Adding a Device to Your New Aesthetic Practice

I decided early on that I wanted to offer noninvasive services in my practice because of the obvious economic benefits. In the last five years, the most significant growth in the aesthetic market has been in noninvasive procedures rather than surgical procedures. In fact, growth in noninvasive procedures has outpaced that of surgical procedures two to one. The market is moving in this direction, likely because patients are seeing the results of some of the newer devices and recognizing that they can get a good result without surgery. They get minimal down time, lower cost, and less risk.

Should You Do it?

When I was in training, we were told to wait five to 10 years before investing in a device. But that advice is outdated. The logic is based on the assumption that devices don't bring patients. While that remains mostly true, it's also true that the more services you offer, the longer you tend to retain your patients. Patients may present for one intervention and then return for a different intervention you offer.

So, once a practice decides it will offer devices, how does it pick the right one(s)?

A key consideration is demand—or anticipated demand—as well as local competition. There are devices that are patient retention devices—stalwart things like IPL and fractional lasers, things that you will be using in your practice regardless of how many systems are in you neighborhood. Then there are things that will attract new patients because they are new or the technology is highly marketed by the companies that manufacture them. Examples are Smart Lipo and Cool Sculpting. The former types of products have durability and the latter have a steep demand curve usually followed by a saturation and either flattening of demand or precipitous decline.

There's no exact science to quantifying demand, but there is a bit of a trick I use when researching a device. Most device companies have a physician finder site and alongside the physician name you can see if the physician is ranked on a certain tier based on numbers of treatments. If you see a lot of devices in your area and only a few doctors making the upper tiers of service, then you may have more systems than there is a demand for. It's not scientific, but it's a rough estimate. In terms of judging demand in your own practice, you can email a survey listing the things your patients would like to see most. It can also be helpful to maintain a list of common patient requests. In the end, the success of the device may depend more on how you integrate and market it than on existing demand, as described more below.

Considering Consumables

Nearly all devices have some type of thing that needs to be replaced, otherwise known as a consumable. Sometimes you need to change a diode after thousands of hits, sometimes a tip for a treatment must be used with each patient. Systems that do not require per-patient consumables tend to be more costly systems to purchase. But once acquired, the practice theoretically doesn't have to make continuous per-treatment investments in the system. Devices with consumables tend to have a lower base cost, but the recurring costs of consumables must be assessed and accounted for. It's the printer and ink model. The printer is not where the company makes the money, they make their money with the use of the printer.

There are two ways to look at consumable costs. Some practices see them as recurring costs that should be avoided. However, I take the alternative view: If the device manufacturer/marketer benefits from me performing procedures, then that marketer has an interest in helping me succeed. If I can lower the capital investment up front then I can offer more treatments and broaden my practice. This can be especially important for the new practice.

Watch It Now

“We've recuperated that probably two or three times over, and I think that was the hardest decision to make in practice in that first year—whether or not to invest in devices.” Watch it now on MODERNAESTHETICS.TV

From a practice standpoint, I was very new at the business when we added a device. I didn't know how to get the patients. I didn't know how to keep the patients. I didn't know how to make these pieces of equipment work well for us financially. I worried that once the equipment was dropped off, we'd have no consistent interaction with the company.

A device with consumables would foster a sort of partnership between our practice and the marketer, and this was very important for my first purchase. I wanted to partner with a company with experience in the aesthetic world—vast amounts of experience, vast amounts of data; test markets in different places; programs that they know work and things that don't.

The Outcome

Ultimately, I settled on a Thermage, Clear + Brilliant and a Liposonix (Solta). And that provided us with a basis on which to expand our practice at a fairly rapid pace. The reps were in our office trying to help us get our practice moving. They were offering us ways to conduct email blasts and programs and giving tips for treating our staff, so that they could become ambassadors to the brand of our practice and the device. They helped us to identify where we needed to reach out to get patients and how we needed to promote existing patients into having noninvasive procedures. It was a large investment that we've recouped probably two or three times over. We have since added aVaser Liposuction System and Isolaz for acne and are continually looking to expand our offerings.