Establishing cosmetic practice starts with basics

"In dermatology, as compared to cosmetic surgery, the products, procedures and techniques that we offer tend to be less expensive, less invasive and not as long-lasting," says William Philip Werschler, M.D., a cosmetic dermasurgeon and assistant clinical professor of medicine/dermatology, University of Washington School of Medicine.

From a patient's perspective, he recommends visualizing one's product and service offerings as a "cosmetic pyramid." At the base resides treatments that offer low cost, low risk and high satisfaction - such as Retin-A (tretinoin, Ortho Neutrogena), Dr. Werschler says.

Evaluating skillset

Additionally, he recommends following a descriptive methodology on levels of cosmetic practice he developed in 1994 ("It seems like the stone ages of cosmetic dermatology," he says). The methodology requires identifying where one stands - and where one aims to go - relative to the following practice levels:

"It's like a journey - one should have a destination in mind. Then one decides how to get there," Dr. Werschler says.

The latter decision requires first analyzing one's resources and capabilities, he continues. Factors to consider here include the location and name of one's practice, the nature of the existing patient base and the possibility of HMO strictures against adding cosmetic services.

Staff resources

"Staff resources can make or break a practice's success," Dr. Werschler adds. In this regard, he warns, "If staff members don't like what one is doing, they'll sabotage you for sure."

Financial resources and time commitments also require consideration, he says. While one can learn to use botulinum toxin effectively and safely during a weekend course, mastering liposuction techniques can take six to 12 months before one is comfortable, Dr. Werschler notes. Therefore, he says, "One must have a timeline for the introduction of new services."