While most physicians enjoy their jobs, dealing with insurance payors can be frustrating and disappointing. Cosmetic services — especially liposuction — can add a large revenue stream to a practice that is independent of insurance. When Dr. Johnson first started liposuction, he was making more money in the one day he did liposuction than he had in the four days of his insurance-based medical practice. But, money is not the only reason.

Liposuction can also be very gratifying. Medical practice is extremely rewarding, although dealing with insurance companies is burdensome. Patients often see the doctor as an expense and a bother — as they’re sometimes placed on expensive medications or recommended inconvenient and painful surgeries. However, patients having liposuction have sought you out and are willing to take on the expense and inconvenience. The appreciative attitude of patients was what drew Dr. Johnson to cosmetics — much more than the money. Patients are overwhelmingly happy with the results , and it’s fun for the doctor. Liposuction is also artistically expressive and rewarding. You have a chance to help someone be more attractive, self-confident, and have a better self-image.

We have a way to add liposuction to your medical practice without spending a lot of money. We have two liposuction procedure rooms in our Dallas office, and two liposuction procedure rooms in our Fort Worth office. In addition, we have personnel fully-trained in all aspects of liposuction, fat transfer, and office-based cosmetic practice. All of our procedure rooms have access to the equipment and supplies needed to do liposuction and related procedures.

Innovations Medical will train you in liposuction procedures. You can then pay an hourly rate for the use of the facility, equipment, and staff for liposuction procedures. We can also help train your staff for pre-operative and post-operative care. You pay a fee for training, and then you pay an hourly rate for the procedures you actually perform at one of our offices. Bring yourself and the patient ready for liposuction, and we’ll provide the rest.

Adding liposuction to your practice can be involved and expensive. At least three things are essential:

    Office space. You need a clean environment with all the necessary electrical, lighting, and related equipment.
    Equipment. You need supplies for adding tumescent fluid, suctioning, skin tightening, and monitoring. In Texas, you’re also required to have resuscitation equipment in the form of a crash cart, defibrillator, and supplemental oxygen.
    Training. This applies to you and at least one staff member — sometimes two, in case the first one isn’t always available. This includes being well-versed on patient selection, pre-operative, surgical, and post-operative care. Texas also requires that at least one person on-site is certified in Basic Cardiac Life Support (BCLS) and Advanced Cardiac Life Support (ACLS).

The office space used for the actual liposuction can be as small  as a 10ft by 10ft room, but — to perform the procedures well — a larger room is better. In addition to the surgical space, you need a place for the patient to keep their clothing and belongings, and a safe space to dress afterward. Adequate space for marking the patient prior to the procedure, and to take reproducible photographs and measurements, is also needed. You will also need space with a sink and water for cleaning the instruments and an autoclave to sterilize after procedures. Lastly, you will need some storage space for supplies like tubing, saline, lidocaine, and medications. Some offices already have space that can be modified for these uses. If remodeling is required, you should estimate costs of $25,000-$50,000 to get a procedure room, lab, and photo area in place.

Perhaps the biggest expenditure is equipment. At a minimum, you must have a suction pump, IV pole and compression bag, and liposuction tools for both injecting the tumescent fluid and suctioning fat. You will also need a table to perform the procedure and a monitor for patients’ vital signs. You need a set-up to allow you to collect and measure the fat as it is evacuated. You also must have a crash cart, defibrillator, and supplemental oxygen. A conservative estimate to acquire all of this equipment is $25,000.

Most people will want an infiltration pump for administering the tumescent fluid and a powered system to help evacuate the fat. You should estimate costs of at least another $25,000 for those items. Finally, most office-based liposuction in 2020 is using lasers, radiofrequency, or other tools to tighten the skin at the time of the procedure. These devices start at around $75,000 and go up beyond $250,000. Realistically, plan on $300,000-$500,000 in equipment and supply costs to get started. You can reduce this somewhat by buying used equipment, but beware, the support from the vendors and reliability of used equipment is inconsistent at best and commonly very poor.

Physician training is usually done in paid conferences with multiple attendees. Hands-on experience is rare and often restricted to cadavers. The basics of liposuction are straightforward, and most physicians can learn it in a few days with adequate instruction. However, the art of liposuction and proper techniques in all body areas can take much longer to learn. These skills can have a real impact on how well your liposuction practice succeeds. You also must train staff for consulting and/or collecting from patients. Many insurance-based offices are not trained to take cash. Many other steps from consents and pre-op labs to appropriate photos and measurements, compression garments, and bandages must also be learned by your staff. Count on this costing from a minimum of $10,000 to about $25,000 — depending on the number of conferences you need to prepare and the cost of training staff.

Note: In total, the cost of adding liposuction to most medical practices is between $350,000 and $600,000.

We want both the training physician and our clinic to be comfortable with the training doctor’s proficiency. Training begins with observing five cases to learn the essential aspects of liposuction. The observation patients are our patients, and the liposuction area may vary somewhat. At least two abdomen cases will always be included. Some of the essentials covered during this time include:

     Proper record-keeping for the case. This includes a description of the work done and the accurate recording of fluids.

After the five case observation period is complete, you will then do three cases with an Innovations Medical physician as an assistant. These cases will be on your patients, and you can collect from them for your services. Once you have completed the three assisted cases, you will be certified to do abdominal liposuction cases at our office without supervision. Areas other than the abdomen require one observed and one assisted case per area for certification. The observed case is at no charge, however the assisted case carries a charge — but, you are collecting from that patient.

Once a physician has performed at least five unsupervised cases, they are eligible for fat transfer training. Fat transfer requires one observed and one assisted case per recipient area (e.g.  buttocks or breast). Again, the observed case is at no charge, but there is a charge for the assisted case. Facial fat transfer is trained with a special one-to-one arrangement.