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When it comes to cosmetic procedures, prospective patients may be doing more research than ever. According to results of a recent survey from Synchrony Financial, eight in 10 consumers said they researched a procedure or treatment before seeking care. The Cosmetic Path to Purchase Research Study reveals that two-thirds of consumers say they always research cosmetic providers online before selecting one.

The majority of consumers (79 percent) research procedure costs, and nearly one-third said they did not have a procedure done due to cost concerns. Nearly two-thirds of those who undergo procedures use credit to pay for out-of-pocket costs.

The decision to undergo some cosmetic procedures can take weeks to months, results of the survey suggest. However, the decision-making period for minimally invasive and skincare treatments is shorter.

The findings of the report add to data suggesting that cosmetic consumers continue to evolve. Practical Dermatology® magazine reached out to experts to weigh in on several aspects of today’s cosmetic consumer.

Wendy Lewis on…The “typical cosmetic consumer”

In 2019, there is no longer a “typical” cosmetic consumer. The fact is that people of all ages, genders, socioeconomic levels, lifestyles, etc. are seeking out treatments and products from toxins to thigh sculpting and everything in between. One trend is certain, however: surgical procedures are holding their own but barely, and non-invasive and non-surgical treatments are what the majority of consumers are seeking out, either as their first foray into aesthetics, as an alternative to surgery, or in addition to surgery or just for maintenance. Practices may see a woman facing a big birthday who is keen to do something about her crepey neck or lax eyelids, yet on the same day, they are also seeing men seeking solutions for receding hairlines and remedies for looking tired, millennials eager to dive into 5 units of toxin to prevent creases and a syringe or more of hyaluronic acid for Kylie lips, body sculpting consults and mommy makeovers, plus a slew of repeat patients coming in for touch ups, laser and light treatment series, and skin services. That could be a typical Tuesday for many aesthetic dermatology practices.

I tell practices to avoid setting up barriers for bringing patients in the door, and never judge a prospective patient by their address, the label on their handbags, or the kind of car they drive. Bread and butter aesthetic patients now come from all walks of life and income levels, because looking good and feeling good about yourself are priorities for a wider segment of the population than ever before. I have talked to practice managers who see women who bring in a plastic bag of gift cards they get at the grocery store for their fillers to keep it from their husbands so it doesn’t show up on their Visa. Where there is a will, there is usually a way.

...Addressing cost within patient conversations and marketing

This is always a sore subject and one that is very difficult for practices to navigate. In general, you never win in a price war. There will always be someone who is willing to do treatments for less and accept a lower profit margin. I think it is important that, as a board-certified dermatologist, you stress your expertise and training and the quality of the products and devices you use and the results you can achieve. But you can’t just tell patients how great you are; you have to show them and get patients to tell them, too. This is where reviews and ratings are a critical success factor today. Broadcast that you use state-of-the-art FDA-approved injectables and systems and the science and clinical studies that back them up. Emphasize that every injector has a slightly different approach and skill set. The proof is in professional, clear, and consistent before and after photographs of your results, patient testimonials, and video diaries. People have come to believe that photos can be filtered and faked, but with video, what you see is what you get. Build a robust library of your results, because that is will be the ultimate portfolio of your work.

Be conscious of how you are positioning your practice in the marketplace, also. If you haven’t changed the carpet in 10 years, and the paint in the waiting room is peeling, and your website is from 2007, you are leaving yourself open to patients getting the impression that your practice is not high end and thus, it may be hard to charge the highest fees in your zip code.

Always think value, not price. Price is just a number but value is something else entirely. You may be able to charge a higher price point by giving patients good value and pampering services.

...Online presence and marketing

Your online presence is the most important marketing investment you can make in your practice, starting even before you are finished your residency. It is well established that patients go online to seek out cosmetic doctors, and the more engagement you can generate from the beginning, the higher your profile will be. It takes time, money, and expertise. You may start this exercise on your own, but a basic website designed in Squarespace or Wix or a simple site you are renting by the month is not going to enhance your profile in the long run in an effective way.

...The 80/20 rule in the digital age

The 80/20 rule applies to most service businesses: 20 percent of your patients generate 80 percent of your revenue. Don’t take my word for it, do the math year over year. You need to take care of repeat customers and keep them happy so they stay with you by offering little perks, special treatment, and thanking them often. This does not mean that you don’t have to continuously generate new patients to come into the practice, because even your most loyal regulars may leave for reasons having nothing to do with you. People die, move, retire, go broke, marry, and remarry, etc. Life goes on, and you will lose patients by attrition naturally so you always need to be actively engaged in attracting new ones.

Wendy Lewis is President and Founder, Wendy Lewis & Co Ltd, Global Aesthetics Consultancy.

Tom Seery on…The “typical cosmetic consumer”

Cosmetic consumers are smart, digitally empowered, impatient, and demanding. The challenge is that their purchase decisions are unique and atypical, as they learn and conduct research based on a melange of word of mouth, online influencers, patient reviews, and media.

Based on traffic patterns we’ve observed on, we know community members of all ages seek and value authenticity above all else. They want stories detailing real patient experiences, and they want transparency around information the aesthetic industry isn’t open to sharing—like pricing, satisfaction rates, and treatment recovery timelines.

There are more distinct differences when it comes to sharing treatment experiences with others. Millennials tend to be more open to sharing personal details with friends and followers, while boomers can be more cautious and less likely to tell the world about their personal cosmetic interests or experiences.

...Addressing cost within patient conversations and marketing

One of the most perplexing aspects of the aesthetics industry is the widespread discomfort with sharing pricing information—whether it be specific price points, ranges, or explanations of pricing policies at a practice.

For a consumer, trying to make a big purchase decision without prices is like shopping with a blindfold on. Imagine going on Expedia for your next luxury hotel purchase, and the prices were entirely missing. You’d be frozen in place, unable to make a decision.

RealSelf data shows that cost is a top concern among consumers considering a cosmetic procedure. That said, it’s not the only concern. According to a recent conducted online by The Harris Poll, US women who have had or are currently considering a cosmetic procedure say their top concern is paying for the procedure (64 percent), but that’s followed closely by fear of complications or a bad result (60 percent) and finding the right provider (51 percent).

Furthermore, the survey points out that cosmetic consumers say patient reviews (67 percent) and a provider’s education and board certification (66 percent) are the most valuable pieces of information when choosing a doctor for a cosmetic treatment or procedure.

What this data shows us is that most consumers are looking for a quality provider that will provide them with the best possible experience and end result, and they are willing to pay for that.

Pricing transparency will be a huge factor in the future of aesthetics. Just look at the next generation of patients—millennials demand value for money spent, and this is influencing their purchasing behavior. I predict that in under five years cosmetic services pricing will be fully transparent to consumers. In our digital world, when enough consumers demand transparency, technology delivers.

...Online presence and marketing

RealSelf has analyzed our platform and other major doctor listings and found that most dermatologists are staying on the digital sidelines while plastic surgeons and non-core providers have embraced the Internet and social media in full force.

Dermatologists are busy, which makes online efforts seem like a hassle. However, my belief is that having a strong web presence is far more than marketing and acquiring patients. It’s an essential medium for elevating the dermatology specialty and expertise in skincare, which is needed when some of the most heard voices are Instagram and YouTube influencers who have no medical training whatsoever.

Whether on or Instagram, engaging in these platforms is integral to maintaining, protecting, and amplifying a professional reputation. Allowing only others to speak for you—such as in a Yelp! review—is selling the world short on what you do for patients.

One tip that’s key for dermatologists is to be radically authentic in how they post to the web. Don’t outsource the effort to an agency a thousand miles away. Take the effort seriously. Regardless of the medium, if you’re phoning it in, consumers will spot that from a mile away.

On our Instagram (@realself), our highest-performing posts are informative, personal, and non-promotional.

Another tip is to make acquiring patient testimonials a common process in the practice. My team has a wonderful (free) training session for staff, “How to Get a Patient Review in Five Minutes or Less” which is available at

...The 80/20 rule in the digital age

It’s not a great strategy to see the world in a binary fashion, because patients live in a mobile, digital, convenience-driven world. My view is that getting effective at acquiring new patients is equally valuable to being effective at retaining them. When a practice has very limited digital tethering to its patients, they are at risk of being disrupted by new entrants. I’d bet a practice that’s overlooking acquisition efforts also has lower loyalty and repeat rates. In short, the investment in digital is simply a cost of doing business for everyone in the economy. The advantage of really driving acquisition is that it makes the practice invest in the right areas, such as a website that works beautifully on a mobile device for both existing and new patients.

Tom Seery is Founder and CEO of

Joel Schlessinger, MD on…The “typical cosmetic consumer”

There are segments of consumers (young fashion-oriented, young career woman, middle-aged soccer mom, post-kids career woman, male metrosexual, divorced male, etc.), but these are just segments and can be somewhat arbitrary and caricature-like in nature. The commonality is that these individuals all feel that they aren’t represented at their best version.

...Addressing cost within patient conversations and marketing

Cost seems to be a concern for just about every person who walks in the door, whether they are wealthy or just starting out on a career. The main thing is that cost has to be defined and explained correctly. Additionally, for doctors’ offices, the usual bump in costs over a med spa or other, non-doctor facility, has to be explored with the patient. This often happens prior to the appointment and can be a reason for lack of conversion to an appointment or a no show when the appointment time happens. Individuals who say they aren’t sensitive to cost are often misstating the facts and are simply trying to show themselves in the best light to be taken seriously by the doctor.

...Online presence and marketing

Marketing is sophisticated in just about all markets. Doctors are no longer competing against each other as in the 1990s and early 2000s. They are competing against national corporations such as Ideal Image and other med spas who have multi-million dollar budgets and endless options for client conversion, some of which aren’t appropriate for doctors to offer in their offices.

...The 80/20 rule in the digital age

Cosmetic dermatologists absolutely should be aware and concerned about the Internet. Digital marketing options are incredibly well-honed to produce a result, and that result may be the separation of a long-term cosmetic patient from a physician’s practice to another corporate entity.

Joel Schlessinger, MD is founder of and Cosmetic Surgery Forum.

Josh DeBlasio on…The “typical cosmetic consumer”

Today’s cosmetic consumer is really anyone who is coming to a dermatologist with a medical condition/concern that can be improved or corrected by a cosmetic procedure or a cosmeceutical product. This not only includes conditions such as fine lines and wrinkles—a stereotypical cosmetic concern—but also conditions including melasma, acne, rosacea, etc. A stereotypical cosmetic consumer is a woman between the ages of 30 and 60 with a higher level of disposable income and/or someone who is willing to spend money to look better. However, this is changing to include both older and younger women and an increasing number of men. With the rising cost, increased hassle, and reduced predictability of prescriptions and an ever-climbing increase in cosmeceutical options, more patients are now prescribed cosmeceuticals vs. pharmaceuticals. The number of cosmetic procedures performed increases each year.

...Addressing cost within patient conversations and marketing

First and foremost, focus on providing a complete and thorough consultation that includes a clear recommendation with the associated expected outcome. Too many providers try to save the patient money instead of focusing on the outcome. Very few patients complain about the cost when they see the result that they were looking for. The biggest complaints come when patients pay for suboptimal results. In very few other specialties does a medical provider try to save the patient money by not doing what it takes to fix the problem. Hiring a Patient Coordinator to help deliver the pricing and walk patients through the options for payment can help keep pricing consistent. Physicians have a tendency to give away the farm when discussing cost with a patient. Designing your pricing around ideal treatment plans will provide high value to the patient, optimal outcomes, and encourage the “right” revenue. Packaging a combination of treatments, for example, IPL, chemical peels, and a broad-spectrum SPF will correct sun damage and ensure the patient understands at minimum what it will take to protect results.

...Online presence and marketing

A consistent online presence on multiple channels is necessary. In many cases, this is the first touchpoint a patient has with a practice and is a great place for practices to credential themselves and communicate their brand. Potential patients respond favorably to videos, before and afters, and current patient and physician testimonials. It allows the patient to get to know the practice, physician, and procedure in the comfort of their own home and is the first touchpoint a patient has with the practice. Regardless of how many steps are taken, many patients are still intimidated once they step into a doctor’s office. Like it or not, this is how a majority of patients are now choosing their doctor.

...The 80/20 rule in the digital age

I have always been a firm believer in focusing on the patients you have and the rest will follow. Making sure they have an outstanding experience with great service and great results will lead to current patients coming back more frequently, spending more, and referring others. In my 20 years, providers who take extra steps, that do not cost anything, with their current patients have the most success with the least amount of spend. This includes a well trained staff, hand-written cards, running on time, a thorough consult, answering questions pre-, during, and post treatment, etc. This customer-centric approach, combined with being results-oriented, play a major role in defeating commoditization.

Josh DeBlasio is Vice President, Sales, PCA SKIN.

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