Cosmetic medicine and aesthetic surgery: Strategies for success
Authors: George J. Hruza
Journal: Journal of the American Academy of Dermatology (2010)

The intended audience for this multiauthor book is the physician interested in expanding his/her practice into minimally invasive cosmetic services. Even though the text is primarily directed at plastic surgeons, the breadth of authors, consisting of about one half plastic surgeons, one quarter dermatologists, and one quarter nonphysicians, makes it potentially very useful for cosmetically oriented dermatologists. The writing is surprisingly consistent and easy to follow throughout, considering the many different contributors. The main thrust of the book are the pros and cons for setting up a medispa, what services to offer, and what form such a medispa should take—in the office, adjacent to the office, freestanding, in an academic setting, or part of a multispecialty group. Successful examples of each type of medispa are presented in detail by the operators of each type. This section provides some of the most valuable advice. The chapters are very specific as to the successes and challenges faced by the different medispa models. A number of chapters written by business types and attorneys address the various business aspects of a medispa, including the business plan, financing, profitability, human resources, marketing, and regulatory considerations. The business plan chapter is especially useful because it provides a detailed step-by-step guide to developing a business plan specific to a medispa. The other chapters provide many questions and possible ways to proceed (food for thought), but seem to lack enough information of what actually has worked or should work in various scenarios. I was left looking for but not finding useful and practical answers to the multitude of questions and options raised. References to additional information that one could look up to help answer some of the questions raised were not included. Next, a potpourri of services, ranging from cosmeceuticals and superficial chemical peels to fat grafting and laser resurfacing—all of which might be included in a medispa menu—are discussed at some length. The botulinum toxin, laser resurfacing, and fat grafting chapters provide very useful clinical information and valuable clinical pearls that would make it possible for the reader to start performing the described procedure or improve their technique. The chemical peel, vascular laser, intense pulsed light, and filler chapters seem to be somewhat superficial, survey type chapters that might be useful for deciding if those services should be included in the medispa offering, but most dermatologists would not find much information that could be incorporated into their daily practice. The skin care, makeup, and cosmeceutical chapters contain very basic information that could serve as an introduction to the topic for a plastic surgeon or a medical dermatologist. The book was a pleasure to hold and read with lots of white space, brief summary points, and tables and takeaway messages throughout. The color illustrations were of very high quality and very nicely showcased what is the current state of the art in medispa design. The text is written from the point of view of a plastic surgeon, but most of the material would lend itself for use by a cosmetically oriented dermatologist. In summary, this is a thought provoking book for a dermatologist contemplating getting into minimally invasive cosmetic procedures in a medispa setting. After reading this book, one should be able to forge ahead with eyes wide open to all of the challenges, pitfalls, and potential rewards of developing a medispa and how it might complement or hinder one's existing practice.