New or improved devices are entering the market, all offering “dramatic” improvement. As the demand for less invasive procedures grows, the pressure to offer these options increases.


Gone are the days of the “impulse” purchase. With so many options, deciding to add a new technology to your practice (with hefty price tags) is a decision that needs careful evaluation.

When deciding to purchase an energy-based device for your practice, the first and foremost consideration should be cost. The machine alone is the tip of the iceberg. Other “hidden” costs include disposables, manpower (additional salary to non-MD providers), service contract, and diverting resources and space from other areas. Other questions to consider are where your patients will be coming from, how you will market internally to your current patient base, or whether you will budget for external marketing, such as advertising, news coverage, or internet and social media buzz. Additionally, office personnel must be trained to answer questions and be knowledgeable about the technology. All of these questions must be answered and considered when projecting your ROI (Return on Investment).

Another important step in the process is careful evaluation of the technology. All of these technologies are “miraculous,” according to sales reps. All of these will show great pictures, but only a few have adequate levels of evidence studies (Level 1 and 2 studies) supporting their claims. Many of the FDA approvals of these technologies are for the “temporary reduction” of cellulite and fat, or for skin tightening. A few have shown apoptosis of fat cells (CoolSculpting, Vanquish, and Liposonix, to name a few), but many have not.

A last question to consider is how to manage patient expectations. What will you do if (and indeed when) the patients' expected results are not met? Do you offer one or more treatments at no charge? Do you refund none, some, or all of their money? Do you give them a credit toward another procedure? Or do you let them walk out of your practice dissatisfied? This is a risk, as there are so many options at their disposal to attack your reputation online or in social media.

With the demand in this multi-billion dollar industry growing, we must make smart decisions regarding this new onslaught of non-invasive contouring devices. Do your research before jumping in with both feet.