments. I suggest you have your customers post a review (hopefully they are predominately satisfied).

You can sign up by selecting the "Free Doctor Profile" at the bottom of the page and follow the form instructions from there

If you would like to list your practice on DermaNetwork

DermaNetwork is your premier online resource for skin rejuvenation. We offer you free access to a network of physicians who perform skin rejuvenation techniques.

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

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:

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

Do you keep track of your phone calls?  Ask the callers how they heard of your practice?

If not, you are missing a huge opportunity to measure your advertising and referral programs.

Tracking calls is not time-consuming or onerous.  Just use a form to ask some consistent questions and log the answers as well as track the follow-up action (i.e. send information, scheduled a consultation/appt).  Indicate their interest:  Laser Hair Removal, Titan, Pearl, Laser Genesis, Vein Treatment, Botox, Fillers, Pigmented Lesions.

Cutera provides a call-tracking form both in our Cutera Success essentials marketing manual (and a customizable version on the CD with the manual).  Once you have customized the form to your needs, print a number of them and put them into a binder or folder and put them by all phones used to take incoming calls.

Go through the completed forms each week (or month) and tally the calls.  If you are running two ads in two magazines, then be sure to ask the caller which magazine ad they saw so you can measure the results.  This will help you monitor not only how your advertising is working for you but also how many calls come from referrals or word-of-mouth.  You can also measure interest in specific procedures and see how adept your front desk is at "closing"; i.e. scheduling appointments or consultations.

A skin care treatment plan to manage the symptoms of Rosacea may include topical and oral medication, Laser based technology, avoiding agravating factors, skin care products and may even include camoflage makeup. Many treatment providers combine Cutera's Infrared Technology of Laser Genesis and the visible to infrared technology of a LimeLight facial (LimeLight 520nm-1100nm) to address the vascular treatment needs of flushing, diffuse redness and telangiectasia.
It is important to educate the client that a treatment plan for Rosacea only helps to control the active signs and symptoms. Rosacea is a chronic condition.

Treating Your Skin with "Intense Pulsed Light"

By Kevin C. Smith MD FACP FRCPC

About the author:
Dr. Kevin Smith is a dermatologist in Niagara Falls, Ontario with a particular interest in protecting the skin and in correcting skin problems resulting from aging, rosacea and sun damage. He is an expert in the use of Botox®, fillers, lasers and intense pulsed light to maintain and enhance the appearance of the skin, and have lectured on those subjects across North America, and in Europe, Asia and Mexico. Read more at www.smithlaser.com

--Renee Lierly, RN

---

Collect and develop your own testimonials.  Ask your patients to give you quotes.  Print them out and put them into a binder for your waiting rooms or reception.  You are going to want to protect their identity (use initials) but if they are happy with their laser hair removal treatments or their Laser Genesis treatments, they wil be happy to say so in writing.  And you will feel good after you read all the praise and positive comments. 

One way to get the attention of the patients who come into your office is to use either a TV with built in DVD player  or a large computer monitor showing patient education videos or before and after photos.

Cutera provides a DVD of patient before and after photos to play in reception areas or exam rooms.  The DVD has over 15 chapters to represent most platform configurations.  Just select the chapter appropriate for your practice and it will automatically loop on a computer or DVD player.

Cutera also provides its customers with those same before and after photos, by application (such as LimeLight for diffuse redness and brown pigment removal, ProWave 770 hair removal, skin resurfacing or vascular treatments), as video files (.avi files) that may be loaded onto a flash card and displayed on a digital photo frame with video capabilities.  Cutera's before and after video files do not have an audio component so they are appropriate for display even in the most peaceful medspa environment.

There are many models of these digital photo frames available.  We recommend the Coby 8-inch (DP-802) or 10-inch (DP-102) digital photo frames as the Coby frames are affordable, have a modern, clean look for a clinical or medspa setting and we have tested several models in-house and we know the Coby frames work with our files. 

These Coby frames also support files with audio so if you have video files with audio, you can display them using these digital photo frames as part of your patient education process.

Remember - your patients are a captive audience while they wait to see you.  They may not know all of the treatments and procedures that you offer.  Show them photos of patients treated for skin tightening, laser hair removal or Laser Genesis and they will ask you about those procedures.  Your $125 investment will pay off in spades.

The goal during any Laser Genesis procedure is to methodically move the laser across a region of the face (typically ¼ to 1/8th of the face at a time) creating a localized zone of heated tissue with vasodilation.  This is visible as blushing or reddening in the area and should be maintained for a period of time.  Additionally, the patient will notice the increase in tissue temperature and the greater efficacy of each pulse.  By the end of treating any region, the patient should definitely feel the treatment.  The procedure does not require any topical anesthetic or other numbing agents meaning that it is not a painful procedure, but if the patient does not experience some discomfort toward the end of treating a region, the results may less than desired.  Once the treated region is sufficient treated (treat to erythema and vasodilation - typically ~2000 pulses), move to the next region.

To achieve proper fluence delivery, the handpiece should remain within about 1cm of the surface of the skin (about the width of your index finger).  Further away leads to beam degradation and can affect treatment.

Laser Genesis is a very deliberate procedure and should be administered in a methodical manner to achieve optimum results on wrinkles, texture, pore size, and diffuse vascular redness (blush or rosacea).  The treatment depends on both the fluence / pulse duration settings and bulk heating, which can only be obtained by focusing on regions of the face delivering uniform energy across the entire area. 

Treatments are extremely safe on all skin types, but to ensure optimal safety, always move the handpiece to prevent delivery of multiple sequential pulses to the same location.  Allow at least 1-2 seconds after delivering a pulse in any location before hitting that same location again.

Laser Genesis works through two parallel actions to stimulate collagen, improve texture and pore size, reduce wrinkles, and improve redness and fine facial veins—direct absorption and bulk heating.  The first part (direct absorption) requires the use of 0.3ms (or 300 us) pulses.  As described in my blog about pulse duration, short pulses target small objects. 

The target for Laser Genesis procedures is the microvasculature in the papillary dermis.  The laser’s 0.3 ms pulse durations enable Laser Genesis to target these vessels while completely sparing the epidermis.  This enables extremely safe treatments at high rep-rates on all skin types.  Each individual pulse specifically heats up this vasculature closing the larger microvasculature that leads to the appearance of blush.  These treated vessels are then cleared away by the body and evoke a healing response with collagen stimulation.

The second mechanism of action occurs through repetitive pulsing.  The laser operates using a 5 mm spot size pulsing at 10 Hz.  This creates bulk heating in each treatment area leading vasodilation and an influx of blood and healing factors.  Vasodilation also increases the amount of target (blood) in the vessels improving the efficacy of each individual pulse.  In addition to the healing mechanism stimulated by treating the microvasculature, extended bulk tissue elevation also leads to collagen stimulation. 

Achieving optimal results with Laser Genesis is easy, and the device is exceptionally safe on all skin types.  Focusing on the mechanism of action, and treating to achieve these biologic responses will optimize results. 

Any devices that claim to have the ability to “mimic” Laser Genesis, must meet all the requirements of wavelength, pulse duration, fluence, spot size and rep-rate.  If pulse duration or fluence is compromised, the laser does not have sufficient energy to treat the microvasculature.  Smaller spot sizes mean less area is treated per pulse, so less heat is applied to the skin per unit time meaning that bulk heating is compromised.  A change from a 5mm spot size to a 3mm spot size reduces bulk heating by almost 3X even when using the same rep-rates.  If the rep-rate is reduced, the laser does not fire as many pulses per unit of time, therefore reducing the heat delivered to the skin compromising the effect created by bulk heating.

Telephone skills are crucial to supporting how you are perceived by the outside world, and a telephone call will no doubt be the first point of contact for new patient leads.  Think of staff members answering the phones as salespeople:  they should have people-skills, be well-versed in the procedures and, ideally, they will have at least sampled the treatments.   

Some helpful tips:

• The phone needs to be answered by the third ring, by someone who is warm and receptive and not disinterested or abrupt. You have all heard this over and over, but it's true. You never get a second chance to make a first impression, and the decision to book an appointment is influenced by whether the caller feels welcomed. If you must place them on hold, do not leave them holding for more than 30 seconds.

• The objective is to help them feel they made the right decision to call your office and that their logical next step is to book a consultation. Address their general questions informatively but briefly, without getting into the consult itself over the phone. Always try to transition back to the importance of meeting in person to discuss their particular needs and treatment specifics.

• Always ask where they heard about you, so you can track the effectiveness of your outside marketing activities.

Some helpful tools to develop:

Telephone scripts provide a general guideline for responding to inquiries.  Specifics about each procedure can be augmented from FAQ’s about Laser Genesis, Pearl, Titan, treating pigmented lesions with LimeLight Facial, using a chemical peel or treating leg veins.  Have FAQ's readily available by the phones.

Telephone tracking forms are useful to track the source and outcome of each telephone inquiry.

On-hold messaging scripts will help optimize your recorded messages.

Frequently Asked Questions (and Answers) are useful for each procedure (and system).  Offices may choose to give general price ranges on skin rejuvenation packages, for example, and offer either a free consultation or apply the consult fee to an ensuing treatment.   It's a Best Practice to not quote specific pricing over the phone.  You might quote a price for laser hair removal based on "assumed" time of treatment and find it takes much more time to treat some patients so always defer price quotes until you can see the patient or else use ranges.

Telephone scripts, Telephone tracking forms, On-hold messaging scripts and FAQs for Cutera applications are available to Cutera customers on Cutera's VIP site as well as provided in the Cutera Success marketing manual (and in softcopy on a CD in the back of the manual for customization).

Cutera announced our new fractional laser using the YSGG wavelength - a fractional version of Pearl at ASLMS.  We are very excited about the future applications of this ablative skin resurfacing technology as both a stand alone product and also combined with Pearl.  Fractional Pearl will complement our other aesthetic solutions nicely.

While working in the Cutera booth at ASLMS this past weekend, I took some time to walk around the exhibit floor with Karen Lederman, of Laser Skin Solutions, to learn about some new products for advanced skin care.

We stopped by PuriGenex where Dr. Suzanne Bennett applied a refreshing collagen mask to our faces. It minimized my fine lines and was an overall pleasant treatment.  PuriGenex is based in Santa Monica, CA.  Their collagen products are kept refrigerated to prevent them from denaturing.  They offer masks and serums for purchase.   

I also spoke with Laurie Walkenhorst of Carrollton, TX based Swiss-American, makers of the Elta MD Skincare line.  I've been a personal fan of their sun protection moisturizers and creams for the past few years.  Elta MD has a new Hydrovase Gel.  Their new skin care treatment seems well-suited to reduce redness and inflammation after laser treatments.

Another new and intriguing product on the show floor was the Ice Mask.  This mask looks like it has great potential for application post-laser procedures to cool the face and provide greater patient comfort.  Several Cutera customers are looking into adding this to their immediate post-Pearl protocol and I will follow up with them to see how effective the Ice Mask is for post-procedure cooling/comfort.


I found this video on the Ice Mask on YouTube; in Italian but I think you will see how it works.

More news soon!

Let's say that you have an existing practice with an established patient base.  How do you let your patients know you are about to acquire an aesthetic laser system, such as the Cutera Xeo with Pearl, Titan and LimeLight?  You will have the ability to treat your patients for facial veins, leg veins, laser hair removal, pigmented lesions and overall skin rejuvenation including skin tightening and laser skin resurfacing.

Wow, that is very exciting!

Your patients will be excited.  So, let them know your news in a variety of ways (most of which are inexpensive and easy to do).

   1. Signage in your waiting and exam rooms
   2. Patient education brochures
   3. Add the news to your invoices and receipts
   4. Direct mail to your patient base
   5. Reception
   6. On-hold messaging
   7. Staff evangelism

1.  Put up posters and/or countertop displays.  If you are pre-announcing, indicate that the services will be offered soon and encourage making appointments right away (before we are fully booked....).  Offer free consulations to existing patients.

2.  Brochures that educate patients are available from your vendors.  Cutera has standard patient brochures for all of our procedures and we are unique in our industry - we also have a web site where customers may order customized patient brochures.  Visit CuteraPatientTools for details.

3.  If you have a custom field on your printed invoices and receipts - add a line about your new aesthetic offerings.

4.  Send a letter with a brochure to your patient base.  Let them know what you now offer.  While it is great to target specific demographics, aethetics are of interest to most of your patients.  They may pass your brochure on using lasers for permanent hair reduction, vascular treatment, Pearl laser resurfacing or Titan to their children, parents, spouse or friends.

5.  Train your front office on your new offerings.  Give them Frequently Asked Questions (FAQs) or a phone script to use to inform, promote and soft-sell.  Consider having a sign at the front desk or have your staff wear buttons that say "Ask me about Laser Genesis" or another application.

6.  Every time you put a caller on hold, you have an opportunity to market to them.  You can record an on-hold message for a few hundred dollars.  Be sure to pick a package that allows you to update the message regularly so you include package information, seasonal treatments and holiday specials.

7.  Your staff are your evangelists.  Give them free treatments.  They need to know what the treatment feels like, how long it takes, what is needed to prepare for the treatment and be alert to the no-no's (such as tanning before IPL or using self-tanning products).  They should be so thrilled with their own results that their enthusiasm and positive comments will help create additional excitement in your patients who are considering any laser based treatments.