Category Archives: Botox Injectors

Modesto Botox 2013 in review

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Some Fun Statistics about my Modesto Botox Practice

by Calvin Lee, MD

I love to share information, and I wanted to be transparent about my Botox experience.  I’ve been injecting Botox since around 2006.  We started having more detailed tracking available to us starting in 2010 by having patients enroll in Brilliant Distinctions.

How the Botox statistics were obtained

The Botox statistics were obtained from Brilliant Distinctions Analytics.  This is a free service included with our participation in Allergan‘s Brilliant Distinctions program which is a “frequent flyer rewards” type program.  It is a free program for our patients to enroll.  I’ve been keeping simple statistics of my Modesto Botox practice before by looking at total number of patients enrolled and looking at the total amount of coupons redeemed.  Most of our Botox patients are enrolled in the Brilliant Distinctions patients.  As are our Juvederm and Latisse patients.  We do not currently have SkinMedica which is part of the Allergan family.  But feel free to call us to see if we have encorporated SkinMedica into our collection of skin care products.  (209) 551-1888.

Possible faults of the data collection

  • Not all of our patients are enrolled in the Brilliant Distinctions program.
  • More and more existing patients enrolled in Brilliant Distinctions as the program became more familiar to us.  This means that any increases in the number of patients “seen” for Botox, may actually be lower than the reported number because the numbers we have reflect Botox patient enrollment into Brilliant Distinctions, not necessarily patients who have received Botox.  Thus we are using Brilliant Distinctions registered visits as a surrogate for actual Botox visits.  But i think the estimate is pretty close because we try to enroll all Botox patients into Brilliant Distinctions.

Here are the Botox Related Statistics of my Modesto based Practice which I have with my wife Dr. Tammy Wu, Plastic Surgeon

  • 724 separate patient visits over the year for 2013.  This represents a 43% increase over 2012 where I had 505 separate patient visits.  In 2011 we had 270 patients registered.  But I think this number might be “artificially” lower because many of our patients at the time weren’t signed up for Brilliant Distinctions.  How is this calculated?  I went through the Analytics part of Brilliant Distinctions and had the computer program extract out the patient data one month at a time.
  • Averaging 60.3 Botox Visits per month.  60.3 Botox visits per month is the average number of visits per month for 2013.
  • 374 unique patients seen for Botox Cosmetic injections who are registered in Brilliant Distinctions in 2013.  In 2012 we had 278 unique patients seen for Botox injections.  In 2011 we had 180 Botox different patients.  Unique, or different, patients means that these patients were counted only once even if they came to the office several times over the year.
  • I couldn’t seem to find too many monthly trends with our Botox Visits.  But from what I can see over three years of data, it seems that there is a consistent increase in patients in March and November.  I’m not sure about these seasonal changes, but this may be specific to our town of Modesto, CA.
  • We grew to have about 245 new Brilliant Distinctions Signups in the last year.  This also includes Juvederm-only and Latisse-only-patients.  This averages about .67 new Botox/Juvederm/Latisse patients per day (365 days per year).
  • We reached 702 unique patients on Brilliant distinctions.  This growth in the number of unique patients is very steady – it doesn’t seem to be increasing exponentially, just a direct increase which is steady.

Financial analysis and comparison with the other components of my medical and surgical practice.

I have many medical colleagues and students who ask is a profession of doing Botox worth it?  They mainly ask from a standpoint of does Botox make money?

Without going into gory details.  I can say that  the other parts of my medical practice was more profitable than the Botox part of the practice.

As with any other medical practice there’s the personal satisfaction aspect.  For me is very satisfying to be injecting Botox.  I enjoy the process and having wonderful patients who value appearance and beauty.  And most of all, I enjoy working with my wife who is a plastic surgeon.  I have been working with her since we moved to Modesto in 2003.  However, it became an every-day work experience together since 2006 after we founded Surgical Artistry in Modesto, CA.

Another financial rewards related Botox question:  How much overhead does one have when injecting?  I guess one way to answer this question would be to look at my Botox and Dermal Filler practice in a vacuum.  Botox and Fillers (ie. Juvederm Voluma, Juvederm Ultra, Juvederm Ultra Plus XC, Belotero Balance, etc) are expensive for the practice to buy.  These are the most expensive products I have ever had for my surgical practice.  Expensive in terms of price for size of product.  In my estimation, I think a Cosmetic Injectible practice’s overhead with lasers (I have one laser) would be about 75%.  Meaning there’s a 25% profit margin.  This is without a surgical practice, vein practice or acupuncture practice.   I don’t use our laser all that much, and this figure of a 25% profit margin on a Botox/Filler/Laser non-invasive cosmetic practice is for my practice.  I’m sure it would vary.  I’m factoring in the cost of the products and the overhead costs of the office – staffing, malpractice insurance, rent, utilities, supplies (syringes, etc).  And this figure would be before tax – which will of course, take out another chunk!  I hope this information helps.  I’m thinking that most of the people reading up to this point are Botox injectors of sorts or interested in becoming one.

Graphical Representations of Botox Data

Modesto Botox Monthly Statistics
Number of Unique Botox Visits to my Modesto Botox Practice broken down by Month
Botox patients per month with actual numbers
The graph shows the Botox Patient Visits for the past consecutive 35 months. It is missing December 2013’s data. But for 35 months before December, it is shown above.

Conclusions and predictions.

Botox is growing at our practice in Modesto.  There is definitely room for even more growth for my practice.   724 separate Botox visits is certainly a good “start.”  I think my practice could handle twice that.  I guess we shall see what 2014 holds – this is hard for me to predict.  I think our growth will slow percentage-wise for 2014, I think it will be lower than  the 43% growth we achieved this year.  I think I would be happy with a 15% growth in the amount of Botox appointments.  A 15% growth for next year will reveal 833 patients.  So perhaps that’s my prediction for 2014.

We currently have 702 different patients signed up for Brilliant distinctions.  If I were to be ambitious, I would hope to break 1000 new patients in our Modesto Practice’s Brilliant Distinctions program.  But a conservative estimate based on calculations over the past 3 years would be 947 members signed up.

Good luck and Merry Christmas!

Please visit our main Modesto Botox home page

Update: Please see a new Blog entry:  Botox Charting of 2011-November 2014: BOTOX patients per month

Juvederm before and after picture for cheeks

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Juvederm and Belotero Before and After
Juvederm ultra plus xc and Belotero injected via Cannula Technique by Dr. Calvin Lee

This is not done with Juvederm Voluma.  As of November 2013, I do not have experience with Juvederm Voluma.  Juvederm Voluma, however, is on it’s way to the office in Modesto, CA and I will soon have experience with this new dermal filler.  [update: I’ve used my first syringe of Juvederm Voluma on 12/24/13.  It was a very satisfying and positive experience.   I look forward to having even more experience with Juvederm Voluma.  I was able to use my 27g 1.5 inch cannula for Juvederm Voluma injections].

To improve my cosmetic dermal filler craft, I’m analyzing my past week. 95% of this result was performed with CANNULAS as an instrument of liquid implant delivery and a whole bunch of other secrets. There’s more that I would like to do with fillers for her, but my instructions were only to work on under eyes (tear troughs) and cheeks.

Background info:

Patient had lost a good deal of weight and it is showing in her face.  Options include face lift.  However, she chose to use Juvederm, Belotero, and Botox.  In the before picture she had Botox and Juvederm expertly done at another plastic surgery practice in our town of Modesto, CA.  I added upon that work to get the 13 day “after” picture using only Belotero and Juvederm.

Info about Brilliant Distinctions in our Modesto Cosmetic Injections practice.

Picture used with permission.  Thank you very much for letting me share this experience.  This is an off Label, FDA usage of Juvederm ultra plus XC for cheek fillers.

BOTOX is now approved by the FDA to treat Crows Feet

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It’s official:  Botox approved by FDA for the cosmetic treatment of crows feet

Hot off the press:  Today:  9/11/13.  These are my views as a Botox injector in Modesto, CA.

Botox for Crows Feet? No, crows do not stop walking after treatment, and No, it’s not something that veterinarians can do for your pet bird.

Crows feet are those wrinkles around the corners of the eyes.  Sometimes these are even called “fish tail”.  Medical folks are somewhat inclined to call this area lateral canthal lines.  The original cosmetic approval of Botox was in 2002 for the treatment of glabellar lines which are cause by a complex of muscles involved in frowning between the eyebrow area.  Botox now has FDA approval for effectiveness and safety in the crows feet area after studying over 800 patients.

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But haven’t doctors been treating crows feet for awhile?

Yes, doctors have been using Botox to treat crows feet wrinkles for many years.  This is called using it off-label FDA usage of Botox – and based on a doctor’s professional discretion.  FDA website.

How Long does Botox last in the Crows Feet?

Botox typically has an effect in my experience and Modesto based practice from 1 to 6 months.  But the results are usually dose dependent.  Meaning that the higher the dose, the longer it lasts.  But there are some minor factors which depend on Botox injection technique and patient factors – but for the most part it is dependent on the amount of Botox injected.

What’s all this about eyelid swelling after Botox?

There’s the risk of eyelid droop.  Then there’s the well known risk of eyebrow droop.  And there’s another complication of eyelid swelling.  The periorbital muscle is the muscle which causes most of the crows feet.  It has the function of closing the eye shut which also serves to squeeze fluid and edema out of the area.  Theoretically if too much Botox was injected into the periorbital muscle – obicularis oculi, it can hamper this mechanical function of squeezing out excess fluid and thus swelling can dwell in the eye area.  However, this is not to be confused with a temporary (few minutes) swelling that appears with the injection site of Botox.  These are small temporary blebs/bulges in the skin which appears as the Botox is injected in a liquid under the skin.  Confusing?  Yes, but these risks are unusual and injectors worry about them so the patients don’t have to worry about them as much.

How about competitors to Botox?  Do they have Crows Feet Approval?

Not yet, the other neuromodulators, which are Xeomin and Dysport do not yet have approval for crows feet.  It is up to the manufacturers whether they want to obtain this type of approval from the FDA.

How will this new FDA approval change my Botox practice?

  1. I think it gives the patients a greater feeling of safety for this product.  Thus I think it is useful.
  2. It becomes easier to pick a product which is FDA approved for the desired effect.  ie.  When deciding between the different neuromodulators available to the Modesto, CA, USA market:  Dysport, Xeomin and Dysport.
  3. I think we would see more advertisements coming from the Allergan company regarding crows feet Botox.  Allergan has historically been very good at advertising directly to the public.

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Other Botox related links

Botox in Modesto – Consider having it done by Calvin Lee, MD

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Botox in Modesto:  I hope you will consider me for your injections

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Locations for potential Botox use. Some of these injections are considered off-label FDA usage of Botox.

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THE BASICS of my Modesto Botox practice:  

I created Surgical Artistry with my wife, Dr. Tzuying Tammy Wu, Modesto Plastic Surgeon.  I am a surgeon & violinist.  I have enjoyed playing my violin at Carnegie Hall in New York twice thus far.  Originally from New York City, I moved to Modesto, CA in the year 2003.  Highlights of my educational life are getting accepted to all the universities which I applied:  Harvard, Stanford, MIT, Yale, and much more.  After careful decision, I felt Brown University was best for me and that was where I met my wife, Dr. Tammy Wu.  She eventually graduated with a #1 designation from our class at Brown .  Surgical Artistry is proud to be founders of the  Surgical Artistry Modesto Marathon, Modesto Symphony Pops Series, and the Gallo Center for the Arts.

 I LIKE HONESTY:

I would like to think of all my patients as my friends. Friends should be honest to each other.

I LIKE NEEDLES:

My staff counted once, and I use up about 500 needles per day. I use needles for acupuncture, vein injections, Botox, Juvederm, Belotero, and DermaPen. Doing surgery with needles is what I do at Surgical Artistry. So if you need medical procedures which involves needles, please consider me.

I LIKE ART:

For my music with the violin, I understand the creation of art which appeals to one’s positive emotions. This artistry is the same for the subtle changes that I need to make when injecting Botox and dermal fillers (Restylane, Radiesse, Perlane, Juvederm, Belotero, etc).

I LIKE COMMUNICATION:

I think at least 50% of creating a great result is based on understanding the patient’s goals and vision, and then also communicating expectations and trade-offs.  The final result is the result of teamwork with me, my office and my patient.  This type of communicative teamwork requires time and patience to achieve the desired result.

I’M PRECISE WITH MY HANDS:

I am a surgeon and an instrumental musician – these are two things which improve my dexterity every day. Having precision is a high priority in my life.

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I WANT GREAT RESULTS:

Why? Because my plastic surgeon wife will kill me otherwise. Well, kidding aside, I am dedicated to great results for all the modalities I offer at Surgical Artistry: Acupuncture, Botox, Dermal Fillers, and Veins. Great results and happy patients are what fuels my enthusiasm and purpose on this planet.

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Calvin Lee, MD
(209) 551-1888 (office in Modesto, CA)

Growth of my Botox and Juvederm practice over the last three years since we started with Brilliant Distinctions, a program for coupons developed by the Botox company - Allergan.
Growth of my Botox and Juvederm practice over the last three years since we started with Brilliant Distinctions, a program for coupons developed by the Botox company – Allergan.

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YelpLogo

Here are some reviews found on my Yelp page:

These are the filtered out reviews which I think are very valid and thank you to those who took the time to write and I’m sorry they got filtered out on Yelp.  I have no control over that

This kind review is about my acupuncture practice

Review Yelp by Nancy

“Dr. Lee is great!  I’ve been going to him for years for various health issues, especially stress.  It leaves me so relaxed with a lasting effect and is very healing.  I am unable to go longer than a month without seeing Dr. Lee because it keeps me healthy like nothing else does.
Dr. Lee has even given me acupuncture for wounds and the flu that have healed much faster than usual.  He’s easygoing and really good at what he does.  It’s very important to be calm, so the energy blockages can be released and your chi can flow again and bring healing.  Before acupuncture, I could not feel the energy at all because I was so blocked.  Now I can feel it as soon as the first needle goes in and my feet vibrate with all the energy that flows.  I highly recommend Dr. Lee.”

This other very nice review is regarding my Botox practice

Review Yelp by Debra

 

“Dr Lee is amazing with botox/juviderm injections. He is extremely people oriented and has a fantasic bedside manner. His results for getting rid of unwanted wrinkles  are fantastic and almost painless I will continue to go to him in the future and hightly reccomend his services if you are looking for injections !!”

I would love to get more Yelp Reviews:

I would love to hear more review (hopefully positive feedback? – if you feel I deserve it).

Review Dr. Calvin Lee, MD Botox and Acupuncture on Yelp

Thank you.

Please visit our other pages

 

Botox and Juvederm informational event at Surgical Artistry

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Celebration with Botox, Juvederm, Latisse, and Obagi at Surgical Artistry, Modesto, CA

Purpose of this page:  To share information with other plastic surgery or cosmetic minded practices regarding open houses.  Our first open house had 235 people come through.  I’ve decided that was too many people, and have since come up with strategies to focus the open house to have fewer people.  We are 2 doctor, husband-wife, plastic surgery practice located in Modesto, CA specializing in Plastic Surgery, Cosmetic Injections, Veins, and Acupuncture.  

My wife and I became a team when we met as part of the Program in Liberal Medical Education (PLME) at Brown University.  My wife, Dr. Tammy Wu, eventually graduated top of her class with the award for highest grades among the women doctor graduates of that Brown University program.  I on the other hand, as a violinist, had the fortunate experience of being the concert master of the Orchestra and a two time winner of the concerto competition at  Brown University (had to add something in there so I didn’t sound too shabby in comparison).  We also helped to start a marthon in Modesto, California called the Surgical Artistry Modesto Marathon – how exciting.  We are now getting ready for the 5th annual edition of this marathon.

Today (Saturday, August 3, 2013) we celebrated the start of our 11th year in Modesto, California.   To kick off the celebration we were supported by Allergan (the makers of Botox and Juvederm) to do an educational event regarding Botox and Juvederm.  I had two models and we injected Botox into different areas of the face, and then the most dramatic changes were using Juvederm.  In many ways, I guess you could consider this an open house.

Happy 11 years in Modesto
11 balloons to celebrate the start of our 11th year in Modesto, CA.

Genesis of this event

I had originally talked with Allegan – the makers of Juvederm, Botox, and Latisse about having a 10 year celebration.  So in essence this was the 10 year celebration of Dr. Tammy Wu and myself (Dr. Calvin Lee) being in Modesto.  The first 3 years of this decade were spent at Sutter Gould and McHenry Medical Group (now known as GMMSA – Greater Modesto Medical Surgical Associates) respectively, for the two of us.  Allergan’s Northern California Regional Manager presented to me the idea of having a nice lunch and then focusing the event on live demonstrations of Botox and Juvederm.  I’ve never done a live demo before of Botox and Juvederm and I was excited by the idea.  I’ve heard of other cosmetic practices having done this, but this would be a first for me.   I didn’t follow his plan exactly.  He had a small admission fee in mind and it was to be set on a work day (Monday-Friday) from 10am-2pm.  The admission fee could potentially be applied to a Botox or Juvederm procedure.  My reason for that was that Dr. Tammy Wu had already been planning an Obagi event from 9am to 11am – a Saturday breakfast kind of event.  And she thought we could Piggy Back onto that event and attract even more people – people who were interested in Obagi and perhaps a separate group of people interested in Cosmetic injections.  We thought the two groups of people would be interested in both events.  So we combined them and didn’t charge an admission fee and had it on the weekend and extended the hours of the event.

Similarly, two months ago we did a Breast Augmentation Open House event sponsored by Mentor with mini lectures by Dr. Tammy Wu, Modesto Plastic Surgeon.  We had a turn out of about 30 people, and the advertising method was similar – all via FaceBook.

How did I advertise our Botox / Juvederm / Obagi Modesto event?

I had advertised this cosmetic event on FaceBook .  I advertised to the Modesto area, and spent about $1000 on advertising.  I created an Botox Juvederm event page (which was free on FaceBook).  But paid for those advertising on the sides and in boosted posts.  I had trouble with boosted posts for some reason and never really figured out the reason.  I’ll have to put in a query to the facebook posts.  But I’ve had trouble in the past with plastic surgery type advertisements in FaceBook.  The free event page received 124 “going” guests – I think that’s a great way to spread the word.

I have three FaceBook accounts.

Each of them are slightly different

We got about 60 guests as estimated by our Surgical Artistry staff.  I was pretty impressed.  I think about 90% of the patients were new to the office.  We offered specials on Obagi as well, and I’m sure this was partly a draw – so not everyone was here for the Botox and Juvederm demonstration.

DEWZ Restaurant was one of the main attractions

We had great food catered by DEWZ Restaurant.  The food and amount worked out well.  We had requested food for 30 people for the catering.  In the past we had reserved for 60 people (we used Surlas before), and that was too much food.  You can get overwhelmed with food.  Back to the topic of DEWZ, Judy, one of the owners of the restaurant came herself to make sure the process went smoothly.  We are very appreciative.

People were able to walk in and out of my procedure room.  I think I heard that the injections into the lip seemed a bit much for patients – it just seemed somewhat “scary” perhaps.  Perhaps lip injections weren’t the best public demonstration.

Regardless, many patients stayed for the demo and I think they learned a good deal and some of them even signed up for cosmetic injections.

Feedback on FaceBook

Here are some comments we got on FaceBook after our event:

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Results of the Botox / Juvederm Banking (pre-sales)

When we counted up the results, we pre-sold 500 Units of Botox and 19 syringes of Juvederm.  We had about 60 guests come to visit.  27 of the guests purchased something – either Obagi, Botox, Juvederm or Latisse.

Thank you very much for coming to our Botox / Juvederm / Obagi event.  We truly appreciate the tremendous support.

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Empty Botox bottles I’ve collected in Modesto, CA. I have much more, but my staff made me put them away.

Lessons Learned

  • Having a sign in sheet may improve the flow of the event for those waiting for the Obagi Rep who did free personalized skin care analysis with the reveal machine.
  • Having catered food for 30 people was enough.
  • It is possible to do all the advertising through FaceBook without tapping into our email list – especially if the goal is to introduce the practice to new patients.  We love having many establish patients come by to mingle and talk about us with the new potential patients.
  • Most folks don’t come right at the beginning of the open house.  The popular time is around 10am or later it seems.  A shorter open house between 10a-2p might be a new possibility and this could possibly be done during a work day instead of a Saturday.
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My Modesto stash of Juvederm Ultra Plus XC.

Other Resources

Summary of the event pages used on FaceBook for my previous events.

I didn’t include our Surgical Artistry Modesto Marathon event pages here.

I had used three different FaceBook event pages for the Breast Augmentation event (June 1, 2013):

1) MAIN: https://www.facebook.com/events/584965031537598/
2) https://www.facebook.com/events/543135229070109/
3) https://www.facebook.com/events/127156384150390/

Only one  Botox Juvederm event page (August 3, 2013)

Attributes of Highly Effective Botox Injectors

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Genesis of coming up with this list of attributes of highly effective MD Botox Injectors

For the past 2 months.  I went around the country to participate in lectures, courses and conferences regarding Botox, Juvederm, and other cosmetic injections.  I also made it a point to personally get to know some of these injectors.  Most of the injectors whom I met were from the United States, but some notable ones were from Russia and Hong Kong.  These doctors don’t just inject Botox – it was just for a catchy title.  A better word to use would be Comsetic Injections.  I wanted to bring back the world’s best Botox information and bring all that to my Botox practice in Modesto, CA.

I only talked with Medical Doctors who Inject

The injectors whom I talked with were Medical Doctors (ie. Dermatologists and Surgeons).  There are highly successful, effective, and well-known injectors who are physician assistants and nurses, but in my past 2 months I didn’t have time to meet them or seek them out.  Perhaps another time in the future.

Here’s the List:  Attributes/Habits of Effective/Successful Cosmetic Injectors who are MD’s

1. They enjoy being the injector – without delegating to a nurse or PA
2. They are constantly looking for newer, safer and better methods
3. They are eager to be on the cutting edge with new products – this allows them to speak publicly about the product and become an early adopter and early expert.
4. They selectively use cannulas for a portion of their injections – much of this is for safety and quicker recovery
5. They are very willing to share / talk / publish.  In fact I get the sense that they really like publishing.  Much of them got famous from publishing often.
6. They make injections a priority in their practice.  Some of the surgeons diminish the surgical part of their practice.  Some of the Dermatologists diminish the medical dermatology portion of their practice.
7. They often go back to knowing the anatomy, and exploring new anatomical concepts – which contribute to what they call paradigm shifts in the thinking regarding filler use or conceptualization of aging.
8. They are not be afraid to show off their grey hair – but will make some attempt to hide their wrinkles.  Just making a light-hearted comment here.
9. Most importantly they do not view fillers or Botox as a COMMODITY. In other words, it’s not a Botox per unit price or cost per syringe of Juvederm (the PRODUCTS), rather it’s the injector’s SKILL which is the true value. And this is how they provide the best VALUE – through the best skill and materials.  However, the rest of the world seems to be viewing Botox and Fillers and a commodity – like something you’d buy off of Amazon.com for example.

Conclusions:

I have much to bring back to my Modesto, CA practice.  I learned a lot of the techniques.  I’m not sure if I’ll ever publish much (besides writing some topics in this blog) and thus I’ll just be famous in my small local area.