I was recently faced with this exact question. In order to figure out where I wanted to the spend money and invest in my practice, I assessed my current procedure offerings and services and what areas, procedures, or technologies I was missing. I had surgical tightening with my OR surgical procedures, injectable treatments, and even minimally invasive tightening procedures (ThermiTight) accounted for. What I really was lacking was a true non-surgical, non-invasive, and no downtime skin tightening procedure that worked! Additionally, I am not a fan of technology where multiple treatments (sometimes up to six) were needed to see a result. What I picked would have to fit within my “brand” as a facial plastic surgeon. On top of everything, if an extender in my office could perform the treatments while supervised, that would be an added bonus.

As I was walking through the aisles of the Expo at the Miami Cosmetic Surgery Meeting in February, I looked at various treatment/device options, but nothing checked all of the boxes that I was looking for…until I came upon the Sofwave device. The high-frequency, low-divergence ultrasound makes sense in its ability to cause a micro-injury directly to the mid-dermis, which is a very important layer in creating skin tightening. Another reason I wanted to add this device to my office is because it offers painless, non-invasive, skin tightening for my patients in a single treatment that my extenders can safely perform. Finally, the financials behind this device make sense in my practice. The average disposable costs are about $250 per treatment, which allows me to charge somewhere between $1,800-2,000 per treatment. That treatment cost is doable for most patients in my practice, even if we repeated the treatment for maintenance every eight to 12 months.

—Jason Bloom, MD, FACS

A few years ago, I would have used this money to purchase a new cutting-edge device. But how I ran my practice then is very different from how I run it now. My focus now is less on devices and more on human capital and the value that a well-trained employee can bring to an aesthetic practice.

You cannot be everything to everyone, and you simply can’t do everything yourself. By carefully evaluating the practice overall, you can create profit centers around specific employees (e.g., nurse injectors), and previously outsourced departments (e.g., Digital Marketing/Social Media) can be brought in-house. One of my mentors from a business school course recently said that most Plastic Surgery practices run too lean and are too afraid of leverage. This has certainly been the case with my solo practice as I strived to “trim the fat” that I saw previously in my group practice. I trimmed too far and went too lean. After really looking at the financials, I realized my errors and pivoted.

Last year, I brought in a full-time Digital Marketing Director to help build our social media reach. This year, I plan to bring in a nurse injector to help grow our facial injectables. The following year I will pivot once again based upon successes of these specific departments as well as growth of the practice overall.

—Gregory Buford, MD, FACS

With thoughts of the COVID-19 pandemic in mind, we all will understand that $100,000 is more serious a number than before, whatever the outcome of the pandemic. This sort of event has a way of sharpening focus on what counts and what is frivolous. Additionally, I have to admit that my thoughts on my priorities and my clinic’s priorities have changed to some degree.

Having said this, my spend at this time would be on digitally enhancing my clinic footprint. Knowing the changes this pandemic forced on clinics that were not digitally fluent and ready for telemedicine, my first recommendation would be to get an electronic medical records system that is telemedicine-ready and invest in computers, iPads, and software that allow for maximum usage of telemedicine for their employees.

Additionally, I would invest a small amount in Zoom membership, which might allow for work-from-home opportunities for various employees.

Not much may remain after this expenditure; I would invest in digital advertising and education on these opportunities. It is essential to understand and leverage Google and Bing to bring patients to your office. Without a clear strategy in these areas, you won’t have growth or even parity for your clinic in the future.

—Joel Schlessinger, MD, FAAD

I would invest in new technology to augment the services at LUXURGERY. We pride ourselves on being innovative in the Aesthetic Plastic Surgery arena, so adding meaningful new technologies is imperative to our mission.

—Sachin Shridharani, MD