New year, new you? The appeal of aesthetic medicine | Nexsen Pruet, SARL

Aesthetic medicine practices are booming in the United States. While both surgical and non-surgical procedures include aesthetic practice, non-surgical and minimally invasive options have grown in popularity during the pandemic as consumers have recognized the value of looking after overall health and wellness, especially as more time was spent in front of video cameras. Aesthetic medicine is attracting providers looking for an alternative to the insurance reimbursement indemnity business model and enabling clinicians from diverse backgrounds to successfully enter the industry. This article briefly reviews the most popular aesthetic procedures and key factors that providers who may be interested in expanding their current medical practice to include aesthetic treatments or open an aesthetics-only practice should consider.

What is aesthetic medicine?

Aesthetic medicine is recognized as a subspecialty of medical and surgical practice comprising various health interventions, including preventive, minimally invasive, and operative procedures involving human tissue, performed by physicians, dentists, advanced nurse practitioners, and properly qualified and registered medical assistants. in order to maintain, improve or restore the physical, psychological and/or sexual well-being of patients, using techniques that combine both medical and aesthetic considerations for the patient. Aesthetic practices often include unlicensed support personnel, such as laser technicians and medical assistants, as well as highly trained estheticians to provide a full range of services. Unlike a practice devoted to plastic surgery, which is the process of reconstructing or repairing parts of the body through the transfer of tissue, either in the treatment of an injury or for aesthetic purposes, an aesthetic practice deals exclusively with otherwise healthy patients who wish to improve their overall well-being through the use of a surgical or non-surgical cosmetic procedure. The current line of products, devices, and procedures provide clinicians with the ability to incorporate aesthetic components into an existing medical practice if diversification is desired, rather than an exclusive dedication to aesthetics.

What are some of the most popular cosmetic procedures?

The aesthetic medicine industry rose to popularity in the mid-1990s, but experienced explosive growth between 2000 and 2018. Despite the pandemic, this trend continues. According to the American Society of Plastic Surgeons, 13.3 million minimally invasive cosmetic procedures were performed in 2020.[1] American patients consume the bulk of this multi-billion dollar international medical sub-specialty each year. Popular surgical cosmetic procedures in the United States include liposuction, breast augmentation, rhinoplasty, tummy tuck, and rhytidectomy. The most popular non-surgical cosmetic procedures include neurotoxin modulator injections including Botox, hyaluronic acid injections, hair removal, non-surgical fat reduction, photorejuvenation, microblading, dermaplaning and treatments to platelet-rich plasma. During the pandemic, aesthetic care providers have reported an increased focus on facial treatments.

The American Academy of Dermatology attributes the rise in cosmetic consultations, in part, to Zoom dysmorphia, a disorder triggered by the COVID pandemic surge in virtual meetings.[2] Shadi Kourosh, board-certified dermatologist, MD, MPH, FAAD, assistant professor of dermatology at Harvard Medical School in Boston, director of community health in the department of dermatology at Massachusetts General Hospital, and director of the surgical center at Laser and Aesthetics from Brown Dermatology, defines “zoom dysmorphia” as “an altered or skewed negative perception of one’s body image that results from spending a lot of time on video calls”. “Zoom estimates daily meeting participants grew from around 10 million in December 2019 to over 300 million in April 2020. [Internal citation omitted] Board-certified dermatologists have also reported a change with this increased use of video calls: an increase in the number of patients they see with negative self-perceptions. »

In a survey of more than 100 board-certified dermatologists to determine how the shift to remote work affected patients’ self-perceptions, Dr. Kourosh found that more than 50% of dermatologists reported an increase in cosmetic consultations. “What was alarming in our research results was that 86% of dermatologists surveyed who dealt with these cosmetic issues said their patients had referenced video conferencing as a reason for seeking a cosmetic consultation,” says Dr Kourosh.

What are the considerations for vendors?

Whether opening a new aesthetic practice or integrating procedures into an existing practice, there are a few common considerations providers should keep in mind.

As with any clinical service, providers’ first priority should be patient safety through demonstrated competence. The American Board of Medical Specialties (ABMS) does not yet offer Board certification in aesthetic medicine, so this area of ​​practice is open to physicians from a variety of backgrounds. Physicians and non-physician providers can gain clinical training in aesthetic procedures and medical-grade products, drugs, and devices through formal continuing medical education programs, as well as training offered by vendors specific to their medical devices. , products and/or drugs. It is imperative that providers acquire and demonstrate clinical competence to perform any procedure before performing the same on patients. The scope of requirements and restrictions vary from state to state, and it is the clinician’s responsibility to ensure that their practice falls within the applicable scope. Therefore, it is important to confirm the applicable scope of practice of the state in which the provider practices when undertaking didactic or clinical training. This is especially important to remember when multiple professionals with different licenses will be training and working together.

Providers wishing to provide aesthetic services should fully understand and plan for the financial commitment necessary to provide the desired aesthetic service. For example, the initial investment and potential revenue generated by a practice that integrates a medical-grade laser differs significantly from integrating injectables into an existing practice. A clinician must consider both the initial investment and the potential revenue stream as non-invasive and surgical cosmetic procedures are entirely elective and are significant potential revenue generators, but have a sliding scale of costs and of potential risks.

Regulatory compliance is also an important consideration. Clinicians are responsible for compliance with all applicable state and federal laws governing their profession, as well as policies, guidelines, regulations, and executive orders promulgated by any entity having authority over them. It is imperative that physicians and non-physicians fully understand the requirements for licensing, registration, record keeping, and/or reporting to any government entity. For example, is the practice required to be licensed by the National Board of Pharmacy? Does the practice need to maintain a DHEC or DEA license? How should the prescribing provider document the patient record before performing a procedure or making a prescription? What are the requirements of the clinical environment in which the service will be performed? What supervision/collaboration considerations should be made to ensure compliance if multiple professionals are working together? Is/should the practice be licensed as a salon to provide some or all of the services provided?

Finally, providers must consider the impact of adding or integrating aesthetic services on their quality of life and the pleasure of practicing. These services provide almost immediate gratification to patients and generally result in high satisfaction for both patients and providers. This practice area typically also offers flexible scheduling for the provider as all procedures are elective and non-urgent. Direct payment for purely elective procedures also significantly reduces the administrative burden of the insurance billing model.


The world of aesthetic medicine invites competent and interested providers to get involved. COVID-19 has proven that the market is ripe for even greater expansion as consumers have developed increased demand and acceptance for the offering of aesthetic services. Concerns about appearance during virtual conferences and the desire to alleviate skin conditions such as “maskne” when it comes to frequent masks have spurred demand for aesthetic services. This demand will certainly increase. Providers must maintain compliance with all applicable scope of practice requirements, applicable standards of care, and stringent state and federal regulatory standards to ensure patient safety, even if an aesthetic practice provides relief from administrative burdens. private insurance payer or government payer policies. . A new year is an opportune time for providers to assess whether this area of ​​medicine aligns with their overall quality of life and practice management goals.