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.

Laser Hair Removal&Permanent Hair Reduction

Each hair has 3 distinct components: the bulb, which lies near the insertion of the erector pili, the isthmus, and the infundibulum.

Pluripotential cells in the bulb and bulge areas cause growth of the hair follicle. Melanocytes are present in these areas. For most people, the bulb is approximately 4 mm beneath the surface of the skin (deeper in some individuals). Therefore, a considerable laser-penetration depth is required to remove the bulb.

Hair grows in cycles. Anagen is the active growth phase, catagen is the transition phase, and telogen is the resting phase. The duration of the anagen phase governs the length of hair at different body sites. Lasers are truly effective in only the anagen phase, when hair-matrix cells divide rapidly and migrate outward from the shaft and when the melanin load is at its highest. During the catagen phase, mitosis ceases, the hair matrix regresses, the papilla retracts to a place near the bulge, and capillary nourishment diminishes. In the telogen phase, the follicle detaches from the papillae and contracts to a third of its original depth, eventually falling out. The telogen phase varies in duration from one body area to the next. For example, the telogen phase may last as long as a year for hair on the leg.

The ratio of anagen follicles to telogen follicles varies with body location. Because not all of the hairs are in the anagen phase at any 1 time, laser treatment must be repeated to capture the new hairs coming into the anagen phase.

The timing of treatments is important because hair should be treated during the anagen phase. This phase is short (6-12 wk) for hair on the head, and treatments are spaced a month apart. On the trunk, the telogen phase lasts 12-24 wk, and 2-month spacing is best.

Author: Mounir Bashour, MD, CM, FRCS(C), PhD, FACS, Assistant Professor of Ophthalmology, McGill University; Clinical Assistant Professor of Ophthalmology, Sherbrooke University; Medical Director, Cornea Laser and Lasik 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

There are possible complications that are associated with the use of any aesthetic laser system. A comprehensive health history including past medical history, allegies, medications, hobbies and lifestyle choices (smoking, alcohol, sun exposure) help the treatment provider identify and prevent possible complications that may occur. Accurate initial assessment, reassessment and evaluation of the intervention along with client education are key to reducing the incidence of complications associated with Laser based technology.

Laser Hair Removal can present an uncommon side effect of
paradoxical hair growth along with the more common side effects found with permenant hair reduction.

Skin Rejuvenation and Laser resurfacing complications can be classified as mild, moderate or severe. It is important that the treatment provider be able to correctly identify and treat these possible complications. Do not ever perform a treatment that may produce a side effect that you are unable to recognize and treat. Accurate assessment and client education are key minimizing many of the potential complications.

Vascular lesions can be associated with other disease processes and require the correct diagnosis of the lesion before deciding on which laser based technology would be most appropriate for the vascular treatment.

Treating pigmented lesions or using an IPL device can prove to be challengeing to many treatment providers. Performing a test spot in the area of treatment and then evaluating epidermal response 48 hours later can be very valuable in preventing unwanted damage to the epidermis ("foot printing"). However, the test spot may take 1-2 months to demonstrate the signs of post inflammatory hyperpigmentation.

R. Lierly, RN

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

Customer incentives when used correctly, can both generate loyal consumers as well as attract new ones. It's important to offer incentives based on consumers' spending habit, interests and still be profitable for the practice.

Patients love frequent buyer programs.  These provide a way in which to take care of patients who regularly come in for aesthetic procedures such as laser hair removal, skin rejuvenation, vein treatments or injectibles. Patients want, even expect, some incentive for being loyal to your practice.  So, give them what they want.

How to get started?  Talk with your injectible and filler vendors, since they may have a corporate VIP program you can tap into. Botox® Cosmetic and Restylane® both offer a frequent user VIP card that offers a discount on their next treatment. 

Create your own with outside assistance - vendors have software programs or web-based programs to assist you in setting up, implementing and measuring your customer loyalty programs.

Be sure to create a system that is effective, fun, offers different levels of loyalty and most of all - is measurable.

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.

I visited the web site of an aesthetic practice recently and I noticed that they asked the visitor to sign up for their newsletter and receive a $50 gift certificate.

What a great idea - they collect the visitor's email (which has to be a valid email in order to receive the gift certificate).  They email a gift-certificate for a set dollar amount good for any non-physician treatment (i.e. can be delegated, not for retail products) such as BOTOX Cosmetic, laser hair removal, laser vein treatments or a skin rejuvenation procedure.  The certificate is good for up to one year from the date of the email (entire page must be presented). 

This is an enticing offer - they may choose a procedure which costs $100-$200 and this certificate gives them a 25-50% discount.  I would find this offer very compelling to visit and check out this aesthetic practice. 

For those customers who offer Pearl, Cutera offers an opportunity to provide a $100 discount on a customer's first Pearl treatment, seen on our Treatment Provider.  Just update your practice's information in your VIP account and to offer this discount.  Visitors will see a coupon icon next to your practice's listing which they can click on and print out.  The coupon has your practice's contact information included.

That is the title of a great article in Plastic Surgery Products' May 2008 issue.

"PR works by highlighting something special that promotes goodwill" - PR is marketing but is not considered advertising.  Usually there is little to no cost involved but it does take quite a bit of effort.  PR also has the advantage of appearing more credible to consumers than advertisements. 

Please read this article - it is chock full of great tips and advice on public relations. 

"Don't be afraid to tell the media about what makes your practice exceptional."  Maybe you have the safest laser for laser hair removal in all skin types or you've just acquired Titan or can offer a variety of vascular treatments.  Did you just attend an aesthetic conference?  Let the media know about the latest news from that event.  Talk yourself up but remember - PR is not advertising so avoid blatant self-promotion.

Skin, Inc. reports on studies that show growth in the overall number of aesthetic laser procedures performed. 

One highlight of the article is "Diagonal Reports forecasts that the cosmetic laser procedure market could grow by much more than 100% over the next three years."

and "Top cosmetic laser procedures are:

• Hair removal
• Skin rejuvenation
• Skin tightening
• Blemish removal
• Damage repair—sun, acne, tattoos and so on
• Cellulite"

That is great news for any aesthetic practice which uses lasers for hair removal, skin rejuvenation, photo-damage and skin tightening.

While working The Aesthetic Show in Las Vegas earlier this month, a colleague was approached by folks from Radiant Life magazine.  They are promoting their publication on aesthetic wellness.  What differentiates this publication is you (the aesthetic practitioner) can order customized copies of each issue with a personal message from you, your photo and your contact information on the front cover.

You can use the publication to help educate clients on new services or prospective clients on your array of services (from laser hair removal to vascular treatments to BOTOX to skin rejuvenation with Pearl).

I think it's an interesting concept.  Imagine having these publications at your local day spas, hair and nail salons and fitness centers.  Another thought is to use them at expos (bridal, wedding, exercise/fitness, career).  These kind of publications are viral - readers often take them with them from the salon/spa and then pass them along to friends or colleagues.

I think they would help drive new clients to your practice.  Find out more on their web site.

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.

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 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.



 

Recently, I received an advertisement from a local medical spa on my front door.  It was not mailed, instead they delivered it by hand.  It is a door hanger.

I thought this was a very clever piece of external marketing that works well in population-dense areas (urban or suburban areas).

The cost to produce and deliver this piece would comprise:

Design
Printing
Distribution

Typically with a postcard or mailer, half or more of the total cost of the promotion is from distribution; i.e. postage.

However this door hanger was hand-delivered.  Depending on a negotiated per-item delivery cost using motivated high school or college students, your delivery rate could be 5-15 cents per item which is much less than up to 42 cents in postage per item.  There are also companies that can produce and distribute this kind of piece for you.  Just do a Google search for "door hanger" and see what pops up.

This particular door hanger offered a perforated card at the bottom with a discount on future services that could be torn off and put into a wallet.  It was approximately the dimensions of a credit or membership card.

The body of the door hanger announced a grand opening, listed services such as laser hair removal, vein treatments, skin rejuvenation, BOTOX.  It also listed the MedSpa's contact info (address, phone, email and web site) and the entire piece reflected their branding (colors, logo, special font, images).  The piece had a glossy coating (a silk laminate feel) to make it weatherproof.  It definitely caught my eye.

Out of the box marketing ideas - try them as a test promotion, monitor their success and if they work for you, use them again!

Pulse duration is one of the most significant laser parameters to understand. Proper pulse duration is key to a safe, consistent and effective laser hair removal or vascular treatment. For this reason, it is typically the first parameter set by practitioners. Vein treatments include facial veins, leg veins and an occasional varicose vein treatment--although varicose veins are part of a larger medical condition not treated by a non-invasive aesthetic laser system.

Pulse duration determines the volume of tissue treated by the laser. Long pulse durations treat large volumes, short pulse durations treat small volumes. As an analogy, imagine a hot iron. A person can tap the surface of a hot iron that is several hundred degrees and not feel pain or get a blister. The reason is only the most superficial cells heated up during the time their finger contacted the iron. The heat did not have time to spread deeper into the finger. Conversely, it's extremely difficult to hold a hot cup of coffee even though it's far less hot than the iron. The difference is contact time. The cup is in contact for a long time so heat has time to conduct into the finger. Another analogy that compares to laser treatments is a pot full of hot soup. The soup stays hot in the pot for a long time, but if it's poured into 10 separate bowls, the bowls of soup cool down rapidly. This is because small objects give away heat to their surroundings more rapidly than large objects.

These same concepts are used when performing a laser vein treatment or laser hair removal treatment with an aesthetic laser system. The goal of every treatment is to heat the target you want to treat, but do as little collateral damage to surrounding tissue as possible. Large vessels (like leg veins) are like a pot of soup. They heat up slowly, and also don't give away their heat to their surroundings as well as small veins. This means long pulse durations will heat the vein, but still not heat surrounding tissue. In contrast, small veins, like facial veins, are very small and give away heat to their surrounding tissue quickly. This means energy must be applied in a short time--faster than they can give away their heat. If the pulse duration is too long, some of the energy (heat) ideally meant to treat the vein is lost into surrounding tissue heating the surrounding tissue, but not the vein. So, if the pulse duration is too long, more fluence (power) is required to achieve a clinical endpoint, but some power was wasted in surrounding tissue increasing the risk of complications. If the pulse duration is too long, it becomes impossible to treat the target regardless of the amount of fluence.

Using the correct pulse duration results in the most consistent outcomes with the lowest risk of complication. This allows the lowest amount of fluence to have the greatest impact on the target with the greatest degree of protection to the epidermis. In a nutshell, every treatment wants to use a pulse duration shorter than the time it takes for the target (hair or vein) to give away heat (thermal relaxation time) and longer than the time required for the epidermis to give away heat. Pulse durations longer than 5-10 ms provide epidermal safety by the same principal that prevents a long pulse duration from efficiently treating a small vein. The longer the pulse duration, the safer it is to the epidermis, but if it's too long, it will cease to be effective on the target.

So, in summary, how does someone select the correct pulse duration? Small targets require short pulse durations, large targets respond to long pulse durations. Longer pulse durations maximize epidermal safety. The following are approximate times to help select the correct pulse duration. If the duration is within about 5-10 ms of the ideal pulse duration, the treatment will achieve maximum efficacy and safety with minimum fluence. Remember, cooling is also a critical factor effecting epidermal protection and is also required for safe treatments.

Hair Treatment:

• Fine = 5-20 ms
• Medium = 15-30 ms
• Coarse = 25-50 ms
• Very coarse = 40-80 ms

Vein Treatment (size of vein is measured diameter):

• Typical pulse durations range from 10ms to 100ms for small high pressure telangiectasias to large low flow leg veins.

What does mid-level external marketing include?

1.  Print advertising—newspaper/magazine
2.  Website—additional content
3.  Public speaking—present to community clubs, host an evening seminar

So, you have implemented tier 1 marketing ideas (both internal to your existing patients and external to attract new patients to your aesthetic practice).  Ready for your next challenge at the tier 2 level?

1.  Advertise.  Carefully evaluate your local newspapers and magazines.  I don't recommend advertising in magazines that cover a wide geographical range or very large metropolitan area but instead recommend magazines that concentrate on your area (say a 10-15 mile radius around your practice).   Most of your patients; especially if you are just starting out, will come from the local population.  Look at Penny Saver type publications. Black and white publications will cost less than glossy magazines.  Look at community newsletters that are distributed in coffee shops or mailed to all residents as an advertising opportunity. 

2.  Put up more pages on your web site.  Add your before and after photos, expand about your skin rejuvenation procedures, add testimonials from happy laser hair removal patients, add anything that will increase your credentials (PR mentions or quotes, list any presentations you've given at medical meetings).  Work the design of your web site into a more branded look that carries over to your business cards, advertising and in-office signage.

3.  Offer to present at local clubs. For example, talk about your practice to local women's clubs and illustrate how your services help women with their confidence or self-esteem. Consider donating services to local fund-raising raffles or silent auctions.  It gets your name out there and builds goodwill with the local charities.  Donating services won't cost very much if you donate a microdermabrasion treatment or Laser Genesis mini-package; usually it's your time and a few supplies.  Be careful about donating a specific treatment as the recipient may not be able to have the treatment safely, for example if they are a Fitzpatrick Skin Type VI, you would not treat them with IPL. 

The more public speaking you do, the more you will be perceived as a medical and aesthetic expert in your community.  You can leverage this with your local media so whenever they have a question about a new technology on skin rejuvenation covered on the national networks or national print media, they will approach you to create a local story. 

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.

Let's start with an overview of the basics....

In today’s competitive environment, marketing activities play an important role in establishing a successful cosmetic practice.   Cutera has a number of aesthetic practice building tools, provided to all customers in the Cutera Success essentials marketing tool kit.  I'll share some of those tools with you.

The reasons why people need to market their services are understood, but oftentimes the particulars on the what, when, and how of marketing are less clear.

Each aesthetic practice must consider the nature, timing and extent of marketing elements that are right for them, and these will vary given different starting points, resources and personal inclinations.

Recognizing there is no cookie cutter plan, the following is offered as a guideline on how one might phase in the various marketing elements, beginning with Tier 1 and moving on to Tiers 2 and 3 as your practice grows.

Tier 1
Internal Marketing to Existing Patients
Should be prioritized above all else and be in place before Tier 2 is instituted

• First point-of-contact skills (reception/phone)
• Product and procedure training
• Patient mailings

Entry-Level External Marketing
Free or low cost efforts which are fundamental (or opportunistic)  

• Advertising in Yellow Pages - consider multiple listings including laser hair removal
• Web site - basic content on services provided, i.e. laser vein treatment and skin rejuvenation
• Networking
• Referral discounts
• Press releases - if "news", i.e. acquired new laser-based technology

Tier 2
Mid-level External Marketing

• Print Advertising
• Web site - additional content; i.e. value of skin care treatment packages
• Public speaking - present to community clubs, host evening event

Tier 3
Advanced External Marketing

• Advertising - additional venues such as radio, billboards, magazines
• Health, beauty, bridal, career and fitness tradeshows or expos
• Sponsorships
• Publicity
• Direct mail - beyond patient base

I'll go into specifics on each point separately with tips on how to apply this to aesthetic practices with laser-based technology.