A review of an article published in Houston Business Journal – by C. Richard Cotton

Originally trained in internal medicine, Dr. Kim Vo shares her new field of medicine — aesthetics — with other Houston doctors like Jim Cain, whose original specialty was interventional radiology.

Both physicians eventually ended up in the field of aesthetics, which, quite simply, is where many people turn to look better and younger.

Laser treatments, Botox injections and wrinkle fillers are the new Fountain of Youth — a step up from over-the-counter potions, but less expensive and intense than cosmetic surgery. And, weary of chasing insurance and Medicaid payments, physicians nationwide are capitalizing on the trend.

Cain compares the influx of physicians into aesthetics with a similar rush into pain management a decade ago: “It was mainly an economic thing — and this is the same thing.

“Doctors are looking for a way to get cash into their businesses,” he says, “and aesthetics is a cash business.”

Few insurance policies cover aesthetics procedures since they are primarily cosmetic and elective. But the economic times, Cain admits with a laugh, are not optimal for entrepreneurial endeavor: “There probably isn’t a worse time in history to start this.”

The Patients
Vo says the typical patient at her Dermagenix Medical Spa, which she opened in the spring of 2007, falls into two main categories; younger patients seeking hair removal and treatment for acne and older patients in their forties or fifties.

“They want to continue looking good for jobs or their social lives,” Vo says of the latter group. “They want something more than the moisturizers found at the mall.”

Of the younger set, she says, “By the time they come here, they’ve been to the dermatologist and through over-the-counter products.”

Vo came to aesthetics through “personal interest” in the field, wanting to explore her own anti-aging options: “I’m getting older and wanted to know what’s out there.”

Through Continuing Medical Education, she studied the procedures for two years, “until I was comfortable with them.”

Her choice of names for her clinic describes its perceived duality of purpose, as much spa as sterile clinic; expect, as Vo describes it, “a combination medical facility in a spa environment with music and ambiance.”

The Procedures
Dermagenix offers the full range of aesthetics, from laser to injections. Vo says Botox injections run $200-$300; fillers of hyaluronic acid, $500-$800; and lasers, $300-$2,000.

Vo notes that lasers, in particular, are coming into more and more applications, including tightening skin, hair removal, vein treatment and skin resurfacing.

She says that in Texas, lasers are in something of a regulating gray area; a physician must purchase them but, beyond that, there is little regulation. Employing them in treatment, for example, is not restricted to a physician. Texas law, in fact, doesn’t mandate the purchasing physician even be on the property ­— or in the state, for that matter — where the laser is operated.

“Since it is my responsibility, I operate the laser,” Vo says.

“I have lasers that can burn a hole through the wall,” says Cain, co-owner of Innovative Aesthetics. With his initial training in interventional radiology, Cain already had experience in the laser arena.

The Doctors
Cain opened his clinic six months ago but still also practices radiology. Through his explorations of other specialties, particularly anesthesiology and pain management, Cain says he became fascinated with anti-aging medicines.

“I’ve just got to get into it,” he recalls thinking before becoming a fellow in aesthetics medicine through a program established by the American Academy of Anti-Aging Medicine.

Cain and his partners opened Innovative Aesthetics in extra space on Audley Street at one of their two imaging centers.

Dr. German Newall offers both aesthetic treatments and cosmetic surgery through Aesthetic Center for Plastic Surgery, of which he is a co-owner. The group maintains two offices and a surgery center.

“While I’m interested in aesthetic surgery,” says Newall, “these (aesthetic treatments) are part of the practice.” He adds that not all plastic surgeons delve into the aesthetics arena.

Newall, who is certified by the American Society of Plastic Surgery, says as a surgeon he’s “more readily available to deal with complications if they arise.” He adds this caveat: “If you do enough through the years, you’re going to have complications.”

And he says he’s dealt with patients who received less-than-ideal results from physicians who have gotten into aesthetics as a way to increase the bottom line.

“I do understand because of economic situations doctors want to subsidize their salaries through aesthetic procedures,” says Newall, “but I do think that making it readily available to MDs is maybe not such a good idea.”

He notes that those times when botched aesthetic and cosmetic procedures and surgeries get the media’s attention, which they periodically do, “it takes all the good guys with the bad guys.

“I think we need stricter regulations. We’re working toward that but it’s not easy.”

He points out that filler and laser manufacturers, naturally, want to be able to sell as much of their product as possible so tighter regulation is not necessarily in their best economic interests. There is, however, one regulator that works to keep the field of aesthetics from being even more flooded. Newall reports that laser machines can cost hundreds of thousands of dollars each.

“Easily,” says Newall, “the investment for a clinic start-up can run $700,000 to $1.5 million for equipment.”

Solta Medical, the manufacturer of Thermage and Fraxel systems today announced the opening of the Solta Medical Aesthetic Center “to advance the company’s new product development, facilitate research on the innovative Thermage(R) and Fraxel(R) product lines and serve as a destination where physicians can participate in research studies and training”.

This is a truly novel development in the industry as Solta is the first company in the aesthetic energy device space to open an in-house clinic and biomedical engineering lab.
The company claims that more than 4,500 physicians in nearly 80 countries perform Thermage and Fraxel treatments. The Solta Aesthetic Center will serve as a central research destination for physicians around the world to access the latest findings about Thermage and Fraxel treatments.
“The Solta Medical Aesthetic Center allows for a seamless transition from the research bench to the treatment room,” said Vic A. Narurkar, M.D., dermatologist and founder of the Bay Area Laser Institute in San Francisco, California. “Solta’s state-of-the-art clinic allows the company’s optics and biomedical engineers to share data and receive immediate clinical feedback about their work in new product development and existing product enhancement.”

Solta Medical has a history of leadership in R&D of the aesthetic devices. Current studies being conducted at the Aesthetic Center include the recently released Thermage Body Tip 16.0 and several advancements in skin tightening, resurfacing and other dermatological applications using new, breakthrough proprietary technology.

The grand opening of the Solta Medical Aesthetic Center occurs in conjunction with the 67th annual meeting of the AAD in San Francisco. Several physicians presenting at the AAD will discuss their clinical findings using Thermage and Fraxel systems and the effectiveness of skin tightening and skin resurfacing.

These presentations include:

• “Lasers, Non-Ablative Fractional Resurfacing,” by Elizabeth Tanzi, M.D., Washington Institute of Dermatologic Surgery, Washington, D.C.
• “Advanced Lasers, Fractional Resurfacing,” by Christopher Zachary, F.R.C.P., University of California, Irvine.
• “Skin Resurfacing & Rejuvenation, Carbon Dioxide Fractional Laser Rejuvenation,” by Christopher Zachary, F.R.C.P., University of California, Irvine.
• “Fractional Laser and Light-based Technologies,” by Vic A. Narurkar, M.D., founder of the Bay Area Laser Institute, San Francisco, CA.
• “Aesthetics and Cosmetic Surgical Procedures in Darker Racial Ethnic Groups, Fractional Photothermolysis & Radiofrequency Devices,” by Vic Narurkar, M.D., founder of the Bay Area Laser Institute, San Francisco, CA.

When offering a spa gift certificate, consider the following.

Spa gift certificates are available in either dollar amounts or by custom designed treatments and packages.
Some of the best gifts are things that one would typically not consider purchasing for themselves. A popular trend today is treatments using more than one therapist. There is nothing quite like a facial (which includes a massage of the face, neck, shoulders, upper back, hands and arms) combined with a laser technician simultaneously doing hair removal or a photorejuvenation procedure.

When considering a spa service for a man, be sure the environment is comfortable for a gentleman. Overstuffed sofas, needlepoint wall hangings, and especially co-ed waiting areas can be very intimidating to men. An upscale, contemporary environment with privacy is more attractive.

Offer delivery of gift certificates (mail or online download). For those who wait until the last minute, gift certificates that can be purchased over the phone or online can be a big help. In most cases, gift certificates can even be emailed to ensure “on-time” delivery.

Most valuable gift certificates offered by medical spas are for laser hair reduction and non-invasive photorejuvenation.