Zerona Lasers

Thoughts on Zerona Lasers

LH (Dr. Lornell E. Hansen II MD) has this comment on the latest Zerona Lasers review discussion around the effacacy of Zerona for 'fat melting' and a study that was just released.

Here's the Zerona Body Sculpting Study

Low-Level Laser Therapy Effectiveness for Reducing Pain After Breast Augmentation American Journal of Cosmetic Surgery Vol. 26, No. 3, 2009
Robert F. Jackson, MD; Gregory Roche, DO; Todd Mangione, DO

LH's comments:

...I do have to apologize as I did not know that the article had been published. The last I had read was that it was waiting for review. I also want people to understand that I am not saying that the physicians involved in the study did anything wrong with my evaluation of the article. I just think that the company is over marketing the product and charging way too much.

My critique:

1. The first thing they teach you in medical school on how to evaluate research is who paid for the research. In this case the sponsor of the research and article was Erchonia the company that makes Zerona.
2. Who wrote the article? In this case the article appears to have been written by Ryan Maloney. Who is Ryan Maloney? He not only is the medical director of Erchonia he actually has ownership in the patent of the Zerona. Other than that you do not know his background. We know he is not a PhD or physician otherwise it would be behind his name under the authorship of the article. He has a direct financial benefit to write the article in a positive light.
3. 8 Individuals did not have final measurements. The first question is why? 4 were from the treated group and 4 were from the placebo group. At first that seems OK, but when you look further into they kept all of these test subjects included in the study. What they did is they took the last measurements for those subjects and carried them forward. Again seems Ok at first but when you start to look at the trend of circumferential loss at the 2 weeks post treatment the measurements are trending back toward baseline. So if you include these patients last measurement (which by the way is the best overall average circumferential loss during the treatments for the treated group) and carry them forward they will artificially lower the true values two weeks post treatment. All 8 of these subjects should have been eliminated from the study.
4. There is no assessment of cosmetic benefit. To have this be worth something you would need before and after pictures that are reviewed by a group of individuals that are blinded to which treatment the individual participant received. So in other words is a 3 inch loss aesthetically significant.
5. They do not state if participants are male or female. So the question is left, does it work as well on males as it does on females? This could be very important as males tend to have thicker skin so does the laser penetrate as deep in men?
6. the study was limited to patients with a BMI of 25 to 30. Now I think it is fine to have this limitation as you have to start your research somewhere. But the limitation is that the article is implying that it will work for all BMI's. What about the thinner female patient with a BMI of 20 but has a small lower abdominal pooch? Or what about the patient that has a BMI of 35? This should be stated in the conclusion but Mr. Maloney seems to forget this.
7. They also do not state if the patients received their treatments for free or if they were compensated for their time. This is only important for the portion of the study that talked about the patient satisfaction. We need to understand that patients will put a value on the treatment because if something is free their expectations are much lower. their expectations are much higher if they paid $2500 for the treatment. So if this was free to the patient and you have 30% of the treated group that are dissatisfied or neutral what would that mean to a clinic if the patients are paying for it. I would guess you will have a much higher dissatisfied group that either wants their money back or free treatments. I do not want something in my clinic that has a 30% failure rate.
8. They do not discuss if either group was asked to change their diets. This should be stated up front in the methods portion of the article. They also do not mention if there were any dietary supplements required such as niacin. Most clinics using Zerona are having the patients take niacin even Erchonia recommends it.
9. They set the standard for success to be an inch loss of 3 inches or greater. Only 62.86% of the treated group achieved success. So this translates in to a 37.14% failure rate. Again, not something that I would want to stake my reputation on.
10. Now what do the numbers mean? If you look at the numbers the patients baseline combined measurement average was 120.31 inches. At week 2 of treatment (the best measurements achieved) the average was 116.79 inches or an inch loss of 3.52 inches on average. This sounds pretty good until you look at the true numbers. Using the numbers from the study this equates to a 2.9% inch loss as measured over 4 areas. Is this clinically (visually) significant? I do not think that most individuals will be able to see a 2.9% change or if they can it will be meaningful.
11. Lets take a look at the 2 weeks post treatment measurements. Remember, these are not true numbers as 4 patients had their best numbers included in these measurements pulled forward and included here. (I think all of their measurements should have been puled out). At 2 weeks post treatment, you see a 0.31 inch increase from the circumferential measurements at the 2 week treatments. What this equates to is an 8.8% increase in inches in only 2 weeks. So what happens at 4 weeks? 6 Weeks? So if it were a perfectly linear increase it would only take about 20 weeks or so to be 100% back at baseline. That is if it were linear and I highly doubt it is a linear response and if i had to guess most patients will be back at baseline measurements within 6 to 10 weeks and this is why there are no long term studies. The company has had ample time to produce longer term studies they apparently do not want to.

So as you can see, there are a few issues with this article and how it was analyzed and written. The first and foremost problem is that the article was authored by an individual with direct financial interest in the product. The ASLMS journal never should have published this article due to the authors conflict of interest or it should have a disclaimer prior to the abstract. I have no vested interest in any of these non-invasive technologies and would love to see something like this work and have long term benefits for the patients. I think this technology may have better long term benefits on cholesterol etc. I have heard that there are some interesting studies coming. I just hope they are not written by Mr. Maloney. And for others reading this I assume that Chad works for Erchonia or the marketing company that is selling this thing to anyone they can including chiropractors.

Sincerely,
Lornell E. Hansen II, M.D. (LH)
www.LazaDerm.com

p.s. Sorry for being so long winded but I could not help myself. I want these companies to be held to higher standards. I think the ASLMS should have higher standards as well.

If you read the thread there's some interesting thoughts that spring to mind. If Chad is not with Zerona it would be the first time in my experience that a patient has been searching for peer-reviewed medical studies before deciding to have a treatment... I'm just saying.

Of course this qualifies as a guest post and a well deserved back link.

Any other physicians using Zerona have any thoughts?

Allergan's Botox Profits Jump 51%

Allergan's profits bounced up an impressive 51%... Could this signal a medical spa rebound?

Allergan Inc.'s (AGN) fourth-quarter profit jumped 51% from a charge-addled period last year while product sales surged 16% amid continued improvements in markets for cosmetic medical procedures following the recession, the company said Thursday.

The Botox-maker forecast weaker-than-expected earnings in the first quarter, which it pegged to increased spending on advertising and product launches. It also projected full-year earnings mostly below Wall Street's forecast while being cautious about economic recovery and challenges for certain products.

Still, shares of the Irvine, Calif., company, which also makes eye drugs, breast implants and fillers for facial wrinkles, recently traded up 2.3% to $58.09.

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Mail Order MedSpa Business Opportunity

If the clients won't come to you, then you can go to your clients. At least for product sales, that is. A new trend that many aesthetic practices are adopting is online product sales. It's attractive for many reasons:

1. It adds an accommodating service to your current client base who may be too busy to stop in and pick up their products. Convenience is the way of life these days!
2. It introduces your practice to new customers.
3. It brings in revenue that you may not have been exposed to before.
4. It's relatively easy to manage and doesn't require much staff time (i.e., low overhead).
5. It gives you the opportunity to stand out when compared to other competitive practices in your area.
6. And, it can even raise your SEO ranking! 

Concerned about the cost of shipping products? No worries! The U.S. Postal Service now offers cost effective Priority Mail Flat Rate boxes in various sizes. So, if it fits, it ships!

Want to make your product line even more attractive and personalized? Try custom label packaged products like the ones from Concept Labs, CBI Laboratories, or Natural Skin Care to name a few. In fact, there are so many companies providing private label skin care products today that you can be very particular with ingredients and additives. Just perform an online search for "private label skin care" and many companies will come up in your search results.

Some practices offer relaxing CDs for sale, aromatherapy products, sleep masks, robes, and many other comfort items that create a sense of personalization with their clients and prospective clients.

How do you add an online store to your website? Companies such as Go Daddy offers "Quick Shopping Cart®", and there's X-Cart®, to name two. Like many internet-based businesses, there are a ton of them. Just use the search terms "online shopping software" and see what comes up!

What comes up then could be your practice's revenue in an area which probably could use a little boosting!

Zeltiq vs. Zerona

Zerona and Zeltliq booth promise to freeze fat and shed pounds well enough that it would be a slam dunk to add these treatments to your medical spa or laser clinic. But do they work?

Here's some commentary from the NY Times Story

Doctors and patients alike are excited by the prospect of having new technologies that can attack fat without surgery. It is too early, however, for consumers to know how effectively either device works. That hasn’t stopped men and women unhappy with back fat and muffin tops from paying thousands for treatment in recent months...

...Zeltiq Aesthetics, based in Pleasanton, Calif., is a cautious wallflower that aims to get the data behind its device approved by the F.D.A. before it makes too rowdy an entrance to the party. Its slogan is “More Science. Less Fat.”

Meanwhile, Erchonia Medical, based in McKinney, Tex., has aggressively marketed its Zerona laser as “the first non-invasive body contouring procedure to effectively remove excess fat” even though it has yet to receive F.D.A. clearance to promote this use. (In general, the F.D.A. must sanction a medical device for a specific use before a company can market that use. But doctors are free to use devices off label. )

Nonetheless, a brochure for Zerona states patients can collectively “lose up to 9 inches without the pain or down time of surgery.” Nationwide, medical spas, chiropractors, cosmetic surgeons, plastic surgeons and dermatologists now offer Zerona for $1,700 to $3,800 for six sessions. Part of the reason the device has made inroads during these strapped times is that doctors don’t buy it outright, but pay per use.

So how is Zerona supposed to work? The low-level laser causes “fat to seep out of a cell, almost like a balloon being struck by a needle,” said Ryan Maloney, medical director for Erchonia Medical. The fat enters the lymphatic system, and is eventually used as energy, Dr. Maloney said.

Zeltiq uses controlled cooling to target and eliminate fat cells, a process called selective cryolipolysis. Skin isn’t damaged, but subcutaneous fat, which is more sensitive to targeted cold, begins a two-month death march soon after exposure to Zeltiq.

Doctors on the advisory board for Zeltiq Aesthetics have put the word out about it on television news segments. But at this stage, the company itself has been careful not to promote its device directly to consumers since its F.D.A. clearances for, say, pain reduction during dermatologic treatments don’t encompass fat reduction. Gordie Nye, the chief executive, sent an e-mail message declining to be interviewed for this article.

The company has clinical data that has been submitted to the F.D.A. for approval, according to a few doctors who were principal investigators. Data relayed at a meeting of the American Society of Dermatologic Surgery showed a 22 percent reduction of the fat layer as measured by ultrasound.

Erchonia Medical has published the results of its clinical trial in Lasers in Surgery and Medicine. Thirty-five patients in the treatment group lost an average of 3.5 inches total in hips, thighs and their midsection according to the company’s clinical trial. The company has promoted Zerona as “a new body-sculpting procedure designed to remove fat and contour the body without invasive surgery.” But the F.D.A. has not sanctioned marketing this use. It has cleared the Zerona laser for pain reduction 24 hours after breast augmentation or as a way to decrease the pain associated with recovering from liposuction.

In general, Karen Riley, a spokeswoman for the F.D.A., said “it is considered off-label promotion if you are marketing to the public a use that has not been cleared.” Steven Shanks, the president of Erchonia Medical, said, “Since we use the exact same power for liposuction and breast augmentation, we self-certified the device.” He said that in January 2009, the company had applied for a 510K clearance — which is based on the notion that an older device is substantially equivalent to a new one — and had yet to receive it. (Such a delay is atypical, Ms. Riley said, adding, “most 510Ks are cleared within six months.”)

Last month, Dr. Robert B. Seltzer, a dermatologist in Pasadena, Calif., ran an advertisement in The Los Angeles Times for an informational seminar that called Zerona “the holy grail.” In a phone interview, however, he said, “I’m not 100 percent convinced” and planned to return his Zerona if he didn’t continue seeing results in his patients. (So far 5 out of 6 have been pleased.)

After reviewing Erchonia Medical’s clinical study, Dr. Brian M. Kinney, a plastic surgeon in Los Angeles, said, “I can’t prove that it works.” His concerns are that the tape measure method of gauging circumferential changes “isn’t consistently reliable.” What’s more, study participants and the placebo group were assessed only two weeks after their last treatment, not long enough to measure adequately whether results last.

Dr. Kinney doesn’t have a Zerona or a Zeltiq cooling device, though in the case of the latter, he said, “it is well documented that freezing fat tissue aggressively enough can lead to fat necrosis,” or, fat dying, over a few months.

Patient selection for any body contouring procedure is crucial, said Dr. Jeffrey M. Kenkel, vice chairman of plastic surgery at the University of Texas Southwestern Medical Center in Dallas. Dr. Kenkel, who recently replicated results of Zerona’s clinical trial in 12 of his patients, doesn’t offer Zerona to obese patients, or to ones who have had surgery in the area they want treated. “It’s critical to be evaluated by a doctor,” he said.

Success is also dependent on diet and exercise, he said. If you’re sedentary and not eating healthy food, he said, then once fat is leaked after Zerona treatments, “your body will just store it again.”

How the body rids itself of fat, and how quickly, after any noninvasive body slimming procedure is unclear, said Dr. Lawrence S. Bass, a plastic surgeon in Manhattan who started using a Zeltiq device last July. That includes, he said, forthcoming devices like UltraShape and LipoSonix, which employ ultrasound waves to single out fat. It’s a “sticking point with the F.D.A. with all these things,” he said. Dr. Bass was not a clinical investigator for Zeltiq, but he said, “I’m convinced both on the science and clinical experience, it’s able to eliminate fat noninvasively.”

Nadine Tosk, a publicist for Zeltiq, explained that the rollout of the device was “very limited right now.” Dr. Jeffrey Dover, a dermatologist in Chestnut Hill, Mass., who advises Zeltiq and participated in its clinical trial, said a few board-certified plastic surgeons and dermatologists were “handpicked” because “we know they do good work.” Restraint is key, he said, because a doctor could apply Zeltiq to “the same spot” in the same day, which isn’t how it’s meant to be used. Hourlong treatments are best spaced out by two months, said Dr. Dover, who charges $700 per spot.

That said, a doctor with a Zeltiq device isn’t hard for patients to find. More than five dozen “Zeltiq specialists” can be found by ZIP code at body-contouring.com, which is a patient guide not sponsored by manufacturers of body-slimming devices. Dr. Jason N. Pozner, a plastic surgeon in Boca Raton, Fla., appears topless in a YouTube.com video that shows his left flank being suctioned and cooled as he reads his Kindle. (His partner, Dr. David J. Goldberg, was an investigator for Zeltiq.)

Ms. Bonvouloir hasn’t given up on Zerona. Recently, she paid $2,100 for six treatments at Parker Day Spa in Parker, Colo. This time, each session is followed by a massage that supposedly speeds the release of fat. “I still have three more sessions,” Ms. Bonvouloir wrote in an e-mail message. “Again, they are convinced I will lose some inches. I’d like to know when!!!”

Not exactly a raging endorsement but that shouldn't come as a surprise. Is anyone we know having success with Zerona treatments? Is Zeltiq or Zerona going to cause trouble for Thermage?

Shine: New Teeth Whitening Services For Medical Spa MD Members

Introducing Shine, teeth whitening services for Medical Spa MD Members.

We're extremely happy to welcome Shine to our growing number of Select Partners who are looking to provide quality products and services for our Members.

Shine's something new. It's a professional teeth whitening service  for Doctors, medspas and Clinics that allow any physician to offer custom teeth whitening, the #1 most requested and sought after cosmetic treatment, directly from their practice or medical spa withouth any equipment or long-term commitment. Just order 'teeth whitening kit's' and everything's included that will allow you to add the #1 cosmetic treatment to your services.

Here's how it works:

1. You order 'Teeth Whitening Kits' from Shine. (Get a special offer here)
2. Your client makes an 'impression' of their teeth that you ship back to Shine.
3. Shine's dentist-trained staff makes custom teeth whitening trays and ships them back to you in 48 hours.
4. Your client picks them up.

That's it. All of the shipping, packages, handling etc is included in the price. Of course you're buying wholesale and your selling retail. You also have the ability to white-label your own teeth whitening pens or use them as promotional items, giveaways, or just sell them retail.

As a Medical Spa MD Member you can call the president of Shine, Vic Conner directly at 801 865-850. (If you're not yet a member you can join here. It's free.)

The smartest next step? Order two trial kits and use them yourself. See how fantastic the service, product, and results are... It's rare that you can offer a product that you can essentially guarantee a result from but this might just be it. After all, the suggested retail price for a Shine custom teeth whitening trays, gel, etc is between $250-$350.

Here's some more about Shine from their press release:

No teeth whitening equipment required

Shine Teeth Whitening Services now offers professional teeth whitening services at wholesale prices to Medical Spa MD Members throughout the US and Canada.

These custom fit teeth whitening trays and professional strength carbamide peroxide gel can bring new profits and an exciting new arm of service to tanning salons, chiropractors, and day spas throughout the U.S. and Canada.

As a Medical Spa MD Select Partner, Shine Teeth Whitening gives every aesthetic practice a way to participate in revenue and profit of the burgeoning $300M teeth whitening industry with no training and no equipment required. Shine is an outsourced lab that provides custom teeth whitening kits and professional strength whitening products. The Shine team is trained by a certified dentist to create custom fit pliable whitening trays, which are the most comfortable and effective means of consistent and lasting teeth whitening. Shine provides these custom fit trays in conjunction with professional strength 22% carbamide peroxide gel for maximum impact. With Shine’s custom fit teeth whitening trays, an amount of gel as small as a match head is enough to provide powerful whitening to the entire front surface of the upper and lower 6-8 teeth in your smile.

The custom trays ensure the gel will stay safely contained in the tray, away from your gums, to prevent sensitivity. Are you a coffee drinker? Colas? Fast foods? No problem! With a custom whitening kit, clients can achieve professional whitening at home while working out, reading or cruising the internet as often as needed—and at a fraction of the cost of an equivalent kit from a dentist’s office--to keep their smile perpetually bright. For practices who provide laser whitening services, pairing that service with a custom kit for home whitening will ensure that your clients’ whitening progress—and their satisfaction with your whitening services—remains as strong as it was on the day the laser threatening occurred in your office, to avoid the typical degradation of their whiter teeth shade over time.

How to Participate

Shine provides dental impression putty and trays in pre-measured kits with easy instructions to help your clients capture a perfect impression. Send the impression to Shine in the pre-addressed mailer and we’ll return your client’s completed kit to your office for pickup within 5-10 days. To help you try Shine’s new service, for a limited time we're making available a special offer of a set of two sample teeth whitening kits, custom trays, manufacture and shipping. When you are ready to provide Shine to your customers, simply order our pre-measured kits as often as needed at our low wholesale price and sell the completed kits (MSRP $230-$300).

Portable Whitening Pens

Shine’s portable whitening pens are one of our most popular products. At $5 (US) and up wholesale, these fun and easy aluminum tubes are easy to private label for your own practice. They deliver professional strength whitening gel through the brush tip of a slim wind up cylinder small enough to fit in a purse or a pocket. These portable tubes sell for $25 and up on popular retail sites like Amazon and Sephora and are great for travel, for touch ups, and are especially popular with young adults and for teens.

Report Shows Teeth Whitening The #1 Most Sought Cosmetic Treatment

For 2010 Americans dream of cosmetic makeovers that tighten abs and leave a brighter smile, rather than those that erase worry lines and lift sagging facial features.

A poll of 2,227 U.S. adults by Harris Interactive on behalf of RealSelf.com found that more than half of all adults (54%) would choose cosmetic work if money wasn’t a concern, and of those who would have work done, the majority (52%) would choose teeth whitening, followed by tummy tuck surgery and liposuction. Not surprisingly, a majority of women (67%), as well as 40% of men said they would also have cosmetic work done.

Few cite Botox as wanted.

In spite of being the most popular cosmetic procedure in the World, just 6% of the survey respondents who would choose cosmetic treatments indicated a desire to get Botox to treat face wrinkles. However the number rises to 15% among women aged 45-54.

Cosmetic Makeover Wishlist Shows Teeth Whitening Most Wanted

If money were not an issue, consumer interest by gender include:

 

Procedure	% of total	% of women	% of men
Teeth whitening	52	51	55
Tummy tuck	29	39	13
Liposuction	29	34	19
Hair removal	25	31	16
Face lift	14	18	6
Laser skin treatment	13	16	7
Cellulite treatment	12	18	1
Hair replacement	11	5	20
Breast implants	10	15	1
Botox	6	3	8

The survey found the average teeth whiteing cost to be $417.

Marketing Your Medical Spa With Facebook Photo Albums

We've already covered how to launch a Facebook page, what to post, and how to advertise your social media pages. Today we're covering photo albums on Facebook.

Facebook photo albums are a great tool for showing off what you do best.  If you've ever used Facebook on the personal side, you've probably noticed how easy it is to flip through a large number of photos.  For example, if your friend posts 200 pictures from their trip to Italy, you can get through them in about ten minutes using the right and left arrows on the keyboard.

If you are engaging existing patients and customers and attracting their friends and curious local consumers through giveaways and any publicity your page garners, then posting a photo album of your best Botox before/afters is a non-obtrusive way of showing off what you do best.  Although it is easy to simply throw up the same pictures that you have on your website, Facebook gives you the ability to write little captions below the pictures, with photo-tags where you can highlight areas.  This is not an annoyance, but an opportunity.

As you can see below, this sample before/after has a detailed note that casual consumers can appreciate, as well as a link to your website and your phone number.  This puts you above your competitors, most of whom simply have an assistant slap up a bunch of pictures without explaining what the procedure is.

An unfounded concern of many medical spas is the photo authorization needed to put photos on Facebook.  If your patient signs a waiver that authorizes you to put their photo on your website, that also applies to Facebook, so no worries there.

You can mass-upload albums of before/after albums with your comments.  Another idea is fun is to organize things chronologically, and have albums like "March 2010 Botox."  This builds up trust with consumers, who know you aren't just cherrypicking your best results from ten years ago, but are routinely getting great results.

You should also have an album of staff in action, like a facial, massage, or the receptionist smiling warmly by the front door.  If you do events, have a photo album for each event showing how informative and fun it was.  If you're a guest on the local tv morning talk show, get a picture with the host and post it.

Your photo albums can be an organic extension of what's going on with you and your practice.  Most of the time, these pictures are already being taken, you just have to use them! 

Dysport Reviews

Evidently Dysport is very friendly with some docs. Too friendly for the FDA when it comes to promoting Dysport before it's been approved.

From Pierce Mattie PR:

It appears it is not only bloggers that are feeling the heat from the government in regards to their relationships with the brands they write about, but cosmetic dermatologists as well. Recently the FDA made an example of Dr. Leslie Baumann by sending her a warning when she was sourced for several beauty magazine articles regarding her positive praise of Dysport, the newly approved Botox competitor created by Medicis prior to such approval. The warning appears to have more to do with disclosure than anything else, which, mark my words, will be the buzzword of 2010 due in part to both the FTC and FDA.

Dr. Baumann was given 10 days to "clean up her act;" I wonder how her publicists will handle that.

It is a publicist's job to land their client in A+ publications and in this fierce competitive world of Beauty PR, everyone wants to be first to be sourced for being in the know about the latest and greatest beauty treatment.

However, Dr. Baumann's publicists should've been more careful considering her relationship with Medicis as an "investigator" for Dysport. In all of the articles she was quoted in, not once did she disclose this relationship, but merely indicated her praise that the neurotoxin was more effective than Botox.

Aesthetic Predictions for 2010

I think everyone staring out in the aesthetic industry, especially if you are a non-core practice, needs some sort of a guru. Someone to guide you along the way in your decisions on equipment, procedures, pricing, staffing, standard operating procedures, menu of services, etc. Our guru many years ago was Fran Acunzo from Acara Partners. Perhaps Fran's most famous, or successful client, is Dr. Bruce Katz of Juva MediSpa in New York City.

I remember listening to some of his suggestions he had for us at the time and saying "Is he serious? I have no idea what this SmartLipo thing is, but if he thinks it is going to be the next big thing, then we had better trust him as our consultant". Needless to say, Fran was right. And not only about adding SmartLipo to our practice when it was first approved by the FDA, but other procedures and services as well. So, to me, when Fran speaks... I listen.

Fran blogged his predictions for aesthetic procedures for the year 2010 and it's already making it's way across the internet cited and adapted into blogs by SpaFinder.com (Read Susie's comments on such predictions) and many, many others. If you have not yet read his predictions, I'd like to post them here in their entirety:

Here are my 2010 top 10 predictions in the world of Aesthetic Medicine

1. Dysport will become a strong competitor to Botox.  Dysport, Medicis’ new entry into the world of botulinum toxin, was launched in the spring of 2009 and has begun to see increased demand as market awareness grows.

2. Non-invasive body contouring will continue to grow in popularity lead by Erchonia’s Zerona.

3. Face lifts will continue to drop in demand while liquid face-lifts grow in popularity, especially with the younger market (40 -54 year olds)

4. Fat transfer, specifically for natural breast enhancement, will become sought after by women who were previously uncomfortable with implants.

5. Laser Lipolysis will continue to be one of the most in-demand medical aesthetic procedures due to its minimal downtime and great results.

6. The younger audience (24 – 40 year olds) will continue to discover aesthetic medical services for preventive aging.

7. There will be an increase in the number of men having aesthetic medical procedures starting with facial fillers and injectables (i.e. Botox, Restylane, Radiesse, etc.)

8. The tipping point of when men and women want to have their tattoos removed will arrive and the demand will grow exponentially.

9. Facial Rejuvenation will come of age as medical practitioners perfect their skill combining aesthetic medical facial procedures for a complete Medical Makeover including the combination of fractional resurfacing, ablative resurfacing, chemical peels, photofacials, skin tightening, injectables and facial fillers, etc.

10. What was an Extreme Makeover in 2003 when the then popular TV show hit the airwaves will now become the Everyday Makeover.

It is entirely up to you whether or not you place your trust in Fran's predictions. I would guess to say there would be some discepancies amongst professions, but I can tell you I am already beginning to see many of these prove true in our own practice. It's also interesting to me that, upon research, I could find no other person or entity posting such predictions.

So, unless you have a crystal ball somewhere that has worked for you, I'm sticking to what has worked for us!