COMING NEXT ISSUE THE NEW MODES OF CO2 Lumenis continues to strive for versatility for their customers and their customers’ patients. Their safe, versatile and cost-effective CO2 laser, the AcuPulse™, just got even better. With four new modes of treatment, physicians now have access to 10 different modes and the ability to treat 34 aesthetic indications. Stay tuned to find out about the capabilities of the AcuPulse™, Combo™, StretchTouch™, FineTouch™ and ToeTouch™.
Table of Contents The Click Clique
4
Spring Break 4EVA: What to do When You Regret Your Tattoos
8
The QX MAX
10
Keeping Safe and Dry: Lumenis Protects Your Practice Investment, Rain or Shine
12
Complimentary, Complementary Cosmeceuticals
14
The Legalities of Aesthetics
16
Social media is increasingly becoming a critical part of external marketing strategy for physicians and practices across the nation. Facebook, YouTube, and Twitter all rank amongst the top 10 Android apps. This means that, in a culture where we are always moving from one activity to the next, being involved on social media will help you gain access to people during the many times when they’re not sitting in front of a computer. Who are the power players, and how can they support your practice?
MEET THE CLICK CLIQUE. 4 SPRING 2013 / REVENUE
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How to Connect: Create a professional Facebook page (not a profile, which is meant for individuals) for your company. Post information pertinent to your practice and patients three times per week. Avoid posting more often than that, as this may actually annoy your followers and cause them to unfollow you. By maintaining their interest through alternating promotional posts and engagement posts that present valuable information and the personality of your practice, you can maintain a stream of frequent communication similar to e-blasts.
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This is the neighborhood “Golden Boy.” He’s president of the student council, captain of the football team, the lead in the school play, and the organizer of the local food drive. His younger social media brothers and sisters such as Google+ and LinkedIn are constantly compared to him and asked, “Why can’t you be more like your brother?” Those who dislike Facebook are typically justified by his instability due to his desire to constantly to do more and be better. However, his popularity far outweighs his critics, as Facebook is now the 2nd most popular online destination, shadowed only by Google.
In a culture where we are always moving from one activity to the next, being involved on social media will help you gain access to people during the many times when they’re not sitting in front of a computer.
TWITTER He’s the philosopher of the crew and every thought he has (apparently) deserves to be shared. He’s chatty with a non-stop flow of information to anyone who will listen. Most of his popularity stems from his open-arms approach. He’s easy to join, and his followers can easily connect with one another. He’s simple, and a man of few words.
How to Connect: Use a social media platform like HootSuite to schedule tweets. This will allow you to share your practice’s specials around the clock, whether at 2am or 6pm, without being tied to the computer. Feel confident about repeating posts because tweets stream more quickly. Find and connect with new people and local business to expand the reach of your brand. 5
YOUTUBE YouTube is the social director and the party-thrower of the bunch because his goal is to provide you with the ultimate experience. YouTube, the 2nd largest online search engine, is the closest option to a virtual reality experience that our digital universe can offer. How to Connect: If a patient finally boils down his or her choices to two great doctors with the exact same credentials, they will ultimately visit the doctor with whom they feel most comfortable. Post videos of live treatments, clips of the staff answering frequently asked questions, and a video tour of the facilities to get potential patients feeling comfortable with your practice.
GOOGLE+ This is the Queen Bee. You’re not friends with her because you want to be. You’re friends with her because you have to be. To be on her bad side – or not to be noticed at all - could completely annihilate your social standing (or in this case your search engine rankings.) How to Connect: By creating your Google+ page as a Local Business, you can merge your Google Local Listing with your Google+ page by verifying it. Because Google+ listings show above the organic website results on the search engine results page, making it more engaging with videos, photos, and posts of your most recent specials can help you increase clicks to your website and outshine local competitors.
PINTEREST She’s the stage mom and the leader of the Ladies Who Lunch. Proud of her efforts, she shares pictures of everything from her kids to her pies, and provides tips for how to create a better life. Seventy two percent of Pinterest users are women; the aesthetic industry serves a high number of females, making this a natural match to the industry. Pinterest is the platform to watch for the aesthetic market. How to Connect: The aesthetic medical industry is about visual advantage. Post your before and after photos. In the description, link back to your website or boost your website’s SEO by blogging and utilize original photography on your blog. Then, pin directly from your blog to increase your inbound-link count through Pinterest followers who share your content. 6 SPRING 2013 / REVENUE
REALSELF RealSelf is the science nerd of the group. He’s educated about your procedures and knows exactly what makes a good doctor. He’s informed about all of the procedures on the brink of the field and asks informed questions. While he may not be the most popular of all, he’s King of the Nerds. His niche looks up to him and respects him as the online authority in his field. How to Connect: Target informed and serious aesthetic patients by answering questions and flexing your medical expertise. Flesh out your answers by including your YouTube videos. Make sure your profile is supported by your before and after photos. You can link your RealSelf to your Twitter and your Facebook page in such a way that you can automatically share your answers to questions across multiple platforms.
LINKEDIN LinkedIn is the workaholic of the clique. She’s focused on business networking over socialization. Because she’s built for business networking, she’s incredibly organized, sorting users based on location, profession, and industry. It is even easier to find users based on culture or gender. How to Connect: LinkedIn is primarily a platform for B2B companies so it’s a great way to follow and connect with products and brands. To connect with potential patients, join groups that focus on people who fit your target demographic. When you have events, create an online purchasing option (for free) via eventbrite.com, and share the link via the groups. LinkedIn sends emails to group members alerting them of recent posts. 7
Spring Break
A V E 4
What To Do When You Regret Your Tattoos By: Harold King
Well, it seemed like a good idea at the time. But it’s time that can cause us to rethink a moment. A moment when through either youthful defiance, loving dedication or drunken folly you got a tattoo. Whether a discreet little heart or a massive phoenix rising, it was how you expressed your individuality. No longer is it only the soldier, the biker or the “bad” girl who indulges in “skin art”. Today anyone over 21, from the accountant to the stay-at-home mom, can sport a full-on sleeve. In fact, one out of every five U.S. adults has at least one tattoo, according to a recent Harris Poll.1 And though statistics vary, it’s estimated that half of that group later regret the decision. That’s when it’s time to relinquish that bit of outward expression or at least modify your little devil into an angel with attitude. 1 The Harris Poll® Feb. 23, 2013, “One in Five U.S. Adults Now Has a Tattoo” Harris Interactive Inc. All rights reserved.
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The American Society for Aesthetic Plastic Surgery (ASAPS) reports that the number of people undergoing laser tattoo removal increased 43% from 2011 to 2012. 2The reasons to have a tattoo removed are varied, but the country’s unemployment rate is a major driving force. With jobs at a premium and Facebook “frisking” on the rise, employers have been selective in their choice of hires. Those seeking employment in banking or other conservative institutions may want to improve their chances at even being interviewed. Here are some things to know about tattoo removal. Have it done by a licensed dermatologist or plastic surgeon, as there is a slight risk of infection or scarring. A doctor will be most able to effectively follow up. 2 American Society for Aesthetic Plastic Surgery (ASAPS) 2012 Statistics Report
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ONE OUT OF EVERY FIVE U.S. ADULTS HAS AT LEAST ONE TATTOO
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Next be aware that no tattoo can be completely removed. Remaining color will depend on size, location, colors used and how long it’s been in place. Depending on the tattoo’s size, removal can take from 8 to 20 treatments at 3 to 6 week intervals at an average cost of $150 to $500 per treatment. The Q-switched laser has become the standard treatment for tattoo removal, as it is low risk with minimal side effects. Patients may require lidocaine injections or topical cream to anesthetize the area. Most patients report laser treatment to be similar to snapping the skin with a small rubber band. The laser produces short pulses of light that pass through the skin’s top layer causing the tattoo pigment to fragment into smaller particles that are then absorbed by the body. The laser selectively targets tattoo pigment. Those with darker skin may experience a reverse image as the laser may remove pigment from the skin.
Before and after photos courtesy of Fotona
B E FO R E
The more colorful the tattoo, the more complicated it may be to remove. Blacks and blues are the easiest to remove, as the laser is better able to target the pigments. Lighter colors, especially yellow are less detectable to the laser as a pigment and are more difficult to remove. After treatment there may be some crusting over the site. An antibacterial ointment and dressing will be applied to the area. Showering is allowed one day after treatment, but the area should never be scrubbed.
AF T
ER
Side effects, if any, are few and most patients are satisfied with the results as long as the expectation is that a moment’s indiscretion may never be completely gone but less noticeable as it fades with time.
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The QX M According to a recent Harris poll, one out of every five U.S. adults has at least one tattoo. Of those approximate 62 million people, 14% of them told Harris that they now regret their decision.1 As society puts more and more stress on the youthful aspect of beauty, many are looking for a solution to restoring and rejuvenating their skin. As practices embraced laser tattoo removal over the last decade, the treatment remained difficult: it was painful, colored ink was particularly difficult or impossible to remove, and patients were well aware of the scarred or blistered negatives of their poor choices which could remain on the skin post-treatment. With treatment numbers climbing in spite of this, Lumenis once again took the lead on medical device development with the introduction of the Fontona QX MAX, a machine that has given MDs a reason to celebrate. The new QX MAX Q-Switched Nd:YAG laser from Lumenis works as a supplement to the body’s natural defenses, using light to generate an energy shockwave which breaks up pigment particles into fragments easily removed by natural cellular processes. Because the darker ink acts as a chromophore, surrounding skin is left undamaged and healthy. The QX MAX is advanced enough to remove all common tattoo colors, even traditionally difficult colors such as sky blues and greens. 1
http://www.eturbonews.com/28032/one-five-us-adults-now-has-tattoo
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MAX
What really sets this device apart from its competitors is the difference in pulse and its 5-in-1 abilities
“I’ve been looking for ten years to add the procedure to our practice, but there have been many problems associated with the procedure,” said Dr. Raymond Kaufman, who recently purchased a QX MAX for his practice in Montana. “The problem before was that various colors of the tattoo require various wavelengths. This device has the wavelengths to address any color and its delivery system is considerably better than other devices on the market,” Dr. Kaufman reported. What really sets this device apart from its competitors is the difference in pulse and its 5-in-1 abilities. Most machines of similar high energy use multipulse technologies while the QX MAX uses singlenanosecond pulses, which can better reach and remove deeper-lying structures. Tattoo removal is just one of many treatments the device offers. QX MAX can be used to provide effective hair removal, vascular treatments, skin rejuvenation and anti-aging treatments, as well as treat a wide range of benign pigmented lesions in patients of all skin types. “I expect to be able to take care of any type of tattoo,” Dr. Kaufman added. “I also believe this machine is capable of completely eliminating a lesion while others just make it smaller.” As the demand for tattoo removal soars, the race for the most effective technology will continue. The QX MAX raises the bar for similar devices and Lumenis will continue to leave its mark on the growing trend.
POWER
SUPERIOR POWER
5 in 1
5 LASER SOURCES
EFC
ENERGY FEEDBACK CONTROL
WIRELESS FOOTSWITCH
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Keeping Safe and Dry: Lumenis Protects Your Practice Investment, Rain or Shine By: Katharine Williams
When it comes to medical lasers, Lumenis puts the practice first. Whether a patient is concerned with unsightly spider veins, suffering from severe skin dyschromia or wanting a tattoo removed, MDs are provided with solutions to help and comfort those struggling with these issues that other companies cannot offer. What is it that sets Lumenis apart from its competitors? How have they helped practices increase their positive MD and patient experiences? The answer is simple: The Lumenis Umbrella. With eight different, oneof-a-kind devices that offer a multitude of treatments, clinical training programs, a direct service team and custom practice building solutions, Lumenis leaves no area of importance untouched. 2012 was a big year for Lumenis; introducing two aesthetic devices, one geared toward tattoo removal and the other toward body shaping, as well as announcing four new modes that will be added to the Acupulse. The company’s device expansion and update has opened doors for practices to offer new treatment options, particularly with the advancement and popularity in noninvasive tattoo removal procedures. The Fotona/QX MAX and Sound Surgical/Vaser Shape join the already popular M22, LightSheer DUET, LightSheer, AcuPulse, Lumenis One, and UltraPulse Encore, adding to the vast number of services this company is capable of delivering. Along with the complex machines the company produces comes a service team solely dedicated to Lumenis products, something that sets them apart from most other medical laser companies. While their competitors often hire outside contractors to troubleshoot, Lumenis has built a service empire over the past 35 years that prides itself on its ability
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to provide certified solutions to any medical practice that utilizes their equipment. With strategically placed service technicians who understand the importance of these machines and the financial facets of each practice, the company has built a positive reputation that has spread throughout the industry. Lumenis service agreements
work hand in hand to provide physicians with Lumenis devices an opportunity to maximize their end profit. Using the newest and most innovative marketing techniques in the business, IF Marketing offers customized packages for all aesthetic practice types allowing them to use their device to its fullest potential.
How One Practice Stays Covered “Mike has been our service guy since we got the DUET in 2010,” says Kaitlin Walker, Esthetics Director at True Skin Care Center. “Compared to other laser companies, he is prompt and always goes out of his way to make sure we are taken care of, even if he is travelling or on the road. It’s great to have the same person who knows us and our office with the personalized attention.” True Skin Care Center also used IF Marketing’s program to create a campaign to launch their LightSheer DUET. “It brought us 59 new patients over 6 months, with a total direct revenue of $21,495. Most of those patients are still with us and have either added on additional esthetic services, converted to medical patients, continue to receive LHR for additional areas, or have referred their friends.”
include a guaranteed on-site response time, manufacturer-certified parts, technical support and loaner programs for downed machines. Finding a program of similar stature is virtually impossible, giving Lumenis the upper hand when it comes to being the pros on mitigating downtime and reducing financial risk. Along with one-of-a-kind service programs, Lumenis raises the bar with customized practice building solutions. Partnering with IF Marketing, a medical marketing firm focused on the aesthetic industry, the two
Lumenis goes above and beyond to bring their clients the most up-to-date technology with the best service available. By combining the devices with Lumenisspecific service packages and unique marketing solutions, the company has made it easy for their clients to explore all that their machine has to offer. With an already large footprint in medical device sales, the Lumenis Umbrella will continue to expand, providing, serving, and marketing total solutions for practices.
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COMPLIMENTARY, COMPLEMENTARY
COSMECEUTICALS Use your laser to supercharge your skincare By: Terri Wojak In a typical aesthetic practice, nearly all procedures are “retail.” What we mean is, the patient is paying out of pocket for a procedure – no insurance is taken. Unlike clothes, lasers and injectable treatments last for a defined amount of time; this leaves plenty of room for forgetful patients to stray or cease coming entirely. Luckily, there’s an incredibly easy solution that brings patients back for return appointments over and over: cosmeceuticals.
2 RETAIL PRODUCT PURCHASES = 60% CHANCE OF RETURN 1 RETAIL PRODUCT PURCHASE = 30% CHANCE OF RETURN NO RETAIL PRODUCT PURCHASE = 10% CHANCE OF RETURN Source: Festoon Salon, Berkeley, CA
Cosmeceuticals provide two proven advantages for practices: visible results and increased patient retention. Good products provide excellent results on their own. Combine them with laser therapies and other aesthetic procedures and the results are enhanced even more. A happy patient will spend more and come back more often.
GET STARTED WITH 4 GREAT COMPLIMENTARY, COMPLEMENTARY TREATMENTS TO YOUR LASER: TIP: Offer a complimentary skincare consultation or facial for patients who have undergone a laser procedure. With enhanced laser results, the patients will find more value in their treatment; this credentials the laser technician and raises the patient’s level of interest in skincare products. When a patient follows a carefully prescribed home treatment regimen you are able to help them along a path of great skin – you and the patient are both focusing on the patients overall goals and this will lead to higher satisfaction rates.
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1. IPL COMPLEMENTARY: An IPL treatment evens and reduces discoloration, making the following products great:
Fractionated Skin Resurfacing can provide more than cosmetic results.
• Superficial chemical peels at 2 week intervals (Alpha HydroxyAcid, Modified Jessners’ Peel, Low-Percentage TCA). • Skin lightening products will enhance the results for pigmented skin. The recommended use is for two weeks before and after treatment; get them hooked on clear even skin! • Topical anti-oxidants and sunscreenwill prevent future damage.
2. FRACTIONATED SKIN RESURFACING COMPLEMENTARY: A resurfacing treatment evens and reduces discoloration, making the following products great: • ACTIVE FX:
Visit Dermtube.com and search HOPE for Real Patient Stories on Scar Revision and Chemical Burn Treatments using Lumenis SCAAR FX.
Mild Alpha Hydroxy Acid peel two weeks prior to appointment, dermaplaning two weeks after. Hydrating agents including Hyaluronic Acid will support healing and patients will love the smooth, firm results.
• DEEP FX: An Ultrasound Facial two weeks after the treatment will introduce hydrating agents and promote collagen production. Peptides will increase collagen stimulation. Topical anti-oxidants and sunscreen will prevent future damage.
3. TATTOO REMOVAL A silicone-based creame will prevent scarring after the epithelium has healed, and then sunscreen will protect your patients’ newlybare skin both during and after the healing process.
4. LASER HAIR REMOVAL Give a free Dermaplaning treatment before Laser Hair Removal to remove vellus hair and introduce your Laser Technician or Esthetician. Free sunscreen samples protect and moisturize skin for best post-treatment results.
IF Marketing’s newest book, DRIVE, reveals industry secrets and growth strategies proven to work in real practices. Containing a core set of philosophies, a single six-step program, and an incredibly creative approach - this is your practice’s complete marketing plan. Visit www.drivethebook.com for more information or to purchase your copy today.
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THE LEGALITIES of Aesthetics By: Stacey Clarke
In 2010, there were a total of 13,117,063 cosmetic procedures performed across the United States.1 The spa industry employed more than 330,000 people and they received an estimated 143 million clientele. 2 With an aging population, and a desire to look young, it doesn’t look like the aesthetic industry is slowing down any time soon. Why is it, then, that its legal system barely exists? That’s a question that attorney Alex Thiersch has to answer every day. His firm has created a unique niche representing medical spas in their formation, licensing and compliance with Illinois and Federal laws. They are currently one of the sole law firms in the Chicagoland area that provides legal counsel to medical spas. It is both a necessary and leagally demanding service. 16 SPRING 2013 / REVENUE
“It is honestly very difficult to find any place where a layperson can go and find out what the rules are. In Illinois, if you want to find out what the regulations are for operating a laser, you have to refer to four or five different statutes,� Thiersch says. The Illinois Department of Professional Regulation is the organization that controls these rules. According to their website, they oversee over one million professionals in nearly 100 industries. Even though they are the sole source of regulation, there is no one place where the laws for the aesthetic practice are posted. As medical spas and laser centers pop up all over the United States, there are inevitably questions that need to be answered. 17
Who can operate the laser? Does that person have to be certified by some certifying body? Do they have to be a physician or can they be somebody else? Can he or she be an esthetician? According to Thiersch, there are only a handful of states remaining that require physicians to operate lasers. In his opinion, there is no reason that a physician should be the only one to operate a laser. “The real future is on the mid-level practitioners – physician assistants and nurse practitioners. That’s where the future of the industry lies because they can do mostly everything without having the doctor there,” says Thiersch. For Thiersch, the questions don’t stop there…Assuming that physicians don’t have to do it, what does their involvement have to be? Do they have to be on-site, available via phone, examine the patients ahead of time, or can this just be done through delegation? Is it legal to participate in a daily deal coupon? What about a referral program? These questions aren’t unreasonable; one unfamiliar with the industry would assume that the answers can be found through a handbook or a website. At the time this article was published, that was not the case. One of the most common times that people contact Thiersch is when they have already broken a state regulation and they need a defense attorney. The majority of the time, however, they didn’t even know they were breaking the law. “Even the investigators from the IDFPR acknowledge that it’s virtually impossible to find out what the rules are. So they are basically acknowledging that the rules are vague, but they are still enforcing them,” says Thiersch.
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“The real future is on the mid-level practitioners – physician assistants and nurse practitioners."
In this day and age, it’s almost unheard of to discover a basic need that hasn’t already been fulfilled by a website. Unfortunately, the laws of aesthetic medicine are uncharted territory. That’s why Thiersch’s clients are constantly asking – where can I find these answers? Finally, in 2013, Thiersch will have an answer for them. Along with the American Medical Spa Association, Thiersch is creating a website that has all of those answers. They will begin with all of the major aestheticpracticing states – California, Illinois, Florida – and continue to add new states as they go. It won’t be an easy task. Most statutes are not directly related to aesthetic medical procedures. This means Thiersch and his associates have to refer to a handful of statutes for each regulation; each statute stands around at least 75 pages. In addition, many of the laws are only clear to those who already have experience, leaving him to refer to consulting attorneys in each state. “It’s difficult to be precise because it’s not a precise field. Most states are consistent. Most states have anti-fee splitting. Most states believe that laser treatments are medical treatments. It’s the minutiae of the individual state laws that will really get you in trouble,” says Thiersch.
Any statements, comments or opinions expressed in this article are for information only and should not in any way be construed as legal advice. Every situation is unique and laws vary by state and jurisdiction, and therefore it is imperative that you consult with professional legal counsel before acting upon any of the information provided in this article. 1
2010 American Society of Plastic Surgery Report.
2
International Spa Association 2010 Report.
aesthetic.lumenis.com • 408.764.3000 PB-1139900_A Lumenis Magazine, Spring 2013, Vol 2, No 1