Botox or BBA: when less is more

The failure by many surgeons to take up providing injectable treatments arguably created a vacuum that has led to undesirable consequences. For some, the decision was a financial: for a BBA, it’s one patient, approximately one hour of operating and £1,500. Whereas, for Botox, it’s multiple potentially problematic patients at a few hundred pounds per patient.

But does the financial argument hold water? What many surgeons forget is the TOTAL treatment time (including the follow-up). Also, a concept that is unfamiliar to many is that of Life Time Value (LTV). This is a number most commonly applied within subscription-based businesses such as magazines. Understanding the LTV allows one to compare different customers and (in combination with the cost of acquiring the customer) allows calculation of profitability. The other important parameter to consider is the Income Per Procedure Per Hour (IPPPH). So, let’s consider a typical BBA where the surgical fee is usually around £1,500:

  • First and second consultation = 45 mins
  • Pre-operative marking up and consenting = 15 mins
  • Total Theatre time = 90 mins
  • Post op ward round =15 mins (averaged, including travelling time)
  • Outpatient visits (2) = 30 mins
  • TOTAL TREATMENT TIME = 3hr and 15 mins

Therefore, the IPPPH for BBA = £460. This amount may be reduced due to complications/ returns to theatre but, as a BBA is (hopefully) a one-off treatment, the LTV is limited to around £1,500 (based on typical fees).

Now, consider Botox injections for a patient being treated for forehead, crows feet and glabellar lines:

  • Gross Profit per treatment = £250
  • Average patients treated per hour = 4

So, the IPPPH for Botox = £1,000, more than double that of the BBA. Patients typically will have 3 treatments a year. Therefore, even with a conservative estimation of a retention of 2 years (equalling 6 treatments per year), the LTV for Botox per patient is £1,500.

This, for an investment of 90 minutes in total. In my practice, many patients have been seen for over 5 years (and gone on to have other surgical treatments).

Add to all of this the fact that, with a Botox patient, you will never be called out to manage a complication. Plus, Botox patients are not likely to return 3 years post-treatment complaining that the treatment you previously provided is now painful / rippling / has become asymmetric. Seen in this light, you can see why many non-plastic surgeons find an aesthetic injectables practice so appealing.

Irrespective of whether you are offering surgical treatments or aesthetic injectables, the key to a successful practice is happy patients. This is why Expert Cosmetic Training offers post-course mentoring so that you can get advice whilst working up the learning curve. Past participants have sent through photos for advice on injection sites and have found it a comforting avenue for referring on patients who need a second opinion.

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Our delegates are always happy to get in touch and provide us with feedback about the training offered by Expert Cosmetic Training courses.

“Great to use these techniques on real people and a very good idea to see the pictures of patients I treated.” S.R

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