Navigating Your Career

How to Start and Maintain an Aesthetic Practice | 10 Tips from the Expert

In today’s environment, the increasing consolidation of medical practices, the cost to finance, and the burden of administrative oversight create a challenge to start and maintain your own dermatology practice. This is particularly true when trying to start an aesthetic practice or medical spa. Here, we will learn from Dr. Eliot Battle, Chief Executive Officer (CEO) and Co-Founder of Cultura Dermatology & Plastic Surgery. Dr. Battle discusses 10 tips on how to start and maintain an aesthetic practice.

Tip #1: Take the business challenge seriously.

Dr. Battle emphasizes that you are starting a multi-million-dollar corporation.  To be successful, you should take the business part seriously, which means you must:

    • Clearly understand your role in the business and choose your role carefully
    • Have a well thought out business plan
    • Have a well thought out organizational chart
    • Wisely hire experts for most of the other roles

These are vital considerations; after all, you are competing against experienced cosmetic dermatologists, corporate-owned expansions and franchises, and dermatologists and plastic surgeons who run their own med-spa—most with extensive marketing and capital reserves.  Additionally, you are competing against nurse- and independently owned medical spas with new competitors consistently popping up.

Building a successful aesthetic practice requires knowing your own role in the business. Are you going to be the CEO or physician medical director? Will you be performing patient consultations and/or patient treatments? Dr. Battle’s advice is to spend your energy focusing on being the best physician/practitioner you can be and a cheerleader of excellent customer service. For the rest, he says “hire the rest and hire the best”, including:

    • Office management
    • Financial management
    • Marketing, advertising, public relations
    • Web design
    • Social media management
    • Medical staff (e.g., practitioners, medical assistants)

Tip #2: Spend money on a well-done feasibility study.

There are 4 key steps to design a successful cosmetic practice for optimal function and profitability. The easiest route is to hire the right team to do the following:

    1. Feasibility study
    2. Financial analysis
    3. Conceptual development
    4. Medical spa design

But you may ask, why do I need a feasibility study? The answer is two-fold, namely to:

    • Determine if the aesthetic practice will create profit or increase the profit margin of the facility, and
    • Carefully consider location, space, finances, market demand and potential competition.

The components of a feasibility study include sought-out demographics, market analysis, operational analysis, and an architectural program. If your model plans to prioritize or focus on cosmetic procedures in skin of color patients, it may require you to be in a geographical location with a strong skin of color population or in an area with minimal competition so you can draw from a larger area.

Tip #3: Ensure your practice is aesthetically pleasing and all patients feel welcomed.

Dr. Battle highlights the importance of finding the right location and having an attractive office.  He also states to make sure your patients feel welcomed and see staff that looks like them. Make sure your before-and-after-pictures displays and wall pictures show the demographics you are seeking.  And always have separation of staff duties.  It is not a good look having your front desk receptionist also perform laser treatments.

Tip #4: Managing people is probably the greatest challenge.

Trust is the foundation of managing people and incentives are the glue to keep them happy, says Dr. Battle. Minimizing turnover is the goal. To do this, Dr. Battle urges finding, hiring, and developing the right team. You need people with high professional standards, a team-based approach, and a willingness to learn and adapt.  Their behavior is as important as their resume.  Using incentive programs to reward good people is essential. He quotes coach John Wooden when stating that it is okay to find and reward superstar staff in a superstar way.

Tip #5: Recognize the Importance of the initial consultation.

The goal in the initial consultation is to gain the patient’s trust and respect. An engaging trustworthy consultation is essential to embrace and emotionally connect with the patient. The ways to do this are to focus on education and establish realistic expectations to help the patient believe in your practice and trust you with their cosmetic journey. Dr. Battle also believes in using computerized skin analyses as part of the initial consultation. They provide objective measurements and give the patient confidence that the treatment will be tailored to them.  It further creates a good platform on which to discuss expectations with the patient and give patients a way to objectively grade their improvement by comparing pictures.

Tip #6: Trust but verify.

Don’t assume your team is performing as they should, suggests Dr. Battle. Your role is to focus on quality assurance. Everyone must treat patients with respect, dignity, compassion, and friendliness but always under the umbrella of expertise. Some ways to verify everyone is on the same page is using client evaluation cards, secret shopping services, staff services program, and ongoing training.

Tip #7: Sustain a practice focus on excellent patient care, stellar customer service, brand recognition, and internal/external marketing.

The key feature of this tip is to focus on bringing patients through the door. The most important thing is to treat your existing patients well. After all, they will often recommend new patients to your practice. You will need to spend 15-20% of your gross revenue on advertising and track everything, so you don’t waste your investment. Internal marketing is more important than external marketing, says Dr. Battle, who includes a variety of examples below:

    • Training all staff to simply discuss procedures, benefits, and practice
    • Encouraging waiting room conversation
    • Looping your own media and procedures in the waiting room
    • Having general brochures and relevant posters/placards

Tip #8: Closely track how patients find you.

Dr. Battle detailed how you must track your company’s marketing and advertising return on investment (ROI).  He discussed that even though over 60% of patients find us from patient and physician referral, you must track ROI for all advertising and marketing efforts, including print ads, SEO, internet marketing, social media, radio, TV, etc.

Tip #9: Clinically approach the skin in two directions.

Successful skin treatments will combine a top-down and bottom-up approach. A top-down approach includes:

    • Use of topicals, like retinoids and vitamin C
    • Broad spectrum visible and UV light sunscreens
    • Topical bleaching creams to suppress melanogenesis
    • Medications, like antibiotics
    • Topical corticosteroids to reduce inflammation

Meanwhile some bottom-up approaches Dr. Battle uses include:

    • Lasers and EBDs
    • Injectables (e.g., neurotoxins, fillers)
    • Plastic surgery

Tip #10: Choose your tools, lasers, and EBDs based on patient’s requested procedures and demographics.

Dr. Battle discussed cosmetic concerns in Caucasian women and women of color and the appropriate lasers and EBDs that can be used on that Skin Type.

Note the figures below that highlight the cosmetic concerns. 

cosmetic practice
Slide courtesy of Dr. Eliot Battle
Cosmetic Practice
Slide courtesy of Dr. Eliot Battle

 What clearly stands out is the difference in top concerns between Caucasian women and women of color.  The main concerns for women of color are hyperpigmentation, uneven skin color, and excessive unwanted hair; contrarily, sun damage, wrinkles, broken capillaries, or varicose veins are the main concern for Caucasian women. Dr. Battle highlights some important lasers and devices available that are best for those different needs.


Dr. Battle highlights that there are some myths to dispel. The 10 tips we focused on will help to build a successful aesthetic practice. However, Dr. Battle ends his talk with some false assumptions and myths that can plague us as we proceed in building a successful aesthetic practice.

    • If I build it, they will come.
    • If I buy it, they will come.
    • The more procedures I offer, the greater my revenue.
    • I can discount my way to success.
    • I can just add cosmetic procedures to my existing practice, and it will grow organically.
    • I can do this by myself.
    • I can be a silent partner.

I like to think of these as myths that exist in multiple professions. In fact, my first thought when I personally heard Dr. Battle talk about them was the restaurant business. In fact, I urge you to think about how running a successful aesthetic practice is like running a successful restaurant. If you think about restaurants that you know that are incredibly successful, you probably recognize that they don’t have a large menu, but their smaller menu is focused on a few items that they specialize in and are very good at. Incredible restaurants also recognize their value and don’t do things to cheapen themselves. And yet, there is arduous labor in running such a practice. In that way, what I take away from Dr. Battle’s talk is that these principles underlie a successful aesthetic practice, so the next time you visit a restaurant, consider how Dr. Battle’s tips apply to that restaurant and how you can apply it to your own business.

As a reminder, here are those 10 tips for a successful aesthetic practice.

    1. Take the business challenge seriously.
    2. Spend money on a well-done feasibility study.
    3. Ensure your practice is cosmetically pleasing and all patients feel welcomed.
    4. Managing people will probably be the greatest challenge.
    5. The Importance of the Initial Consultation.
    6. Trust but verify.
    7. Sustain a practice focus on excellent patient care, stellar customer service, brand recognition, and internal/external marketing.
    8. Closely track how patients find you.
    9. Clinically approach the skin in two directions.
    10. Choose your tools, lasers, and EBDs based on patient’s requested procedures and demographics.

This information was presented by Dr. Eliot Battle during the 2022 Skin of Color Update conference. The above highlights from his lecture were written and compiled by Dr. Nishad Sathe. 

Did you enjoy this article? Find more on Starting and Running a Practice here.