1 + 1 + 1 = 10: The Additive Effect of Combined Procedures

Although I am an ophthalmologist by training, I have streamlined my practice around medical aesthetics injectables; in particular, toxins such as Botox (onabotulinumtoxinA; Allergan, an AbbVie Company), fillers such as Restylane (cross-linked hyaluronic acid; Galderma), and collagen stimulators including Radiesse (calcium hydroxylapatite; Merz). For simplicity, I do not perform surgery or use lasers or energy-based devices. These unique injectable products, combined with our enhanced understanding of the aging process, allow us to more completely and effectively address patients’ concerns.

As is true in nearly all fields of medicine, the availability of noninvasive and minimally invasive therapies has increased dramatically. At the same time, more physicians are becoming more specialized. I think of my practice as a high-end restaurant with a limited but superb menu, as opposed to a diner with a 10-page menu containing merely average food.

INSTANT GRATIFICATION

I focus my practice on injectables primarily because patients can quickly notice and enjoy improvements in their appearances. We cannot underestimate the power of instant gratification. Similarly, LASIK patients can enjoy improvements to their vision immediately after surgery by simply looking across the treatment room after their procedures. After LASIK, they can immediately read as well. Often, they start crying tears of joy. These experiences leave indelible marks on patients, which inspire them to share their experiences with their friends. These word-of-mouth referrals underpin all successful practices, including mine. I rely on my patients to market my skills, which has allowed me to avoid ever paying for advertisements.

I am passionate about working with medical aesthetics companies of all sizes, from startups to large businesses, to continue to improve patients’ experiences through new drugs, devices, and technologies. I have supported RVL Pharmaceuticals with its product Upneeq (oxymetazoline 0.1% drops), a new type of product that treats acquired blepharoptosis and quickly causes patients’ eyes to appear more wide open. My upcoming clinical trial with Peregrine Ophthalmic will test an injectable drug that targets unwanted under eye bag fat, which would improve the appearance of patients’ treated eyes and is only achievable via costly incisional surgery. These products offer (or will offer, if approved) comparatively low prices and/or simple means of administration and thus are great entry points into injectables for new patients.

Other companies in the industry are serving medical aesthetics patients in innovative ways. I have partnered with Acorn Biolabs, for example, to support the rollout of its noninvasive cryopreservation solution to preserve healthy follicle cells for use in future cellular treatments. Acorn Biolabs is distributing its products through medical providers that also offer injectables services, thereby offering providers an opportunity to broaden the ways in which they serve their patients. As another example, STRŌMA Medical is developing a noninvasive laser system for permanent eye color change. With approval, this technology would be the first of its kind.

The industry is also developing solutions to address adverse events when they arise as well. For neurotoxins, practitioners have few options, if any, to reverse adverse events, such as ptotic eyelids, heavy eyebrows, and worsening malar edema, which is particularly noteworthy for new longer-duration neurotoxins. I am conducting a clinical trial for a startup called DelNova, which is developing a novel drug that would allow practitioners to reverse adverse events that are caused by neurotoxins.

HAVING THE CONVERSATION

When counseling prospective patients who are considering medical aesthetic services, I encourage them to articulate their desired physical changes, if possible. This is similar to patients describing their symptoms to primary care physicians. In my experience, patients invariably tell me that the areas around their eyes or their mouths make them look old. Ultimately, practitioners aim to enable patients to identify their symptoms and then trust practitioners’ expertise in developing treatment plans. You might not be able to finalize treatment places all at once, but patients can complete corrections over their next few visits. It is crucial not to wait too long before those touch-up visits.

How do I ensure that my new patients, who have never met me before, will trust my recommendations? I strive to credential myself so that my patients feel confident with my skillset. I also discuss the following with my patients: my level of experience, my commitment to safe and outstanding outcomes, and my desire to deliver outstanding service. One must embrace a different mindset to be successful with medical aesthetics, including recognition of the way that bundling services can enhance patient outcomes, because one plus one plus one does not equal three in medical aesthetics; it equals 10. I do not use a handout with service “packages” and corresponding prices. Rather, I develop a custom treatment plan for each patient, which is much simpler and more organic. Also, as an owner-operator, I have the operational freedom to do what I think is best.

For medical aesthetics, I want to focus on outcomes—not how many syringes I use. All the patient cares about is whether he or she looks better and likes the result. If the patient is satisfied, then I am satisfied, too. We cannot lose sight of what is really important: each patient’s excitement once the procedures are completed. When patients receive these treatments, there is no question that they look better, but they also feel better and are happier. It is not just about the lines on their face. It is much more than just skin deep.

BECOME THE BEST

By being the best practitioner you can be, you can truly instill confidence in your patients, provide outcomes that exceed patients’ imaginations, and ensure patients’ comfort throughout the experience. Patients remember how they look and how you made them feel. This also extends to how your entire staff made patients feel, from the time patients initially contact your clinic, to when they open the door for their visit, to when they leave, and if or when they receive follow-up calls to ensure that they are okay.

Little things add up to big things that exceed the sum of their parts. In medical aesthetics, one plus one plus one does not equal three; it equals 10.