Building Enterprise Value in the New Age of Consolidation and the Millennial Consumer

In this episode of the Business of Aesthetics Podcast, host Don Adeesha is joined by Audrey Neff, Chief Marketing Officer at Aviva Aesthetics, to discuss a critical industry paradox: why, in a booming $25.3 billion market, do so few practices build sustainable, scalable value? Audrey lays out a blueprint for long-term success, arguing that the practices that win will be those who master generational behavior, patient experience, and recurring revenue. She identifies major industry shifts, including the intersection of wellness with functional medicine and the acceleration of private equity consolidation, which is forcing owners to think strategically about their exit from day one. A major focus is on the rise of the millennial consumer, now the largest demographic in aesthetics. Audrey explains that this group values human interaction and experiences above all else, and studies show they will pay more for a provider they trust. This makes "experience-driven marketing" the new invisible engine for growth. She provides actionable strategies for building this trust online, where millennials conduct their research, emphasizing the need to dominate Google Reviews (aiming for "triple digits") and Instagram, a platform used by 83% of millennials to research aesthetic providers. From a business perspective, Audrey advises owners to "begin with the end in mind" and operate "as if it were for sale" from the start. She warns against selling too early out of fear, noting that in a valuation, "culture is everything" because aesthetics is a human-to-human business, a nuance many investors miss. She also identifies a massive "profit leak" in most practices: retail. She urges owners to target 15-20% of gross revenue from retail, up from the common 2-5%, framing it not as being "pushy" but as a critical tool for delivering better clinical results, which in turn creates happier, more loyal patients. Finally, Audrey looks to the future, predicting that as competition increases and treatments become commoditized, differentiation is paramount. She reminds listeners, "competition only exists if you're doing the same thing as everybody else." Her key takeaway for all practitioners is to "put the noise on mute" to ignore the social media drama and "shiny new toys" and instead focus with intensity on what is happening inside their own business, with their own patients, and with their own team.

In this episode of the Business of Aesthetics Podcast, host Adeesha is joined by Dr. Gregory Buford, a nationally recognized board-certified plastic surgeon, author, and speaker known for his forward-thinking business strategy and entrepreneurial approach to practice management. The discussion, titled "The Entrepreneurial Edge in Aesthetic Medicine," tackles a critical vulnerability in the industry: the fact that most highly-trained medical professionals are never taught how to actually run a business. Dr. Buford warns that in a field changing at a "logarithmic" pace, a static, "business as usual" approach is a recipe for failure, and provides an essential blueprint for why cultivating an entrepreneurial mindset is the single most critical factor for success in the modern aesthetics market. Dr. Buford defines this essential mindset as a "constant strival for growth, change, and evolution" that "never accepts the word no". He outlines practical strategies for sharpening this skill, emphasizing "constant education" not just in medicine, but voraciously across disparate fields like philosophy, art, and business to develop the ability to "think out of the box". He explains that entrepreneurs must be receptive, know how to pivot, and actively create opportunities rather than waiting for them. This relentless drive for learning is captured in his core belief, which he once shared with a patient: "The day that in any profession that you think you know it all, hang up your hat because you don't". From a practice management perspective, Dr. Buford identifies professional relationships as one of the most "underappreciated aspects" of success, noting "it's not about always what you know, it's who you know". He shares his strategy for building this network by "paying it forward" and offers a key negotiation tactic from his time at Kellogg: always "leave a few crumbs behind for your opponent", as it's a small world and you will likely work with them again. Looking to the future, he demystifies AI, advising practitioners to use it as an "assistant" to augment their work, not a "crutch" that replaces critical thinking. Finally, Dr. Buford tackles the biggest hurdle for high-achievers: the fear of failure. He reframes failure not as an endpoint, but as a "call to action and... a pivot point", revealing that his own biggest early mistake was "the arrogance of thinking that I could do it all by myself". He makes a powerful case that true success comes from humility, the ability to "ask for help", and the wisdom to "put your ego on the shelf". His key takeaway is that in the rapidly evolving world of aesthetics, the greatest risk isn't failing, but becoming complacent.

In this episode of the Business of Aesthetics Podcast, host Don Adeesha is joined by Dr. Alexis Delobaux, a world-renowned plastic surgeon, pioneer in high-definition body contouring, and the creator of the groundbreaking SMART BBL. The discussion, titled "Beyond Blind Injections: How Dr. Delobaux's SMART BBL is Redefining Safety and Liability," tackles the immense patient safety and liability risks associated with one of the industry's most in-demand procedures, the Brazilian Butt Lift. Dr. Delobaux provides an essential blueprint for how pioneering a new standard of care isn't just about offering what's popular, but about pioneering what's safe. Dr. Delobaux details the specific anatomical dangers of the traditional "blind" BBL, explaining how the risk of a fatal pulmonary fat embolism (PFE) comes from accidentally injecting fat into the large veins within and below the gluteal muscle. He shares the story of how a patient's question about safety sparked his journey to find a solution. The answer was the SMART BBL, a revolutionary technique that uses real-time ultrasound to transform the procedure from a tactile, feel-based surgery into a precise, visually-guided, and data-driven one. This shift allows surgeons to see every anatomical layer, ensuring fat is placed exclusively in the safe subcutaneous space and never in the muscle. Beyond preventing catastrophic complications, Dr. Delobaux explains how this visual precision leads to superior aesthetic outcomes, including better fat survival, symmetry, and contour regularity by targeting specific deep compartments. From a business perspective, adopting this technique is presented as essential for future-proofing a practice. Dr. Delobaux discusses how the state of Florida now mandates ultrasound for BBLs, signaling a new legal standard of care that significantly impacts a clinic's liability and enhances patient trust during the informed consent process. Finally, Dr. Delobaux addresses the resistance to new technology within the surgical community and outlines the manageable learning curve for mastering the ultrasound-guided technique. His key takeaway for all practitioners is an unwavering focus on "Safety, safety, safety". He makes a powerful case that when technology exists to lower the risk of an aesthetic procedure, there is an ethical obligation to adopt it, because no patient should risk their life for the sake of beautification.

In this episode of the Business of Aesthetics Podcast, host Adeesha Pemananda is joined by Dr. Shino Bay Aguilera, a world-renowned dual board-certified cosmetic dermatologist and a pioneer in bioregenerative techniques and the number one provider of Sculptra aesthetics in the U.S. The discussion, titled "Breaking the Regenerative Plateau: How Clinics Can Differentiate, Diversify, and Scale Beyond Biostimulators in 2026," provides a visionary roadmap for clinics looking to move past traditional biostimulation and into the future of cellular longevity and orchestration. Dr. Shino Bay emphasizes that the next wave of aesthetics isn't about adding more biostimulators; it's about activating the body's own cellular intelligence through orthomolecular signaling, like polyrevitalizing micronutrients, to improve tissue structure and function. He explains the difference between these micronutrients and PRP, detailing how combining them with traditional biostimulators like Sculptra or Radiesse can amplify results, leading to a total rejuvenation of the dermis's structure and function. He shares his practice's financial success, showing a massive return on investment from integrating these inexpensive micronutrients. To stand out in a crowded regenerative space, Dr. Shino Bay advises clinics to educate and elevate their patients' understanding, positioning the body as an ecosystem, not a canvas. He urges practitioners to adopt a philosophy of achieving true bio-restoration—not just external rejuvenation, by integrating functional aesthetic medicine principles like orthomolecular diagnostics, mitochondrial optimization, and hormonal balance into a unified, evidence-based system. Finally, he provides strategic advice on scaling, focusing on diversity through depth, not volume. He covers the financial, operational (investing in full-team training), and regulatory obstacles, stressing the need for compliance, transparency, and partnering with credible, ethical suppliers. Dr. Shino Bay's key takeaway is that every cell is a conscious, living entity that needs nutrition, protection, and hydration; when practitioners deliver this locally, they amplify all other treatment results.

In this episode of the Business of Aesthetics podcast, host Adeesha leads an expert panel: Rebecca Landiault (Apex Aesthetic Consulting), Sean Duncan (CPA and Strategist), Naren Arulrajah (Aesthetic Marketing Strategist), and Amy Ingle (Aesthetic Consultant) to deliver a full-spectrum guide on Optimizing and Maximizing Revenue with Next-Gen, Long-Lasting Injectables. The discussion begins with Rebecca Landiault detailing the necessity of "lifetime treatment planning" and stacking modalities (injectables with energy devices) to secure superior clinical outcomes, while emphasizing the use of robust patient financing to overcome initial budget objections. Financial strategist Sean Duncan reveals powerful sales psychology by explaining The Decoy Effect a technique for framing treatment choices to make high-value plans more appealing. He also stresses the critical importance of collaborating with legal and financial experts to select the proper business entity for major tax savings and asset protection. Marketing expert Naren Arulrajah breaks down the most effective promotion strategies, focusing on creating authentic before-and-after content and positioning the provider as a subject matter expert on social media (Instagram and TikTok). He then instructs practices on how to set up dedicated tracking mechanisms to accurately measure marketing ROI, CPA, and LTV. Finally, Amy Ingle addresses the common operational pitfalls of launching new products, including managing expensive inventory, blocking appropriate time for comprehensive consultations in the EMR, and ensuring full team education. She concludes with strategies for value-based pricing and structuring patient loyalty programs, like the "cash and stash" concept, to drive long-term retention. This episode provides a complete, actionable roadmap spanning clinical, financial, operational, and marketing strategies to future-proof your aesthetics practice.

In this episode of the Business of Aesthetics podcast, host Adeesha sits down with Naren Arulrajah, CEO of Ekwa Marketing, to tackle a crucial challenge for dermatologists: "Why Can't Gen Z and Millennials Find the Dermatologist They Need?" Despite high demand, Naren reveals the common marketing mistakes that limit a practice's visibility to this digitally-savvy generation. He exposes the two primary errors practices make—neglecting the high-value aesthetic patient base and relying on expensive, untrusted paid advertising over sustainable organic growth (SEO). Drawing on his 18 years of experience, Naren provides the essential "correct map" for dermatologists looking to future-proof their business. He details the importance of optimizing for the patient's buyer's journey (find, like, trust) through mobile-friendly communication, authentic case studies, and strong Google reviews. He also explains how to establish personal authority and use credentials to gain a competitive edge in the age of AI search tools like Google AI Overview. This episode offers the strategic guidance needed to attract, engage, and convert the next generation of aesthetic patients.

In this episode of the Business of Aesthetics podcast, host Michael Walker sits down with Dominique Waples Truffle, an accomplished practice owner who successfully grew her business from a single location to a thriving multi-location operation with over 1,200 membership patients. Together, they discuss "Scaling Smart, From One Location to a Thriving Membership Model." Dominique shares the biggest challenges she faced during her expansion, particularly the "terrifying" mental block of letting go of control when moving from one to two locations. She emphasizes the importance of intentional systems, processes, and a strong culture centered on employee experience to maintain the personal touch that patients love. Dominique also provides insight into her successful membership model, explaining how it creates predictable revenue for the practice and a sense of belonging for patients. For any aesthetics professional looking to expand their practice, this episode offers an invaluable guide to achieving sustainable growth through a focus on team empowerment, culture, and a smart, scalable business model.

In this episode of the Business of Aesthetics podcast, host Michael Walker sits down with Anita Layne, a seasoned aesthetics industry leader with nearly two decades of experience , to discuss the crucial topic of "Growing and Scaling Without Overwhelm". Anita shares practical strategies for managing business growth without burnout, sacrificing service standards, or losing your peace of mind. She introduces her core philosophy of simplifying operations before attempting to scale and explains how to get clear on both operational and emotional capacity to make your vision manageable. Throughout the conversation, Anita provides actionable advice on nurturing client relationships in the digital age through "tech-assisted touch" , adding new revenue streams like wellness products that enhance client outcomes , and creating predictable income through her "4R" framework: reviews, referrals, rebooks, and retail. For any med spa owner or aesthetics professional looking to expand their practice strategically, this episode offers an invaluable guide to achieving sustainable growth while maintaining a healthy business culture and work-life balance.

In this powerful episode of the Business of Aesthetics podcast, host Lester is joined by a panel of industry titans including Dr. Michael Salzhauer, Dr. Johnny Franco, Naren Arulrajah, and Chad Sawyer. Together, they deliver a masterclass on scaling the modern plastic surgery practice. This comprehensive discussion provides a roadmap for practitioners looking to grow efficiently, build an authentic brand, and navigate the competitive aesthetics landscape. The episode kicks off with Dr. Salzhauer's hard-hitting advice on establishing data-driven systems from day one, emphasizing the need to track practice "vital signs" like leads and conversions while building a brand that is unapologetically authentic. Dr. Franco then shares his firsthand journey of explosive growth, offering practical lessons on creating scalable operating procedures and expanding a brand's identity beyond a single surgeon. Throughout the conversation, marketing expert Naren Arulrajah provides critical insights, breaking down the ROI of different channels and explaining why mastering fundamentals like SEO is crucial for sustainable growth. Finally, Chad Sawyer demystifies the integration of weight and wellness programs, exploring how technology like asynchronous consultations and strategic pharmacy partnerships can create new, scalable revenue streams. This is an essential listen for any surgeon or practice owner aiming to build a resilient, profitable, and future-proof business.

In this dynamic episode of the Business of Aesthetics podcast, host Omer leads a discussion with three distinct experts, Ang, Naren, and Nico, to unpack the complexities of multigenerational skincare. This conversation provides a holistic framework for aesthetic practices aiming to serve a diverse patient base, from Gen Alpha to Baby Boomers, with intention and precision. The episode moves from the internal to the external, starting with Ang's insights on how skin concerns are deeply connected to gut health and hormonal shifts unique to each life stage. Naren then provides a masterclass on digital strategy, revealing how different generations search for treatments online and how clinics can tailor their SEO and website content to build trust and drive conversions. Finally, Nico bridges the gap with a deep dive into the biology of aging, explaining the critical role of hormones and advocating for regenerative treatments like Hormone Replacement Therapy (HRT) to ensure long-term skin health. This is an essential listen for any practitioner or clinic owner looking to create personalized, effective patient journeys for every age group.