Several factors go into whether a cosmetic service will be profitable for a practice, including patient satisfaction, disposable costs, competition and marketing. We asked four physicians with established, successful cosmetic practices what they thought were among the most profitable treatments in their practices and why. Some also weighed in on money-losing propositions, as well as why profitability is a dangerous topic in cosmetic surgery.


To look at profitability, a physician has to look at demand, as well as the cost of obtaining and maintaining that service, according to dermatologist Tanya Kormeili, M.D., who has a private practice in Santa Monica, Calif.

Dr. KormieliFor a cosmetic service to be profitable, Dr. Kormeili says, it has to be in high demand and low supply by other doctors and spas. Botox (Allergan) is an example of a product in high demand, but so many practitioners are offering it that it’s not very profitable, she says.

“You also have to calculate the most important question: ‘Is this a safe, ethical and effective treatment for my patients?’” Dr. Kormeili says. “I think the worst mistake is to start offering a service that doesn’t work or harms patients. In the long run, that is a financial disaster — not to mention terrible for you as a professional.”

In addition, providers have to consider the cost of obtaining certain technologies, including costs for associated consumables, Dr. Kormeili says.

“… if you have a high demand for a service that you can solve with a product that is cheap to obtain and does not have consumables, you have the most profitable service. This varies by the practice and expertise of the doctor,” she says.

Dr. Kormeili says her practice revenues are particularly high with lasers, such as the Vbeam (Syneron-Candela), which don’t have consumables. Those chemical peels that only dermatologists can offer are also profitable because they’re less likely to be offered by non-physicians or at spas.

While there is a growing demand for nonsurgical body contouring, devices like market-leader CoolSculpting come at a price to the practices offering them, Dr. Kormeili says.

Practices must buy the system and consumables needed to use the device. Providers also buy new applicator handpieces as the technology changes, which can be pricey. And patients may need many application cycles to get desired results, therefore, patients are encouraged to buy packages, she says.

“… profit margins decrease when you discount on your end to create packages for the patients,” Dr. Kormeili says.

There’s also the issue of time. Each fat reduction treatment can require the use of a treatment room for at least 35 minutes—even longer, if it’s more than one cycle.

Then, there’s competition.

“If there are many providers in your area offering the service, you might not have the demand,” she says. “Be mindful also that there are other body shaping technologies on the market that will be competing with your service, perhaps at a lower price since they don’t all have consumable parts.”