Medical Spas Review SEPTEMBER 2014

Page 1

SEPTEMBER ISSUE 2014

ANNE BOLDUC Group Publisher & President EDITOR IN CHIEF Guy J. Jonkman

the aesthetics business review

18

SENIOR EDITOR Bernard Burt

the medicine environment of the future –TODAY

WHAT TYPE OF LOCATION IS BEST FOR YOUR MEDICAL SPA? Now that you have completed your medical spa concept design, let’s turn it into a physical reality. – Determine your location and keep in mind the old adage, “location, location, location” applies to any business marketing to the public. But what constitutes a good location?

20 WHEN IS IT TIME TO FIRE A PATIENT? Perhaps a patient initially seems like a dream. – Perhaps you feel bad for his or her lifestyle situation, like a rocky divorce or recent death in the family. Perhaps you’re in a financial slump and, if you’re being completely honest, the additional revenue will help you pay the bills this month. For whatever reason, you’re considering taking on a patient and ignoring the bright, bold red flags that follow him or her in your doorway. How do you handle the situation?

22 MED SPA OWNERSHIP: One question that seems to come up time and again is “who can own a med spa?” Unfortunately, there is not one answer to this question. While some states make it easy for interested individuals to find an answer to this and related questions, other states bury it in cumbersome and confounding regulations that look foreign to even the most astute lay person. To make matters worse, there is currently no national standard regulating the ownership of med spas in the United States, so what may be commonplace in one state is strictly prohibited in another.

25 PREVIEW OF EUROPE’S LARGEST MEDICAL SPA RESORT The hills are alive with the sound of med spa construction in the Austrian Alps. Medical Spa construction in the Austrian Alps promises to create Europe’s largest center for healthy holidays and wellbeing.

Monica T. Brown Bernard Burt Jon Canas Dr. Ronald Klatz Raoul Andrews Janet McCormick

EDITORIAL Hannelore R. Leavy Jonathan Paul de Vierville Shirley Meerson Douglas Preston Dr. Robert Goldman Melinda Minton

SEND EDITORIAL INFORMATION info@MedicalSpasReview.com or P.O. Box 2699 Champlain NY 12919-2699 Fax (450) 833-2444 Please forward all advertising material, insertion orders to: Northeast Group / MEDICAL SPAS REVIEW 12 Nepco Way, Plattsburg, NY 12903-3961 (450) 833-2400 • Fax: (450) 833-2444

the aesthetics business review the medicine environment of the future –TODAY

SUBSCRIPTIONS Yearly subscriptions prices in the United States are US $68 for 1 year, US $108 for 2 years, US $138 for 3 years. Canada are CDN $98 for 1 year, CDN $158 for 2 years, CDN $198 for 3 years. International US $148 for 1 year US $228 for 2 years, US $278 for 3 years. Send payment to: P.O. Box 2699, Champlain, NY, 12919-2699 6-12 WEEKS FOR FIRST ISSUE MEDICAL SPAS REVIEW Chief Operating Officer, ANNE BOLDUC Systems Manager, DANIEL DOREY Director Human Resources, ESTHER AMAR Treasurer, STARR WYLKIE Group Publisher, ANNE BOLDUC Chief Editor, GUY J. JONKMAN MEMBER International Spa Association American Academy of Anti-Aging Medicine American Med Spa Association

Copyrights © 2014 by MEDICAL SPAS REVIEW All Rights Reserved

e-mail: info@MedicalSpasReview.com This issue is published by Publicom Inc. CP 399 Place d’Armes, Montreal, QC H2Y 3H1 (450) 833-2400. Postage paid in Montreal, QC and Plattsburgh, NY. POSTMASTER: PLEASE SEND ADDRESS CHANGES TO MEDICAL SPAS REVIEW, P.O. BOX 2699, CHAMPLAIN NY 12919. Nothing contained in this publication

Located in the Austrian Tirol, an easy drive from Munich, Stanglwirt’s new luxury medical spa, scheduled to open Spring 2015, will complement the existing wellness center.

30 IS “OFFSHORE”ASSET PROTECTION RIGHT FOR YOU? Over the last decade, an increasing number of doctors have looked internationally in their wealth planning – although, overall, still a small minority. That is not necessarily a bad thing; as there are numerous pitfalls for using international planning that can catch naive doctors. In this article, you’ll learn what to do (and what to avoid) in international planning, and about specific tools top attorneys use in their international planning.

42 75 WAYS TO MARKET YOUR MEDSPA

shall constitute an endorsement by Medical Spas Review of any information contained in this publication. The publication and/or ownershareholders directors, disclaim any liability with respect to the use of reliance of any such information. The information contained in this publication is in no way to be construed as a recommendation or approval by Medical Spas Review of any industry standard, or as a recommendation of any kind to be adopted by or binding upon any spa owner. Reproduction of any portion of this issue by any means (facsimile or electronically, for example) is strictly forbidden. Editorial supplied must be accompanied by return postage. The publisher assumes no responsibility for return of unsolicited photographs or manuscripts. Subscriber: Send subscription inquiries and address changes to: Circulation Department, Medical Spas Review, P.O. Box 2699, Champlain NY 12919. Give old and new address, including postal code and the address label from most recent issue. Allow six weeks for change. Printed in Canada. Legal deposit number 500073-D. US POSTAGE PERIODICALS PAID AT PLATTSBURGH NY 12903. ISSN #1199-0600. MEDICAL SPAS REVIEW reserves the right to accept or reject advertisers and/or advertising material. Medical Spas Review is not responsible for the advertising contents in this magazine.

Printed in Canada on recycled paper Printed on 100% recyclable paper with an aqueous coating, this is an “environmentally friendly” magazine

PUBLISHED SIMULTANEOUSLY in United States and Canada www.MedicalSpasReview.com The Worldwide Guide to Spa on the Internet

MEDI CAL SPAS

Med Spa Location

MEDI CAL SPAS

LOCATION – LOCATION – LOCATION

WHAT CONSTITUTES A GOOD LOCATION?

Med Spa Location

Location Options

CHOOSING YOUR LOCATION What type of location is best for your medical spa?

If you have a business opportunity that you would like to share with us, contact us at: info@ medicalspaconsultant.com

■ Office space in an medical/office complex ■ A free-standing building ■ Retail space in a retail center ■ Retail space in a hotel ■ Adjoining space to the physician or medical director’s current medical practice

Space in a medical/office complex Although most doctors’ offices are in this type of

Cheryl Whitman, founder and CEO of Beautiful Forever

space, it is not usually the best choice for a medical By CHERYL WHITMAN, Founder and CEO Beautiful Forever

spa. The lack of exposure to the general public is a

www. medicalspasuccess.com

drawback as signage is often not visible from the street to encourage walk-ins. Prospective clients can learn about you only through advertising or referrals. As a result, your advertising budget will need to be

N

ow that you have completed your medical

show the location of competitors on the same

significantly higher than a more visible medical spa.

spa concept design, let’s turn it into a

map. If you have your own map, you will be in a good

Your business becomes a “destination” in that the only

physical reality. Determine your location

position to evaluate sites that are offered

clients coming by will be those with an appointment.

and keep in mind the old adage, “location, location,

to you through commercial realtors; and you may also

location” applies to any business marketing to the

direct the process by indicating “where you

public. But what constitutes a good location?

want to be.” For help with the mapping process, call

Building

Beautiful Forever.

an existing building, the drawbacks to this type of location involve both time and money. Construction projects take patience, persistence and a healthy budget. Cost overruns are common. You have to make sure the property is properly zoned and appropriate permits are obtained on time-consuming tasks. However, when the project is complete, the result is a building distinctly yours which displays your commitment to the area.

Retail Space This type of location is generally the best option for a small to medium sized facility. Engage a commercial real estate broker to help you find an available space in

If properly developed this can be a very good location an appropriate area that is within your budget. Often

Since a medical spa or an aesthetic medical practice is highly

When you actually begin to look at potential

option. A free-standing building is often larger than the developer will include an allowance for any

recommend that you select a location with great

locations; we recommend a minimum of 2000 square

the other location options with more opportunity to custom build-out necessary.Although retail space can

visibility and ease of access. This part of the

feet for a start-up medical spa or aesthetic medical

expand. Ideally, position your facility on a busy street be more expensive than office space, this cost is offset

process is best accomplished visually. In Section 1 we

practice.

or near a facility that draws significant traffic such as by business gained with the increased exposure to the

primarily

discussed

a

“retail

business,”

demographics

and

we

a hospital or a retail center. Proper signage and an public. ■

competitive

appealing design will also be important to its success.

analysis. It is best to map your demographics and 20

A Free-Standing

Whether you are building from scratch or renovating

MEDI CAL SPAS • September 2014

www.medicalspasreview.com

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MEDI CAL SPAS • September 2014

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MEDI CAL SPAS

Medspa Patients

DO NOT IGNORE BRIGHT BOLD RED FLAGS COMING FROM THE DOORWAY

A PATIENT INITIALLY SEEMS LIKE A DREAM

WHEN IS IT TIME TO FIRE A PATIENT? PERHAPS

A PATIENT INITIALLY SEEMS LIKE A DREAM.

Medspa Patients

2. Having post-procedure issues with the patient? • Body dysmorphic disorder issues, when a patient Know that, like any other relationship, you don’t sees issues that the rest of the public doesn’t have to be in a lifelong relationship with every • Receiving an unwanted treatment or procedure patient. purely to make a partner or spouse happy Perhaps your patient’s lifestyle situation has changed, • A constant attempt at negotiation on price, to a

Perhaps you feel bad for his or her lifestyle situation, like a rocky divorce or recent death in the family.

and they are no longer a prime candidate for your degree where the procedure or treatment is no longer office. Whether they can no longer afford your worth it for your office

Mara Shorr serves as the Vice

Perhaps you’re in a financial slump and, if you’re being completely honest,

regular, necessary follow-ups, or simply had a change town messed up his/her treatment

the additional revenue will help you pay the bills this month.

in attitude about treatment and care, there may come

President of Marketing and Business Development for The Best

For whatever reason, you’re considering taking on a patient and ignoring the bright,

3. Realize that the “break up” may cost you.

company helping aesthetic

If a client is truly unhappy with the outcome of a counseling. In the case of a patient who will simply be

practices and spas with the financial, operational

procedure or treatment, save yourself the time, effort more of a headache for you or your staff, we

By MARA SHORR, BS, CAC II-IV

and administrative health

IV Certified Aesthetic Consultant utilizing knowledge and experience to help clients achieve their potential. A national speaker

and headache and agree to a partial refund or office recommend you turn the patient away altogether. 1. Considering taking on a patient? Make sure you’ve not only had those conversations in First, make sure you’ve fully educated the patient person, but as office policy, sent the patient home with on the procedure they’re seeking. written instructions and guidance. Although many of Is it medically necessary? Will it actually offer a

the steps may be common sense to you, that’s not the

about who/what went wrong is going to eat into your Every prospective patient isn’t for you… brainpower (and time to treat other patients). It’s and that’s okay.

any work needing to be done before the procedure, medicine on a daily basis.

didn’t feel you were worth the dollars, but coming to a Go with what’s best in the long run; fair agreement on a refund is worth it. the short term fix just isn’t worth it for you

like weight loss or alterations in medication or

Ms. Shorr can be

proper post-procedure care, and possible downtime saying we use all the time: “What I said is not what

thebestmbs.com

amount of time you’ll spend going back and forth

never easy to learn a patient was so unhappy they

skincare routines? Does the patient understand the Our founder and managing partner, Jay Shorr, has a

marashorr@

credit for a correction, if possible. In the long run, the

cosmetic enhancement? Does the patient understand case with someone who doesn’t deal with the field of

and writer, contacted at

disorder, there may be a stronger mental issue in which you refer him or her to seek mental health

HOW DO YOU HANDLE THE SITUATION?

and cosmetic medical

It’s okay to let a patient know you’re not the best provider for them. In the case of body dysmorphic

Solutions, a Florida-based

She is a Level II, III and

a time when it’s time to part ways with a patient.

bold red flags that follow him or her in your doorway.

Medical Business

of their business.

services, have moved too far away to come in for • Tales of how EVERY other doctor or provider in

OR the patient. 4. Avoid the situation altogether: go with your gut.

or side effects? All of these items are key. Make sure you heard.” Having all of the information in writing to you get the sense that s/he is actually listening and examine later is beyond precious.

Get a bad feeling about a new patient before you start

comprehends what goes into his/her end of the deal.

treating him or her? Have things changed with a

While some patients believe their end is simply A problem with a patient could be avoided down the

previous patient? Situations may include, but

keeping (and paying for) the appointment, as road with simple communication ahead of time.

obviously aren’t limited to, the following:

providers you understand there’s so much more. 22

MEDI CAL SPAS • September 2014

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MEDI CAL SPAS • September 2014

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MEDI CAL SPAS

Medspa Onership

THERE IS NO STANDARD REGULATING THE OWNERSHIP OF MEDSPA YET

WHO CAN OWN A MED SPA?

MED SPA OWNERSHIP: ONE QUESTION THAT SEEMS TO COME UP TIME AND AGAIN IS “WHO CAN OWN A MED SPA?” By RENEE E. COOVER, JD

Renee Elise Coover rcoover@thierschlaw.com practices with Thiersch & Associates in Chicago, Illinois. Thiersch & Associates specializes in med spa law.

For more information contact

Unfortunately, there is not one answer to this question. While some states make it easy for interested individuals to find an answer to this and related questions, other states bury it in cumbersome and confounding regulations that look foreign to even the most astute lay person. To make matters worse, there is currently no national standard regulating the ownership of med spas in the United States, so what may be commonplace in one state is strictly prohibited in another. While in Illinois, New York, Pennsylvania and Wisconsin, the laws regarding med spa ownership are clear that med spas must be physician-owned, some other states do not make such a distinction.

Thiersch & Associates,

I

n Illinois, for instance, the Illinois Medical Corporation Act prescribes that a medical spa (i.e. Thiersch@thierschlaw.com any entity that provides medical treatments) must be owned and operated by a physician. A person who is not licensed under the Illinois Medical Practice Act cannot lawfully have any part in the ownership or control of the medical spa at any time. This requirement prohibits a business corporation or lay person from controlling the medical decisions of a physician or professional staff and as a legal concept, it is known as the “corporate practice of medicine.” Medical decisions must always be controlled by a physician, not a lay person or corporation. (312) 981-0990

But California has a different set of guidelines—there, only licensed health care professionals (including nonphysicians) can own any part of a medical spa.

Although there is a general prohibition on the practice of 24

MEDI CAL SPAS • September 2014

medicine by corporations, the California “Moscone-Knox Act” establishes the right of physicians to incorporate and operate professional medical corporations. If the med spa is organized as a professional corporation, 51% of the corporation must be owned by licensed physicians, but the other 49% may be owned by non-physicians such as registered nurses and physician’s assistants. In Florida, the laws differ once again as Florida has no laws or court decisions prohibiting the corporate practice of medicine. As a general rule, physicians and other health care providers may be employed by or contracted by corporations and other businesses owned and controlled by non-physicians. And corporations and investors can freely invest in and own medical practices that employ physicians so long as the physicians supervise and control the management of the med spa. Ohio has gone even further, the legislature declaring that www.medicalspasreview.com

the corporate practice of medicine doctrine no longer exists states, it is considered illegal. in Ohio. There, the law does not prohibit licensed physicians from rendering medical services as employees of a In Illinois, for example, hiring a physician to be the corporation or any other form of business entity. The Ohio medical director for a med spa owned by non-physicians is Medical Practice Act only requires that the physician illegal and if caught, the physician’s license can be exercises professional judgment to render medical services suspended or revoked and the med spa could be forced to based on the best interest of the pay steep fines or penalties. “The patient and within the minimal Illinois Department of Financial and standards of care of similar Professional Regulation is really Although it seems practitioners under the same of cracking down on med spas that that the laws similar circumstances. advertise as having medical directors,” regarding said Alex Thiersch, founder and Although it seems that the laws General Counsel for the American Med ownership vary regarding ownership vary from one Spa Association (AmSpa). “In most from one state to state to the next, most states do cases, these spas are operating illegally, the next, most employ fee-splitting provisions that with no physician ownership.” states do employ prohibit physicians from sharing or splitting any percentage of their This type of arrangement seems to be fee-splitting medical professional fees with any prevalent in several states because provisions that non-physician. If the laws regarding individuals do not know or do not prohibit physicians ownership are not clearly stated for a understand the laws governing the from sharing or particular state, there may be practice of medicine or they do not provisions that prohibit fee-splitting think these laws apply to med spas. But splitting any between physicians and nonignorance of the law is not an percentage of their physicians, in essence rendering it acceptable excuse if the State launches medical professional impossible for a non-physician to own an investigation of a med spa due to its fees with any and operate a medical spa and split the alleged illegal ownership. fees from medical services with a non-physician. physician. It is imperative to protect yourself and

Medspa Onership

For more information: American Med Spa Association americanmedspa.org

your med spa business by structuring Some med spas have attempted to circumvent the ownership laws in their state by employing a physician as a “medical director” while a non-physician owns and operates the med spa in its entirety—overseeing all treatments, including medical treatments. In these situations, the physician serving as the medical director generally does not have any ownership interest in the med spa, but is rather operating as an independent contractor for the med spa. This is a perfect example of fee-splitting between physicians and non-physicians and in several www.medicalspasreview.com

and operating the med spa in compliance with your state’s laws. If you have questions regarding what is legal in your particular state, contact Thiersch & Associates in Chicago, Illinois, at Thiersch@thierschlaw.com for all of your med spa needs. ■

MEDI CAL SPAS • September 2014

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People & Places

RELACHE SPA BOTANICAL TREATMENT IS WASHINGTON’S BEST BARGAIN

GAYLORD NATIONAL HARBOR’S RELACHE SPA

BLOOMING

ON THE

POTOMAC,

First, we discussed scent for the massage oil. Joining in the farm-to-spa movement, Gaylord hotels partnered with Body Bliss to develop custom aromatherapy blends that incorporate indigenous plants from each of its four regions.

BOTANICAL TREATMENTS AT

GAYLORD NATIONAL HARBOR’S RELACHE SPA DEFY SUMMER

ABOUT THE AUTHOR Author/historian Bernard Burt documented the new wave of spas in the 1980s with his book

Drenched in wild ginger, a signature scent of the Relache Spa at Gaylord National Resort, my voyage to National Harbor was a refreshing escape from summer heat.

Fodor's Healthy Escapes. Founding

People & Places

By BERNARD BURT

Here in the mid-Atlantic, the grounding scent of wild ginger was my choice. Other signature scents use lavender, blue sage, and citrus magnolia. Adding a touch of echinacea to the blend gave support to my immune system, and wintergreen soothed muscles and joints. Participating in the fall botanical promotion are Gaylord Hotels in Kissimmee, Fla., Nashville, Tenn., and Grapevine, Texas.

Director of ISPA, he launched PULSE magazine in 1991, co-authored 100 Best Spas of the World, and tracked trends for Spa Management Journal. Currently his reviews are on Examiner.com and Insider's Guide to Spas.com

WITH A NEW MENU OF BOTANICAL TREATMENTS INSPIRED BY THE RESORT’S ATRIUM GARDEN, WEATHERPROOF, THIS IS WASHINGTON’S BEST BARGAIN.

(minimum age 18) with 11 treatment rooms. Its core philosophy stems from its name: Relache means “let go” or “take a breather” in French. The menu of massages, body treatments, facials, and salon services features top-quality skincare products like Eminence, Check in Monday through Thursday and the Spa HydroPeptide, Jane Iredale, Jan Marini, and Kneipp Escape package costs $215, including two European bath salts. treatments and lunch with wine in the spa. New this summer, hydrating botanical treatments add For the ultimate summer pampering, three botanical to your glow. Available a la carte, Green Tea and treatments are in the $325 package Monday- Lemongrass offerings include a body scrub, facial, and Thursday; Friday through Sunday the cost is $340. pedicure. And there’s an 80-minute Relache signature Plus a 20% gratuity for your therapist. Autumn botanical facial that increases circulation and firms seasonal treatments are available daily through your skin ($210 Monday-Thursday, $220 FridayThanksgiving. Sunday). Located above the hotel reception area, the Relache Spa is a luxurious oasis. Views of the Potomac are calming as you relax in the lounge and sip herbal tea. Arrive early to detox in the sauna and soak in the whirlpool just outside the locker room. Settle into a posh robe and forget your daily stress.

Operated by Marriott International, a fourth Gaylord Resort is under construction near Denver, Co. Reservations: www.EscapeToRelacheSpa.com

To understand these natural therapeutic qualities, I selected the Relache Botanical Body Ritual, a 105minute combination of body exfoliation and scrub, scalp massage, wrap, and full-body massage ($290 Monday-Thursday, $300 Friday-Sunday).

In the soothing hands of Gulcin Johnson, stress melts The Relache Spa at Gaylord National Resort and away. A seasoned professional, Johnson has worked at Convention Center caters to a diverse crowd Gaylord several years, and clearly enjoys her work. 26

MEDI CAL SPAS • September 2014

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MEDI CAL SPAS • September 2014

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MEDI CAL SPAS

People & Places

MEDI CAL SPAS

FIRST MEDICAL RESORT IN AUSTRIAN ALPS TO CAPITALIZE ON WELLBEING

EUROPE’S LARGEST MEDICAL SPA BIO RESORT

T HE

HILLS ARE ALIVE WITH THE SOUND

OF MED SPA CONSTRUCTION IN THE

A USTRIAN A LPS .

AUSTRIAN TIROL, AN EASY DRIVE FROM MUNICH, STANGLWIRT’S NEW LUXURY MEDICAL SPA, SCHEDULED TO OPEN SPRING 2015, WILL COMPLEMENT THE EXISTING WELLNESS CENTER. IN THE

Surrounded by the magnificent Alps, with five-star gourmet dining, a working Lipizzaner riding stable, and an internationally renowned tennis program, this high-end resort caters to families as well as romantic couples.

The Stanglwirt Fitnessgarden is an adult-only oasis for indoor fitness, cardio, and strength training, plus outdoor sports programs.Work out on state-of-the-art TechnoGym equipment, Kinesis, and Galileo vibration trainers.

KEEPING IT IN THE FAMILY

Medical Spa construction in the Austrian Alps promises to create Europe’s largest center for healthy holidays and wellbeing at the Stanglwirt Resort, an authentic haven of the good life.

LOCATED

People & Places

Expansion of the Fitness & Well-being facility, scheduled for completion next summer, includes an exclusive new medspa, plus an adventure waterworld for children. The expansion already has several superlatives: the largest saltwater pool in Europe, and the only 80-foot sport swimming pool with an OMEGA timekeeping permanent installation. Designated a “Bio Hotel,” the Stanglwirt was built with wood from the site. Mountain springs supply water for the entire resort. An eco-friendly heat pump system warms the resort.

Family owned and operated, the Stanglwirt traces its development from mountain inn to spa over 400 years. The Hauser family’s pioneering role in sustainable tourism was the focus of a preview in New York recently. Maria Hauser told us about her younger brother Johannes who is a food and beverage specialist, her sister Elisabeth currently working in Switzerland at a Marriott, and brother Richard, a specialist in all matters concerning strategy and structure. Their mother Magdalena, the “soul of the hotel,” oversees decoration and, as a qualified hiking guide, regularly goes on mountain tours in the summer with Stanglwirt guests, while father Balthasar Hauser oversees it all. Contact: www.stanglwirt.com

GROTTOS, CAVES AND WATERFALLS – As of now, Stanglwirt guests enjoy panoramic views FAMILY FUN IN THE ROCK SPA of the mountains while relaxing in a spacious sauna that holds up to 40 persons, or a Swiss stone pine sauna for up to 25 persons. Splashing in a waterfall grotto, or swimming in an outdoor pool enhanced with filtered seasalt, you have the option of bathing nude or family style.

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MEDI CAL SPAS • September 2014

A fitness and well-being oasis made from local stone with grottos, winding paths, caves, and waterfalls awaits all guests great and small at the Rock Spa of the Stanglwirt. Built of natural stone from nearby hills, the sauna scene with its spruce bio sauna, salt grotto, natural stone sauna, and a rock crystal steam grotto, boasts a seawater aquarium with a coral reef. www.medicalspasreview.com

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People & Places

MEDI CAL SPAS

TOWN OF ANDERMATT WAS A HEALTH RESORT & HEALING VORTEX

SWISS

RESORT OPENS FIRST WELLNESS CENTER WITH

EAST/WEST CHIC, THE CHEDI ANDERMATT Swiss ski resorts like Gstadd, St. Moritz, and Davos are famous for luxury and style. Now comes The Chedi Andermatt with a new lifestyle: wellness.

WELLNESS

AND FITNESS MIX WITH LUXURY Located half-way up the famed Gotthard Pass Railway, the SKIING AT THE FIRST NEW RESORT IN THE town of Andermatt has in the past been a health resort and healing vortex. SWISS ALPS TO CAPITALIZE ON WELL-BEING.

Built by a developer with Asian and Egyptian roots, the Swiss (CHF) 300-million project represents the first phase in an ambitious plan to offer winter sports combined with a new twist on spa traditions with an Asian accent. 30

MEDI CAL SPAS • September 2014

THIS VILLAGE ONCE ATTRACTED QUEEN VICTORIA & JAMES BOND

People & Places

Sawiris brought in General Hotel Management (GHM Ltd) to develop and operate the hotel, while Andermatt Swiss Alps went about selling investments in luxury homes and apartments. The Chedi (meaning a stupa or Thai Buddhist monument) known for Asian resorts like the Naam Hai in Vietnam, now has its first European hotel.

Standing by is your sport butler, with Head skis and mountain bikes. Catering to ski enthusiasts who enjoy personal attention, the butler selects boots and skis in a warm, comfortable lounge, outfits you, and escorts you across the road to the new ski lift. Surrounded by the Swiss Alps, the valley enjoys ideal snowy conditions, but the combination of facilities for Sedrun and Andermatt is Opened in 2013, the hotel’s interpretation of traditional unprecedented, and will offer the finest skiing in central Swiss style conceals its Asian roots. Past registration, you Switzerland. suddenly are in a royal court of the heavenly Himmalaya. On one side, a 35-metre swimming pool, glass covered; in Creating the Chedi’s East/West ethic was the task assigned the central section, conversational firepits among soaring to Jean-Michele Gathy, chief designer at Denninston columns are a setting for tea and talk. The hotel’s twin International Architects and Planners Ltd., based in Kuala kitchens offer Asian and European menus, illuminated by Lumpur. The restaurants designed by SPIN Studio in 12 huge chandeliers. Beyond, the spa welcomes you to Tokyo introduce a new attraction: sushi or traditional wellness. Swiss.As a compromise, The Chedi Menu (CHF 125) offers Shanghai spring rolls or Maine lobster, tandoor-marinated The Spa opens like a lotus flower. At the registration desk, monkfish, saddle of local veal with Alpine cheese yak tart, manager Irmgard Kuchernig offers choices: signature Jade and dessert of Guanaja chocolate with caramelized combination of shiatsu, Balinese, Thai, Lomi-Lomi, and cherries. Cheese comes from a five-metre-high glassSwedish techniques (60 min., CHF 350), work on the lymph walled cellar that houses the valley’s famous unpasteurized system combined with energy-building Tibetan Ku Nye product from Uri canton. massage done by a therapist from Tibet (90 min, CHF 300), or go for chakra massage of muscles (75 min., CHF 250). Built on the site of a former health spa, there are just 104 rooms and suites, 31 deluxe rooms, and 13 grand deluxe, Made in Austria, Alpienne containing oils from plants and plus 45 condos, and 196 fireplaces. Here it’s all about fruits found in the Andermatt region allows the spa to Alpine chic meets Asian zen: dark wood walls, heated feature an indigenous menu. stone floors, soft leather chairs and a long sofa under a mural of a ski scene. Bathrooms feature free-standing Treated in one of 10 spa suites, I was left alone to enjoy soaking tub, separate rainshower and toilet. Even the swimming pools, hammam, or manicure, pedicure, and wardrobe area is detailed in leather, with space for a winter hair styling. Active guests work out on a full line of visit. Technogym equipment with the Visio Web line, Kinesis wall, Power Plates, and Pilates machines. Then I discover Walking around Andermatt evokes the old village history the hydrotherapy pools, three heat zones inter-connected, that once attracted Queen Victoria and James Bond. Time plus rainshowers and saunas. True bliss. for a beer and fondue, perhaps. But those who are sensitive to metaphysical vibrations of the earth will enjoy a sense of well-being at the energy hot spots or vortex. The local tourist board has compiled 10 such maps, including the source of the River Rhine. Future plans for physical rehabilitation facilities will add to the attractions of Ursener valley. The Swiss Army training center may have left, but for now, The Chedi is reviving a commitment to well-being.

Discovered ten years ago by Egyptian entrepreneur Samih Sawiris, who declared it a sleeping beauty, the hotel and spa became centerpieces for an ambitious plan that includes hotels, golf course, and a new skilift that will unite with an existing network .

www.GHMhotels.com www.medicalspasreview.com

www.medicalspasreview.com

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Offshore Assets

MEDI CAL SPAS

HAVE YOU LOOKED OFFSHORE ON YOUR WEALTH PLANNING?

MANY OFFSHORE BANKS WILL NOT REPORT INTEREST TO IRS

Offshore Assets

The bottom line: going offshore to save taxes has non-exempt options for doctor clients who must have

IS “OFFSHORE” ASSET PROTECTION RIGHT FOR YOU?

rarely been tax compliant and many tax evaders are the top level of protection. now “coming clean.” A number of jurisdictions have adopted LLC GOING OFFSHORE TO GET RICH QUICK LEADS legislation over the last decade, most notably Nevis.

B y DAVID B. MANDELL, JD, MBA JASON M. O’DELL, MS, CWM

DAVID B. MANDELL, JD, MBA, is an attorney and author of five national books for doctors, including FOR DOCTORS Only: A Guide to Working Less & Building More, as well a number of state books. He is a principal of the financial consulting firm OJM Group (www.ojmgroup.com), which works collaboratively with physicians and their CPAs nationwide. JASON O’DELL is a financial consultant, lecturer and author of two books for physicians. David B. Mandell & Jason O’Dell are both principals of the financial consulting firm OJM Group.

in their wealth planning – although, overall, still a small minority.

The desire to get rich quick leads many clients into problems most pervasive in the investment arena. 1. Owning foreign insurance policies: One of the

That is not necessarily a bad thing; as there are numerous pitfalls for using international planning that can catch naive doctors. In this article, you’ll learn what to do (and what to avoid) in international planning, and about specific tools top attorneys use in their international planning.

Here, scam artists and fraudsters abound, poised to leading international financial planning strategies take advantage of the next client who wants to “get today is purchasing a permanent (cash value) life rich offshore.” The savvy doctor understands that any insurance policy offshore. In terms of tax planning, if investment that offers truly outstanding returns is on the policy is U.S. tax-compliant, then all of the growth

GOING OFFSHORE TO AVOID U.S. TAXES LEADS hope that they are never caught. This “hide the ball” TO TAX EVASION

strategy is used not only by knowing clients, but also by shady advisors who concoct ever more

A

mericans are liable for taxes on all income sophisticated schemes like … moving money from earned offshore. However, it is true that one Trust to another company to a third foundation many international banks, mutual funds, … and so on in hopes of avoiding detection.

the radar screen of the world’s most sophisticated within the policy will accumulate tax-free. Further, financial institutions and their super affluent the proceeds will pay out to the beneficiary income clientele. Then, the investment is reserved for the tax free and the client can take loans against the financial institution’s billionaire clients. They know accumulated cash values during his life tax-free. This that the only thing that can be achieved from chasing is similar to the benefits of a domestic cash value life fantastic returns in international markets is a insurance policy. significant, if not complete, loss of principal.

and other financial institutions will not report

2.

earnings/interest to the IRS. This is the chasm where Although the pitch may seem complex and many greedy clients – or unscrupulous advisors – impressive, astute doctors know to always ask the operate. This is also where tax evasion – a federal following question: If the income will eventually

report it to the IRS? They know that they must steer While the client is required under U.S. law to make clear of these schemes unless they want the cloud of a

planning

for

an

OF A CLIENT’S PLAN

to create a nest egg for future generations like children, grandchildren and beyond. And let’s say it is

Done right, these tools can be used to achieve a high important that the nest egg be asset-protected in an (+4/+5) level of protection. Compared to state (+5) ironclad way. In this circumstance, an international exempt assets (discussed in other articles), which do Trust would be an ideal tool. This would be especially not have professional, government or accounting fees, appropriate if the trust was created in a country where

internationally (and advisors should instruct their for years to come.

these tools are expensive – but they may be the best the law does not limit the duration of Trusts under the

clients to do so), many clients may keep quiet and MEDI CAL SPAS • September 2014

Multi-generational

INTERNATIONAL LLCS & TRUSTS: CAN BE PART international family: Let’s say the goal of a client is

accrue to my benefit, how come I don’t have to

the necessary tax reporting on income earned possible tax evasion indictment hanging over them

32

Also, many jurisdictions have international Trust (IT) laws as well. Common uses of these tools include:

Over the last decade, an increasing number of doctors have looked internationally

crime – is committed. They can be reached at 877-656-4362 or mandell@ojmgroup.com

TO SCAMS & FRAUDS

www.medicalspasreview.com

www.medicalspasreview.com

MEDI CAL SPAS • September 2014

33

MEDI CAL SPAS

Offshore Assets

GOING OFFSHORE TO SAVE TAXES HAS NOT BEEN TAX COMPLIANT “law against perpetuities,” found in many of the Disclosure: states. By using an IT, the client from an international OJM Group, LLC. (“OJM”) is an SEC registered investment Micro-channeling technology has been gaining popularity as a highly effective aesthetic therapy for skin rejuvenation. This well-researched treatment, also called micro-needling or percutaneous collagen induction (PCI), was pioneered in 1996 by plastic surgeon Des Fernandes and numerous clinical studies demonstrate its benefits, including helping to improve the appearance of aging skin, pigmentation, scarring, and uneven skin. Traditionally performed with a handheld microroller, micro-channeling utilizes very small needles to cause a gentle injury to the skin, which triggers the body’s natural response to regenerate collagen and increase fibroblast activity.

family could literally secure the family’s ability to adviser with its principal place of business in the State of enjoy the fruits of the gift for hundreds of years, as Ohio. OJM and its representatives are in compliance with the long as other tax issues were addressed by an

current notice filing and registration requirements imposed

experienced tax expert.

upon registered investment advisers by those states in which OJM maintains clients. OJM may only transact business in

Conclusion

those states in which it is registered, or qualifies for an exemption or exclusion from registration requirements. For

The benefits of international planning can be information pertaining to the registration status of OJM, significant. However, the international tax and please contact OJM or refer to the Investment Adviser Public reporting laws are highly complex. There are many Disclosure web site (www.adviserinfo.sec.gov). areas where an individual or advisor could make a

DermaFrac™ by Genesis Biosystems is an innovative micro-channeling treatment that punctures the skin with stainless steel needle tips that roll across the skin to the precise depth that is ideal for producing the body’s own positive responses. Unlike other micro-channeling technologies, DermaFrac™ simultaneously delivers a targeted infusion serum via vacuum-assisted occlusion, enabling the serum to penetrate through the micro-channels to the dermal-epidermal junction for maximum absorption and effect. This unique delivery system allows DermaFrac™ to achieve highly effective outcomes without pain or downtime.

mistake. Though all areas of planning require the For additional information about OJM, including fees and assistance of advisors, no area of planning requires services, send for our disclosure brochure as set forth on greater expertise than international planning. Make Form ADV using the contact information herein. Please read sure your team of advisors has an asset protection the disclosure statement carefully before you invest or send expert who can help you navigate the tricky waters of money. international planning. The authors welcome your questions. You can contact them at (877) 656-4362 or This article contains general information that is not suitable through their website, www.ojmgroup.com

for everyone. The information contained herein should not be construed as personalized legal or tax advice. There is no

SPECIAL OFFER: For a free (plus $10 S&H) copy of guarantee that the views and opinions expressed in this For Doctors Only: A Guide to Working Less and

article will be appropriate for your particular circumstances.

Building More, please call (877) 656-4362.

Tax law changes frequently, accordingly information presented herein is subject to change without notice. You should seek professional tax and legal advice before implementing any strategy discussed herein.

34

MEDI CAL SPAS • September 2014

www.medicalspasreview.com

“In my 25+ years as a Licensed Medical Esthetician and medical spa owner, I have never seen a medical aesthetic device perform in practice like DermaFrac™. This amazing device gives us the ability to stimulate collagen while infusing potent topical treatment solutions without pain or downtime. We have seen miraculous results for the clients and unbelievable profits for the spa.”

Lyn Ross, LME

Owner, Institut’ DERMed Spa

The DermaFrac™ Treatment Designed expressly to drive topical solutions deeper into the skin, DermaFrac™ creates micro-channels to the dermalepidermal (DE) junction while simultaneously infusing topicals to this all-important tissue layer. In comparison to other micro-channeling devices which have to apply topicals prior to a treatment and manually force the solution into the tissue with the micro-needles, DermaFrac™’s concurrent micro-channeling plus delivery of highly potent solutions makes the treatment fast, effective, pain-free and without downtime. The surgical-grade micro-needles on the roller hand piece have been carefully selected for a controlled depth of penetration. The tips are available in 0.25mm or 0.5mm depths, which is the range just below the DE junction and just above capillaries and nerve endings, ensuring no bleeding or pain. A study by Dr. Joseph Greco ascertained that new collagen is not created below a depth of 0.5-0.6mm, even if longer needles are used; lengths exceeding 0.5mm increase patient discomfort necessitating the use of topical anesthesia.1 Findings by Dr. Lance Setterfield substantiate these results; he found the best outcomes using 0.5mm micro-needles, with 0.2mm and 0.3mm micro-needles performing second best.2 Thus DermaFrac™ maximizes treatment benefit and patient comfort by treating within the sweet spot of the body’s natural regenerative processes. The two needle depth choices allow the practitioner to customize treatment depending upon the skin anomaly being targeted and the overall skin texture.

DermaFrac™ Infusion Solutions Propriety infusion solutions were developed exclusively for DermaFrac™ with a viscosity and molecular structure designed to ensure controlled delivery through the DermaFrac™ hand piece. Rejuvenate This cocktail of five active ingredients has been shown to up-regulate fibroblasts leading to new collagen while attenuating the release of neurotransmitters to temporarily relax muscles. t 4ZNQFQUJEF¼ .ZSJTUPZM 1FOUBQFQUJEF VQ regulates two fibroblast growth factor related genes by over 250% after 24 hours. t .BUSJYZM¼ 1BMNJUPZM 1FOUBQFQUJEF $MJOJDBM TUVEJFT PG BOUJ XSJOLMF QSPEVDUT DPOUBJOJOH .BUSJYZM¼ IBWF reported wrinkle reduction by as much as 36%. t 4/"1 ¼ "SHJSJMFOF¼ BOE 4:/¼",& 5IFTF QFQUJEFT reduce the ability of the neurotransmitter to reach its receptor on the muscle. This muscle contraction decreases the appearance of lines and wrinkles.

Lighten ,PKJD "DJE JT B QSPWFO FòFDUJWF OPO UPYJD lightening ingredient which acts upon melanin-producing cells to suppress melanocyte BDUJWJUZ BOE UIF QJHNFOUBUJPO QSPDFTT ,PKJD "DJE also has antibacterial and antifungal properties.

Hydrate 5IF )ZBMVSPOJD "DJE )ZMB4QPOHFÂĽ System is comprised of proprietary levels of small and large hyaluronan molecules and highly IZESBUFE )ZMB4QPOHFTÂĽ 5IJT TQFDJĂśD DPNCJOBUJPO PG hyaluronan components assures that a large amount of water is retained and guarantees the delivery of water to the deeper layers of the skin. The intense Anti-Aging hydration reduces the appearance of grooves,Peptide fine linesSolution and wrinkles while smoothing the skin. The hydration TPMVUJPO BMTP DPOUBJOT 3FUJOZM 1BMNJUBUF 7JUBNJO " an antioxidant that accelerates skin turnover and stimulates new skin formation; Tocopherol Acetate, XIJDI FOIBODFT 67 SFTJTUBODF BMPF HSFFO BOE XIJUF tea and grape seed antioxidants to calm the skin.

Clarify Cleansing congested oily pores results in more vibrant, clearer skin. Salicylic Acid exfoliates, opens clogged pores and neutralizes bacteria. Lactic Acid loosens the bonds between dead skin cells and reduces the formation of whiteheads and blackheads.

The Science Behind DermaFrac™

Improving Laser Treatments with DermaFrac™

Increases Collagen and Skin Thickness

Many patients request treatments to counter or reverse the effects of photoaging in skin, which results from exposure UP 67 SBEJBUJPO BOE PUIFS FOWJSPONFOUBM GBDUPST 7JTJCMF TJHOT PG QIPUPBHJOH NBZ JODMVEF XSJOLMFT EFDSFBTFE TLJO laxity, fine lines, and/or pigmentation. Typically, photoaging and skin laxity are treated with ablative procedures that remove the stratum corneum and can destroy the epidermis, leading to fibrosis and dyspigmentation. DermaFrac™ revolutionizes this approach by providing a viable option for improving photoaging and skin thickness without damaging the outer layers of the skin.

An international retrospective analysis of patients demonstrated increases in collagen and skin thickness as a result of micro-needling. Histologic examinations revealed significant increases in collagen six months postoperative and a thickening of stratum spinosum at one year postoperative.3

Doesn’t Destroy Epidermis or Cause Dyspigmentation A pilot study evaluating the effects of micro-needling on post-burn scarring showed the procedure to be a safe scar treatment without damaging the epidermis.4 $PODMVTJPOT GSPN 'FSOBOEFT SFUSPTQFDUJWF TUVEZ JOEJDBUFE UIF epidermis was not damaged.3 An in-vivo non-human study revealed micro-needling left the epidermis intact with no damage to the stratum corneum, any layers of the epidermis, or the basal membrane. Melanocytes neither increased nor decreased, improving skin appearance without risk of dyspigmentation.5

Patrick J. Clark, Ph.D., CMSLO, is CEO of Medical Laser Dynamics, an internationally recognized independent aesthetic laser and intense pulsed light education group with the largest clinical laser and intense pulsed light training program in the world. In his experience, DermaFrac™ enhances the results of fractional or ablative procedures by better IZESBUJOH UIF TLJO CFGPSF BOE BGUFS MBTFS *1- BOE PS 3' QSPDFEVSFT “Getting the skin fully hydrated before a laser peel or any fractional procedure makes for a more predictable treatment and faster recovery.

Clinical Trial: Ultrasound Studies /JOF QBUJFOUT BHFE SFDFJWFE B UPUBM PG TJY %FSNB'SBD™ anti-aging treatments every two weeks. Highly significant results were observed after six treatments using ultrasound imaging.

Baseline After 6 Treatments A 14.79% increase in collagen was observed in the treatment area. ŽƾĆŒĆšÄžĆ?LJ ŽĨ ĆŒÍ˜ DÄžĆŒÇ€Ç‡Ĺś WÄ‚ĆŠÄžĆŒĆ?ŽŜÍ• tŽŽÄšĨŽĆŒÄš ĹŻĹ?ĹśĹ?Ä?Í• h<

Case Report: Periorbital Melanosis in the Dark-Skinned Male " SFDFOU DBTF SFQPSU QVCMJTIFE JO UIF +PVSOBM PG $VUBOFPVT BOE "FTUIFUJD 4VSHFSZ PCTFSWFE B JNQSPWFNFOU JO QFSJPSCJUBM NFMBOPTJT BGUFS GPVS %FSNB'SBD™ TJUUJOHT BOE JNQSPWFNFOUT BGUFS TJUUJOHT BT BTTFTTFE CZ UXP independent physicians. “A number of treatment modalities have been tried for this condition with mixed results, JODMVEJOH UPQJDBM BHFOUT /E :"( MBTFS BOE FWFO GBU USBOTQMBOUBUJPO /POF PG UIF USFBUNFOUT JT VOJGPSNMZ FòFDUJWF w6

After Before Subject received four DermaFrac™ Rejuvenate and four DermaFrac™ Lighten treatments. ŽƾĆŒĆšÄžĆ?LJ ŽĨ ĆŒÍ˜ DÄ‚ĆŒĆ&#x;Ĺś <Ä‚Ć?Ć?Ĺ?ĆŒÍ• Ä‚ĹŻĹŻÄ‚Ć?Í• dy͘ (SFDP +' .JDSP /FFEMJOH BOE *OKFDUJOH 1MBUFMFU 3JDI 1MBTNB UP &OIBODF $PMMBHFO 4ZOUIFTJT BOE 4LJO 5JHIUFOJOH +VM IUUQ XXX NJDSPOFFEMF DPN NBJO .54@3PMMFS@131@1BQFS@CZ@%S(SFDP QEG QBHFNPEF UIVNCT QBHF "DDFTTFE "VHVTU 4FUUFSĂś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ĂśDUJPO 1MBTU 3FDPOTUS 4VSH /PW 4BIOJ , ,BTTJS . %FSNB'SBD™ "O JOOPWBUJWF OFX USFBUNFOU GPS QFSJPSCJUBM NFMBOPTJT JO B EBSL TLJOOFE NBMF QBUJFOU +PVSOBM PG $VUBOFPVT BOE "FTUIFUJD 4VSHFSZ +VM 4FQ 7PM *TTVF

“In ablative resurfacing or any fractional procedure where water is the true target, full dermal hydration is desirable. Dermal hydration cannot be seen and is very different for each and every patient but it is safe to say that most people need to be hydrated prior to such procedures. Therefore DermaFrac™ hydration treatment with hyaluronic acid a few weeks before a procedure helps to raise the target abundance in the epidermis and upper dermis, normalizing target levels so that most patients will have an even response to treatment and an equal ability to recover posttreatment. i3FQFBUFEMZ UIF QIZTJDJBOT and practices I work with echo B DPNNFOU XPSUI TIBSJOH the best care is not just a Before After simple procedure but a plan ^ĆľĆ?ƚĂĹ?ŜĞĚ ĹšÇ‡ÄšĆŒÄ‚Ć&#x;ŽŜ Ĺ˝Ä?Ć?ÄžĆŒÇ€ÄžÄš ĆšÇ Ĺ˝ Ç ÄžÄžĹŹĆ? Ä‚ĹŒÄžĆŒ ƚŚĞ ĎŜĂů ĆšĆŒÄžÄ‚ĆšĹľÄžĹśĆšÍ˜ involving both preparation ŽƾĆŒĆšÄžĆ?LJ ŽĨ ĆŒÍ˜ DÄ‚ĆŒĆ&#x;Ĺś <Ä‚Ć?Ć?Ĺ?ĆŒÍ• Ä‚ĹŻĹŻÄ‚Ć?Í• dy and recovery of the patient from even the most basic MBTFS *1- 3' QSPDFEVSFT 1SFQBSBUJPO GPS QSPDFEVSFT PGUFO JODMVEFT EFSNBM IZESBUJPO GPS everyone and tyrosine inhibitors for the darker Fitzpatrick types to avoid Post Inflammatory Hyperpigmentation. Always look to consultation and plan implementation as a threefold QSPHSBN GPS 3FQBJS .BJOUFOBODF BOE 1SFWFOUJPO 5IFSF BSF NBOZ HPPE TPMVUJPOT PO UIF NBSLFU but DermaFrac™ and ablative fractional procedures are an excellent way to accelerate, repair and enhance maintenance. Those who follow those concepts find themselves and their patients/ clients more satisfied with their outcomes.â€?

A Superior Treatment /PU POMZ JT %FSNB'SBD™ IJHIMZ FòFDUJWF GSPN B DMJOJDBM TUBOEQPJOU JU JT JEFBM GPS UIF NFEJDBM TQB FOWJSPONFOU CFDBVTF of its applicability to any patient, its quick turnaround time, and its potential for profitability.

Precise Depth of Penetration Manual rollers work by pushing a needle down into the skin, which causes pain to the patient. Additionally, since the skin is elastic, the depth of penetration by a manual roller is never even throughout an entire treatment and therefore unpredictable. Since the DermaFrac™ hand piece operates under vacuum, the skin is drawn up into contact with the rollers, ensuring an even depth of penetration. The simultaneous infusion of a serum makes the procedure very comfortable for the patient and targets the patient’s specific skin condition.

Dr. Alberto Carro Medical Director, Cypress Cos-Medic Center “DermaFrac™ has greatly increased our revenues and is not rivaling fillers and Botox but is an adjunct to them. The results have been nothing but spectacular from the first to the last treatment.â€?

Before

After ^Ĺ?Ĺ?ĹśĹ?ÄŽÄ?ĂŜƚ ƉĹ?Ĺ?žĞŜƚĂĆ&#x;ŽŜ Ĺ?ĹľĆ‰ĆŒĹ˝Ç€ÄžĹľÄžĹśĆš Ĺ˝Ä?Ć?ÄžĆŒÇ€ÄžÄšÍ˜

^ĆľÄ?ĹŠÄžÄ?Ćš ĆŒÄžÄ?ÄžĹ?ǀĞĚ ĨŽƾĆŒ ÄžĆŒĹľÄ‚&ĆŒÄ‚Ä?ÎĄ ZĞŊƾǀĞŜĂƚĞ ĆšĆŒÄžÄ‚ĆšĹľÄžĹśĆšĆ? ĂŜĚ ĨŽƾĆŒ ÄžĆŒĹľÄ‚&ĆŒÄ‚Ä?ÎĄ >Ĺ?Ĺ?ŚƚĞŜ ĆšĆŒÄžÄ‚ĆšĹľÄžĹśĆšĆ?͘ ŽƾĆŒĆšÄžĆ?LJ ŽĨ ĆŒÍ˜ DÄ‚ĆŒĆ&#x;Ĺś <Ä‚Ć?Ć?Ĺ?ĆŒÍ• Ä‚ĹŻĹŻÄ‚Ć?Í• dy͘

Results without Pain Clinical studies indicate that micro-needling produces zero collagen fibers deeper than 0.5mm even if a 2mm needle is used. A paper published in 2014 states that the best results from micro-needling were found with needle lengths of 0.3 to 0.5mm compared to 2mm needles. These results show that DermaFrac™ maximizes effectiveness and patient comfort by utilizing 0.25mm or 0.5mm needle tips which do not require topical anesthesia.

Quick Turnaround Means Greater Profitability 5IF %FSNB'SBD™ USFBUNFOU UBLFT NJOVUFT DPNQBSFE UP UIF NJOVUFT SFRVJSFE GPS B SPMMFS PS QFO VUJMJ[JOH UPQJDBM anesthesia. This means that a room can be turned over in 30 minutes accounting for patient check-in and room clean up. With such a short turnaround time, DermaFrac™ allows more patients to be treated for greater profitability.

Meredith Benton Licensed Esthetician “Utilizing the microneedling technique with DermaFrac™ has increased my service revenues by 200%! DermaFrac™ challenges the skin just enough, without crossing the threshold of causing inflammation in the skin. I have noticed tremendous improvement in the skin texture - real change, not just temporary hydrating. It’s a stellar treatment for most individuals.â€?

Before

^Ĺ?Ĺ?ĹśĹ?ÄŽÄ?ĂŜƚ Ĺ?ĹľĆ‰ĆŒĹ˝Ç€ÄžĹľÄžĹśĆš Ĺ?Ĺś ĎŜĞ ĹŻĹ?ŜĞĆ? ĂŜĚ Ç ĆŒĹ?ŜŏůÄžĆ? Ä‚Ć? Ç ÄžĹŻĹŻ Ä‚Ć? ĹšÇ‡ÄšĆŒÄ‚Ć&#x;ŽŜ ĂŜĚ ƉůƾžĆ‰ĹśÄžĆ?Ć?͘

Anyone is a Candidate DermaFrac™ provides micro-needling for a greater number of patients because it is safe for all skin types and the infusion serums address four of the most common skin conditions. Everyone who walks through a spa or clinic door is a candidate.

Serum Effectiveness With traditional micro-needling, serums are applied just before or just after treatment. There is speculation that if serums are applied immediately after needling, the majority of the channel is full of interstitial fluid and blood therefore limiting the penetration of the serum. DermaFrac™ solutions are not only applied simultaneously, allowing for deep delivery into the skin, but are water based and will have less tendency to cause granulomas, which form from skin care products that are not designed to be absorbed into the skin.

After

^ĆľÄ?ĹŠÄžÄ?Ćš ĆŒÄžÄ?ÄžĹ?ǀĞĚ Ć?Ĺ?dž ÄžĆŒĹľÄ‚&ĆŒÄ‚Ä?ÎĄ ZĞŊƾǀĞŜĂƚĞ ĆšĆŒÄžÄ‚ĆšĹľÄžĹśĆšĆ?͘ ŽƾĆŒĆšÄžĆ?LJ ŽĨ WĆŒŽĨÄžĆ?Ć?Ĺ˝ĆŒ ^ƚĞƉŚĞŜ ͘ ^Ä?ŚĞŜĚĞů͕ D Í• ^Í• WÄ‚ĹŻĹ˝ ůƚŽ͕ ͘

Dr. Martin Kassir Aesthetic Dermatologist, Mona Lisa Dermatology i,OPXJOH UIBU %FSNB'SBD™ XPVME become revolutionary in skin care, I was fortunate to become one of the first clinicians with extensive experience with this procedure, and I’ve lectured on this procedure since its inception in 2010.�

Before

After

DĹ˝ĆŒÄž ĞǀĞŜ Ć?ĹŹĹ?Ĺś ĆšŽŜÄž ĂŜĚ ĆšÄžÇ†ĆšĆľĆŒÄžÍ– ĎŜĞ ĹŻĹ?ŜĞ ĂŜĚ ƉĹ?Ĺ?žĞŜƚ Ä?ŚĂŜĹ?ÄžĆ?Í– Ĺ?ĹľĆ‰ĆŒĹ˝Ç€ÄžÄš ĹšÇ‡ÄšĆŒÄ‚Ć&#x;ŽŜ ĂŜĚ ƉůƾžĆ‰ĹśÄžĆ?Ć?͘ ^ĆľÄ?ĹŠÄžÄ?Ćš ĆŒÄžÄ?ÄžĹ?ǀĞĚ Ć?Ĺ?dž ÄžĆŒĹľÄ‚&ĆŒÄ‚Ä?ÎĄ ZĞŊƾǀĞŜĂƚĞ ĆšĆŒÄžÄ‚ĆšĹľÄžĹśĆšĆ?͘ ŽƾĆŒĆšÄžĆ?LJ ŽĨ WĆŒŽĨÄžĆ?Ć?Ĺ˝ĆŒ ^ƚĞƉŚĞŜ ͘ ^Ä?ŚĞŜĚĞů͕ D Í• ^Í• WÄ‚ĹŻĹ˝ ůƚŽ͕ ͘

'SR½KYVEXMSR 3TXMSRW %FSNB'SBD™ EFMJWFST QSPĂśUT BOE øFYJCJMJUZ CZ PòFSJOH NVMUJQMF USFBUNFOU NPEBMJUJFT JO POF TZTUFN

The DermaFrac™ Treatment: t t t

.JDSP DIBOOFMT EFMJWFS IJHI HSBEF TFSVNT UP UIF %& KVODUJPO 5IF CPEZ T OBUVSBM SFTQPOTF UP B NJME USBVNB JODSFBTFT DPMMBHFO BOE ĂśCSPCMBTU BDUJWJUZ 5IF EFMJWFSZ PG TPQIJTUJDBUFE TFSVNT UP UIF TLJO OPVSJTI BOE TUJNVMBUF GPS FYDFMMFOU SFTVMUT

Microdermabrasion: t t t

#JP #BSSJFS™ EJTQPTBCMF UJQ DBQ EFTJHO FMJNJOBUFT concerns of viral or bacterial cross-contamination. /P DMFBOJOH PS TUFSJMF QSPDFTTJOH SFRVJSFE CFUXFFO treatments, saving you time and money. $IPPTF GSPN TJY EJTQPTBCMF DSZTUBM GSFF UJQT SBOHJOH JO abrasiveness and shape for exact, even peels.

LED Light Therapy: t t t

)JHI FOFSHZ -&% MJHIU UIFSBQZ SFEVDFT USFBUNFOU UJNF $PPM#SFF[F™ XBOET DPPM BOE TPPUIF UIF TLJO XJUI gentle airflow during the treatment. #MVF BOE 3FE -&%T HJWF ZPV BEEJUJPOBM USFBUNFOU options depending on the skin condition being treated.

Dr. Toni Stockton Board-Certified Dermatologist, Stockton Dermatology “The DermaFrac™ treatment is beneficial for all skin types. It is not just a spa treatment but a real treatment giving real improvements in the skin. DermaFrac™ is the next generation in skin treatments.â€?

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Melinda Minton is a spa consultant and health and beauty expert with offices in Scottsdale, New York City, and Denver. Minton is a certified massage therapist, esthetician and cosmetologist with an MBA in marketing. In 2006, Minton was appointed to the United States Business Advisory Council (BAC) representing small business interest and was named Colorado Business Women of the Year by the Bush Administration. Minton is the founder of The Spa Association (SPAA), a world-class organization dedicated to enriching the professional beauty industry through self-regulation, education and sound business practices. SPAA is the largest spa association in North America. Waterpik, Sandals and Beaches, Borghese, Avon, Disney and W hotels. www.spaminton.com

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1. Grand Opening Incentives: offer a free gift or a small discount for every first-time patient during your grand opening week. 2. Flyers: More cost-effective advertising than print or direct mail. Design your flyers so they won’t get tossed into the trashcan without being read.

Medspa Marketing

10. Thank you Notes: Mail thank you notes to repeat customers offering a discount on their next visit. 11. Happy Birthday Coupon: Mailing a birthday postcard offering a discount is a great way to maintain frequent customers and ensure that your mailings aren’t discarded. 12. Sponsorships: Sponsor industry related events like a 5K race or a health fair. Make sure your medspa name gets out before during and after the event. 13.Write to a Newspaper’s Health and Beauty Section: Write a press release regarding a new product or service or write an industry-related article. Remember that the newspaper is going to be careful not to give you free advertising. Make sure press releases or feature articles are well written and relevant. 14. Less Popular Holiday Promotions: Everybody does promotions for Valentine’s Day, Christmas and Easter, but what about St. Patrick’s Day or April Fool’s Day.

3. Offer Product Samples to First time customers: Offer something to new patients. 15. Handwritten Notes: A handwritten note will catch a customer’s eye more than a general direct-mail letter. 4. Mailing Lists: Create a monthly or bimonthly mailing to your clients, advertising your latest product, service, or promotion and providing a health tip or two. 5. Reward Customer Referrals: Give regular medspa customers business or referral cards offering new customers a discount or free gift.Also reward your regular customer for any successful referrals. Remember word of mouth can be the best advertising.

16. Cart Crazy: Advertise on grocery carts. 17. Movie Madness: Advertise in movie theaters before the previews.You have a captive audience with nothing to do but stare at the big screen until the movie begins. 18. Phone Fun: Advertise on phone booths. Maybe you can even post a flyer for free.

6. Customize It: Offer a customized product or service plan. The public usually loves products designed specifically for them. Use a database as a way to remember your client’s preferences. Offer health and beauty outside medical consultations to recommend the best products and treatments.

19. More than What you Paid For: Many grocery stores offer advertising on the back of their receipts. 20. Bathroom Reading: Many restaurants, malls, or other public venues sell advertising in bathroom stalls.

7. Host a Contest: Use your medspa’s products or services as a prize package. Place entry boxes in malls or other small businesses such as gyms or restaurants (with their permission). Then use the entries as a basis for a mailing list.

21. Advertising All Around You: There is advertising everywhere, take a moment to notice all the potential advertising Opportunities in your area: schools, health clubs, vending machines, taxis, etc.

8. Buy One Get One Coupons: Using buy one get one free, or half off or 10% off, for services on the same visit guarantees that you have at least two customers coming in on a single visit.

22. Team Up: Team up with other industry related companies to do a promotion, contest or sponsorship.

9. Accept Competitor’s coupons: It can be expensive to print your own coupons so if there are competitors to your medspa, offer to accept their coupons.

23. Person Advertising: Advertise on your personalized license plate or on your car, give cards or coupons to your friends, doctors, dentists, car repair people, etc.

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MEDI CAL SPAS

Medspa Marketing

MEDI CAL SPAS

USE A DATABASE TO REMEMBER CLIENT’S PREFERENCES

MAIL THANK YOU NOTES TO REPEAT BOTOX CLIENTS

24. “On Hold” Recordings: If you provide a recording while your customers are on hold try to make them humorous instead of a boring sales pitch. Use voice-overs, music, etc. Warning: don’t make it cheesy. 25. Share Ideas with Other Spas: If you serve a local market, exchange tips with other spas in other locations.

37. Mascot: If you have a pet on your premises, use it as a mascot. If you have an animal in your logo, use it.

26. Keep on Eye on the Competition: Make sure you’re up to date on industry trends and specifically the products and services being offered by your competition. Know their promotions, coupons, etc.

39. Celebrate Your Anniversary: Every year on the anniversary of your grand opening, plan a promotion to celebrate and thank your customers and community.

27. Newsletters: Producing a newsletter with relevant health, beauty and fitness articles may provide direct mail that won’t get thrown away. Don’t forget to add in your latest promotion, product, service, or coupon!

40. FREE!: If you’re giving away a free gift, make sure any published material says “free” as much as possible.

28. Put your Name and Logo on it: If you provide things to your customers: tissues, pens, notepads, soap, or anything else, put your medspa’s logo on it. 29. Do Something Extra or Unique: Do something unique that will create word of mouth. For example, a shoe store in Texas gives foot massages while the salesperson searches for the correct shoe size. 30. Gift Certificates: Gift certificates are advertising by themselves. Regular customers may buy them for potentially new customers or they may be purchased by someone looking for a unique gift. 31. Testimonials: Include testimonials from real customers in other promotional materials. Don’t forget to encourage your regular patients to spread the word. 32. Make them Stars: Instead of models and celebrities, use your customers as the stars. With their permission, use pictures in brochures or company newsletters. For a better effect, combine it with testimonials.

Medspa Marketing

38. Customer Anniversary Cards: Mail an anniversary card to your customers on the anniversary of their first visit.

41. Buy and Ad in a High School Yearbook or Newspaper: Advertising your medspa near prom or graduation may open up a new potential market. 42. E-mail Ads: Some e-mail services offer users free e-mail in exchange for allowing an advertisement at the end of every e-mail message. Contact various service providers for more information. 43. Build a Web site: People will often check for location, products and services via the Internet instead of picking up the phone. If you’re not Internet savvy and you’re on a budget, hire a college student to develop your site. 44. List your Site on Search Engines: Get your site on search engines or people won’t be able to find it unless they already know your Web address. 45.Web Banner Advertising: Many search engines or other Web sites offer banner advertising that also provides a direct link to your Web site. 46. Sponsor a Float in your Town’s Next Parade: Especially if your medspa caters to very local clientele.

33.A Real Star: If a prominent person in your community is a client, you may be able to use it: If you’re good enough for a famous person, you’re good enough for everyone. 34. Create a Unique Business Card: Use contrasting colors, or create a vertical or abnormal shaped business card. Be careful not to use an abnormal shaped card for industry related or business to business use because they won’t fit in a Rolodex or other business card holder.

47. Participate in Your Community’s Street Fair or Festival: You may have the opportunity to hang a banner or rent a booth. 48. Join your Local Chamber of Commerce: They may host special events or fairs or sponsor various local events. 49. You Could Win a Million Dollars: Attach a lottery ticket to your direct mailing.

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35. Local Welcome Wagon: Donate magnets or notepads with your logo to a local welcome wagon or community welcome organization.

50. Calendars: Provide calendars to you clients marking sale events, providing health and beauty tips, etc.

36. Hidden Discounts: Mail coupons with scratch off hidden botox discounts.You can also make the scratch coupons on valid when scratched off in your spa by an associate.

51. Go Green: As a health related industry, your medspa can create an earth-friendly image by supporting environmental groups or environmentally safe products.

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Medspa Marketing

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WRITE ANTI-AGING COLUMNS ONLINE & TO YOUR LOCAL NEWSPAPER

EXCHANGE TIPS WITH OTHER MEDICAL SPAS

52. Make Friends: Make friends with other businesses in your industry and refer business to each other. Be creative it may be health clubs or other doctors, vitamin stores, etc.

65. Offer Your Expertise: Speak at community events related to health. It gets the word out about your business and demonstrates your expertise and concern for the community.

53. Costumes: Dressing up and costumes catch people’s eyes. If you’re handing out flyers or samples, think of something creative to wear.

66. Free Video: Create a video of 10 beauty tips, 10 ways to healthy skin, etc. and offer free to clients on their second visit, enticing them to come back.

54. Frequent Customer Program: Use punch cards or something else to monitor how often a customer comes and offer rewards at various intervals. It provides incentive for a customer to return to you instead of trying the competition.

67. Letters to the Editor: If you see an article pertaining to your field, write a letter to the editor offering more beneficial information and providing your contact information.

55. Focus on a Small Market: Medspas usually market to women. Try to create an event or promotion that might market to men or children. Take a risk to do something unique.

68. Make a Date: Contact publications that you’re interested in, requesting and editorial calendar. They will provide an outline of the articles, themes and topics the publication will cover throughout the year. This way you know when is best to pitch a related article. Remember you may need to pitch an article months in advance of its desired publication.

56. Comeback Customer: Mail a $50 voucher to a customer you haven’t seen in a long period of time. Most won’t turn it down and most will spend more than $50. 57. Tip Sheets: Create a tip sheet for any topic, for example summer or winter skin care, and mail it with a coupon for an appropriate product or service.

69. Safety Conscious: Be socially responsible and recognize the safety concerns that accompany your products and services. For example the alcohol industry encourages people to drink responsibly. Recognizing a product’s potential risk will show your concern for your clients.

58. Chatting: Enter online chat rooms where you can provide your expertise and sneak in a little publicity.

70. The Envelope Please: Give an award to a member of your community. It will promote your medspa while demonstrating your participation in the community.

59. Coupon Clicking: Provide coupons on your Web site. It costs you nothing to print and the customer is already interested enough to look up information on your site.You just have to bring them into your medspa.

71. 100% Guarantee: Guarantee satisfaction in the products and services your offer. This demonstrates your confidence and your concern for your client’s satisfaction.

60. Brand It: Carry a well known, respected brand name and use it in all your marketing materials to affiliate your spa with a previously established name brand.

72. Be on Top of It: People love “new,” so constantly be on the cutting edge of the industry with new products and services. Market yourself as innovative, new, and modern.

61. Fax Coversheets: In addition to the usual information on your fax coversheets, add something promoting your recent specials or new products. Since you’re faxing the coversheet anyway, you might as well add a marketing message to it.

73. Repetition: People need to hear messages multiple times before they recognize it. Repetition in advertising is extremely important. Don’t forget you can market a product again.A client may have bought a product several months ago, like it, but hasn’t bought it again. Remind your clients how much they like a product.

62. Go Kid Crazy: Even though your medspa probably does not market directly to children, try to do something that appeals to your client’s children. Happy children lead to happy parents. 63. Double Up: Offer a second item free with purchase. For example with the purchase of a lotion you provide a sample of a similar product or an information booklet about skin care, etc.

74. Can’t Have One Without the Other: Use promotions or coupons to increase sales of complementary products. For example: with the purchase of a skincare product, you receive $5 off the same brand conditioner. 75. Follow Up: Telephone new patients a week after their first visit to see if they like their new product, etc. Make sure you have kept track of the products and services each customer buys to personalize the phone call.

64. Tell Them What You Don’t Have: In addition to telling them the products and services you do offer, tell them what you don’t offer. It can make your medspa seem more luxurious.

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