Eye care professionals are ideally suited to offer surgical and nonsurgical aesthetic services

For some ophthalmologists and optometrists, adding cosmetic services to their practices happens naturally. A patient who comes in for an eye exam may ask about eyelash-lengthening serums like Latisse, or a blepharoplasty patient may inquire about Botox. For other eye doctors, adding aesthetic offerings is a strategic decision to increase revenue. There are pros and cons to delving into cosmetic procedures and products, as well as some special considerations to be aware of. Here, experts discuss what you need to know.

A natural segue from blepharoplasty

“Aesthetics is much more than blepharoplasty,” said Julie Woodward, M.D., associate professor of ophthalmology and dermatology and chief of oculofacial surgery at Duke University Medical Center, in an article on ModernMedicine Network’s Aesthetic Channel.

“Lid lift” surgeries can be enhanced with lasers and injectable fillers to reduce under eye hollows and rhytids, said Dr. Woodward. Her practice also provides topical cosmeceuticals, such as antioxidants, retinoids, anti-pigment agents and moisturizers, ablative laser skin resurfacing, laser blepharoplasty, brow lift, vascular laser, micro-focused ultrasound skin lifting, and micro-needling radio frequency skin tightening.

Even when the initial reason for blepharoplasty is medical, many patients want a cosmetic outcome, said oculoplastic and orbital surgeon Jacqueline R Carrasco, M.D., F.A.C.S., in the article. “When you are performing cosmetic surgeries of the eyelid and/or face, it is natural to segue into injectables,” Dr. Carrasco said. She frequently uses botulinum toxins (Botox) and various injectable fillers on her patients.

Ophthalmologists are already trained for detailed work like cosmetic procedures.

Ophthalmologists are ideally suited to offer aesthetic services because they are already familiar with using small instruments and have been trained for detailed work, according to Robert Goldberg, M.D., president of the American Society of Ophthalmic Plastic and Reconstructive Surgery and chief of ophthalmic and orbital surgery at UCLA.

“When you think about surgery on the face, the most important working part is the eye. That is why so many patients come to ophthalmic plastic surgeons for cosmetic surgery around the eye,” he told Ophthalmology Management.

Nonsurgical cosmetic products and services

Even if you don’t plan on offering cosmetic surgery, there are some special considerations before delving into nonsurgical aesthetic or cosmetic products or services.

For instance, dispensing laws vary by state for Latisse (bimatoprost 0.03%, Allergan) – approved by the FDA in 2008 with the specific indication to treat hypotrichosis of the eyelashes by increasing their growth including length, thickness and darkness. Initially launched to dermatologists and cosmetic surgeons before expanding to optometrists and ophthalmologists, the drug cannot be prescribed and dispensed by every doctor, according to the Review of Optometry. Check with your state medical board if you’re unsure.

Some optometrists are finding great success selling over-the-counter eyelash serums such as Zoria Boost from OcuSoft and Lash Boost from skincare company Rodan & Fields. According to a New York Times article, sales of Lash Boost – which topped approximately $175 million in 2017 and briefly sold out over the summer – are largely driven by impressive “before and after” pictures on social media.

Eye care professionals are ideally suited to prescribe lash-lengthening serums like Latisse—and deal with any potential side effects.

Latisse is “a very safe drug,” said optometrist Daryl Mann, former chair of the AOA Medical Eyecare Committee, in the Review of Optometry. The most common side effects found in clinical trials were hyperemia, ocular itching, and skin hyperpigmentation. And, he pointed out, who is better prepared to address those issues than an optometrist or ophthalmologist?

Also, eye care professionals have one less barrier to entry in the cosmetic product space: practices that sell glasses are already set up for retail sales, making it easy to introduce skincare or other aesthetic products.

Where to invest in cosmetic services for your practice

It’s easy to see why practices might consider offering cosmetic services as a new source of revenue. And increased profits can indeed be a benefit for some practices. The catch is that you have to spend money to make money.

Lasers, injectables, and office upgrades top the list of investments necessary to start a successful cosmetics services practice.

Depending on the technology, an intense pulse light laser can run $50,000 and a Fractionated Co2 laser $75,000 with a five-year lease agreement, reported Ophthalmology Management. If you’re not ready to delve into lasers and cosmetic surgeries just yet, injectables like Botox and fillers such as hyaluronic acid can be a good way to start. Injectables are “very popular and a core part of our specialty training,” Dr. Goldberg said.

Even though injectables are relatively inexpensive, ophthalmologists should think carefully about how to best schedule patients to avoid waste, pointed out Dr. Carrasco. The cost of botulinum toxins is about $500 for each vial, so “if the bottle is open for only one patient, you will not make a profit over the cost of the product.” The cost of fillers, on the other hand, is easier to recoup since patients purchase by syringe, she said.

Another necessary expense is making sure your office is up to par with the standards of discerning cosmetics customers. As Dr. Goldberg put it: “The whole office has to be appropriately upscale and concierge-like so that patients with disposable income will want to have their [procedure or treatment] there.”

For more on this, see our eBook, How to Design the Perfect Waiting Room for Patients

Educate yourself before you start

There’s one common refrain amongst eye doctors who have expanded into cosmetic services: be prepared for a lot of competition. Competitors include not only fellow ophthalmologists and other medical specialties like dermatology and plastic surgery, but also aestheticians and “med spas.”

Eye care providers who’ve successfully added cosmetic services to their practices recommend educating yourself through CME courses, trainings offered by the drug companies, and watching videos and lectures by experts in the aesthetic space.

To get started, check out our featured optometry, ophthalmology, and facial aesthetics videos.