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Aesthetics clinic: ‘It’s important for the patient to feel comfortable with you’


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By Rachel Carter

03 Aug 2020

Name of pharmacy: Elegant Aesthetics, AR Pharmacy, Southampton.

Name of pharmacist: Shikha Rishi-Tibbs

Why did you start offering the service?

I had a lot of requests from patients. People were interested in accessing the aesthetic treatment for correcting a ‘gummy smile’ [where people feel they have too much gum tissue showing above their top teeth] and this was not available at the local dentist.

I also personally felt like I needed an extra challenge alongside my role in the pharmacy. I looked into aesthetics, decided to give it a go and immediately loved it.

We have now been offering this service for four years.

How much did it cost to set up the service?

The amount I’ve spent on training to date is in the region of £15,000.

You’ve got to have a clinic room and make the room adequate — the bed is probably the most expensive item for this. I started off with a bed that cost around £150, but I have a much nicer one now, which was around £3,000.

When you first start, you can do it relatively inexpensively. As long as you have a bed, gloves, a mask, numbing cream and lip filler, then you’re good to go. You want to buy a product, but you also need to make sure you have the customers for the product, so you have to weigh that up a bit and start small to begin with. As you grow as a service, you can buy more product — and also have more scope to buy in bulk.

The main ongoing costs are the actual products. At the stage I’m at now, I normally spend around £3,000 per month on stock. My room is fully kitted out now, because I do lots of treatments. I also needed to invest in a centrifuge for platelet rich plasma (PRP) therapy, which is a technique used for ‘vampire facials’, where blood is taken from the client and re-injected into their face.

What, if any, training did you or other team members have to undergo?

I did independent prescribing training, which is worth doing if you want to do Botox. I then went to the SkinViva training centre in Manchester. I have done numerous courses with them, including a foundation course, lips and advanced lips, cheeks, and jawlines.

In a nutshell, what does the service involve?

I run the service from a dedicated room in AR Pharmacy, in Southampton, and at the Sandbanks Clinic in Poole, where I rent a room.

When I first started offering the service, one of the things I hadn’t realised was how vulnerable people are. When you give them a mirror and ask them to tell you about their face, they can’t even look in the mirror. They are that upset — people shock you all the time with how they feel about themselves.

I have a lot of people who will say to me ‘what would you do to my face,’ and I always refuse to answer that question. It’s about the person, their inner confidence and what would make them feel better, not about being aesthetically perfect.

So, the first thing I do is give them the mirror and ask them to tell me what it is that bothers them. At the end of the day, if someone has something that bothers them then it’s the first thing they see when they look in the mirror. So, they tell me — and I’ll say let’s fix that then.

I then go through the different treatment options available. If for example it’s wrinkles on the forehead, then I explain that Botox is an option and we talk through that. But I also talk them through more natural methods that I offer. This could be the vampire facial, which involves taking the blood from the veins, spinning it in the centrifuge and then popping it back into the face. Another is the Aquagold facial, where you gently stamp hyaluronic acid into the face. We also do skin peels and chemical peels. I go through every single service that could be used for the area that bothers them and the prices.

I tell the patient to go away and think about it after the consultation. However, most patients normally have an idea in their mind of what they want before they come to see me, so I tend to leave myself enough time to do the procedure there and then if I can — as long as we’re both confident. Sometimes they go away to have a think.

How often I see patients depends on the treatment. Botox is every three months or so, whereas lip or cheek fillers is something you’d probably want redone every two years. The fat dissolving injections I do are permanent, but it’s very unlikely you will get it all in one go. So, what I always say to people is that this is going to be a journey. We look at where they want to be and how long it will take to get them there. It’s a journey we do together and it’s important for them to be comfortable with me, and me with them.

I have a system for recording my injection points and how much I’ve used and there are consent forms and aftercare forms for the patient to sign. I’ve made tailored consent forms for every single treatment – there’s no one size fits all with this. I always do the consent form at the beginning, after talking them through the treatment. I also take a ‘before’ photo and I call everyone back two to four weeks later to take an ‘after’ photo. I give them a copy if they want it. People forget what their face looks like especially if they’ve had a treatment that works gradually, so it helps them to have the comparisons.

Are there any opportunities to sell over the counter or prescription products during the consultation or after it?

I use a company called ZO for skincare products, some of those are prescription strength, but link selling doesn’t work that well in aesthetics.

How have patients responded to the service?

Patients love it. At the beginning, I thought this type of service was something that was only there for people who had money. But I’ve actually realised that there are some people who are struggling in life and they will still try and get something done for themselves, because it brings out so much confidence in them. If they are the sort of person who has worked a lot towards getting the treatment done, when you do the comparisons they are just blown away. It’s really lovely when you see you’ve made that difference — it’s brilliant and it’s [setting this service up] the best thing I’ve ever done.

Roughly how often each month do you carry out the service?

I work seven days a week and I see at least one patient every day – some days I see 20 or 30 people.

How much do you charge for the service?

I don’t charge for the consultation. A lot of people say that I should, but I think patients should shop around for this type of service, because they are trying to find a practitioner that they like. So, I think they might get put off if I charge a consultation fee, when they’re not yet convinced that they want to come to me. I don’t mind that, it’s their face, it’s important, and I think people should see a few people and find who they’re most comfortable with.

The treatment charges vary massively. At the lower end, I’m doing the B12 injections, which are £50, and one area of Botox costs £150. But if someone wants a full sculpting of their face, then that could be up to £1000.

Roughly how much a month do you make from offering the service?

It really varies. It can be around £10,000, but you’ve got to invest as well. You have to look at your diary for the next month, buy the products, and see if you’ve got enough left for any additional training. Whatever I’ve made over the past few months, I’ve been saving towards a new training course.

Would you recommend offering this service to other contractors?

Yes, but only if they can devote the time to doing it well. It’s not like doing an MUR, where you can pop off for five or 10 minutes. You can’t be doing lip fillers and then have staff asking you to check prescriptions at the same time. If someone is coming to you for a treatment, you’ve got to focus and do it really well.

You also need the space to do it. If someone has a treatment like a vampire facial or a chemical peel, they don’t look great afterwards and they don’t want to walk through a crowded pharmacy to get out or to do the payment. Our pharmacy is huge and I have a dedicated room with its own entrance for patients to exit. But if it’s just a normal community pharmacy then I’m not sure it would work. You’ve got to give this service the dedication it deserves.


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