The Aesthetic Practice in 2021

AA: What did we learn in 2020 that will follow us into 2021?

Dr. Chilukuri: I think our safety protocols, especially into 2021, are going to continue [to be] similar to what we have today. We are still sterilizing the rooms. We're still asking our patients to text and let us know that they're outside so we can invite them in. There's still no waiting in anybody's waiting room or reception area. And in our aesthetic practice, it's always been like that. It's truly a greeting and meeting area, and then we invite the patient back.

In the past, every single one of our rooms has been sterilized in between patients anyhow. We're just spending a little bit more time and energy doing that. Some practices are using a UV light that's going to be emitted, and then sits there for five minutes to theoretically break down any bacterial and viral particles. Unfortunately, we haven't seen whether this actually makes a continued difference or not.

From the most recent guidelines from the CDC, what we're finding is that there are viral droplets in the air. The question becomes, how long are they lasting inside the air? What we've done for several years now is we've used a product called lasercyn and it contains hypochlorous acid. [All these hypochlorous acid product products are] not the same across the board. This particular one was tested in Australia and has been proven to actually kill or stop the progress of COVID-19. …upon contact, within less than 90 seconds, we're seeing that there's kill of the bacteria, the viruses, fungus, as well as yeast. So it's something that we spray on the patient, as well as what we do for our equipment immediately afterwards. We're now using that same product to spray down our tables.

AA: Is telemedicine here to stay?

Dr. Chilukuri: We’ve been talking about telehealth now for at least eight or nine years. We've had decent technology for it. We have better technology every single year… better Apple phones… better Android phones, our camera systems are better, so we're more accurate in what we're seeing. From a cosmetic perspective, it's nice to get an idea if we’re talking about [issues like] pigmentation and what can be done. But in terms of what we're doing for in-office procedures for anti-aging, it's still always better to have a physical exam.

I think that we're able to screen patients better. In our case, we're still using some virtual consults, but [seeing] a decrease in the number of patients that we're seeing virtually just by the sheer fact that we have a full clinic. But if you don't have a full clinic, or you're offering virtual consults afterhours, or on those days that you're not quite as busy, it is a neat opportunity to get a patient on a skincare regimen, so when that person comes in, their skin is going to be fully prepped and you're able to offer them that procedure.

The other thing that I think virtual consults have allowed us to do is to get rid of those no-shows. You can kind of gauge whether [prospective patients are] truly engaged in the procedure that you're offering or talking about. And you also get an insight into the patient him or herself. You see their surroundings. Are they in bed and their hair's a mess? Are they still wearing proper clothing? Or do they look, at least, less disheveled? And is it going to be a fit for your practice? So I think it's been an interesting way to weed out those patients, and really see whether it's a good fit for your practice.

AA: When will we see a return to live professional meetings?

Dr. Chilukuri: I don't know if we'll ever have those meetings like the AAD for a long time where you have more than 10,000 people congregating into one convention hall. I don't know when that's going to be allowed again and when people are going to feel safe doing that. But my second concern is really, what are we doing in terms of revenue loss? Many of us had to close for one, two, three, and even four months. And when you have… minimal revenue coming in, are we willing to take those Wednesday, Thursday, and Fridays away from our office to go to a meeting where, again, it's not just that you're not making money that day, but you're actually truly losing money depending on your overhead costs, and what else you're supporting in that space.

I can tell you right now, there's several technology-based companies that are offering both virtual as well as in-person gatherings. They're smaller gatherings. They're 25 to 50 people per room. They're very, very properly, socially distanced. People are wearing masks. They're very cautious about the whole thing. But what we're seeing in the industry is people are still buying their technology. They're still spending $200,000 to $300,000, on their lasers and energy-based devices.

AA: What are we going to see in terms of trends next year?

Dr. Chilukuri: I think that's the that's the crystal ball that we all want to know what's happening. In the U.S. there was definitely a pent-up demand for injectables. I think there's a lot of concern in the medspa industry about whether patients are going to be able to “afford” their Botox or fillers. To me Botox is still what we call the lipstick effect—[what] it was called in during the Great Depression. Even if they couldn't necessarily put tons of food on their table, [women] would still spend money on lipstick. And the reason was, when you put lipstick on, you just felt better.