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12/5/2020 1 Comment

How to set up an aesthetics business - a guide

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Whether you're thinking of booking your medical aesthetics training, you're booked on to train, or you've already trained and you're thinking of going it alone and setting up your own aesthetics company here's 12 tips on setting up your business.
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1. Where are you going to practice:

Naively this may seem like an odd choice to be first on the list of considerations. However, from personal experience both when I was finding a location for myself to work from and then once established as a company finding a location for my other practitioners this is one of the greatest challenges you can face. I wrote letters, emails, called into salons and went through at least 15 options before finding premises for myself and then my practitioner. That being said, it does no harm to be picky about where you choose to practice. One of the greatest difficulties we personally faced was issues on professionalism. As a Dentist professionalism, is drilled into you from day dot, as it is when working in general practice, but, you may not expect the same level of professionalism from beauty salons you may collaborate with. We are lucky now to have set up which is mutually beneficial to us and the salons we work in.  


"Do your research, know who you are getting into bed with and make sure your ethics, morals and professionalism are aligned. "

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2. Are you going to register as self-employed sole trader or a limited company? 

If you are working for yourself, taking payments directly from customers and deciding where you want to work then in the eyes of HMRC you are self-employed and therefore must be registered as so. Being self-employed, you can be one of three forms; sole trader, limited company or a partnership. As aesthetic businesses rarely set up as a partnership, I will focus on the two more common forms; sole trader and limited company. 

Sole trader 

If you are a practising Dentist, you will likely already be registered as a sole trader. Working as a sole trader is the most straightforward way to start a business. As a sole trader, there is no distinction between yourself and your business. You can set up to receive payments from customers and purchase stock directly yourself - you need to declare to HMRC your self employed status. A separate bank account is not necessarily required. However, you may choose to open a second different account to ensure you stay on top of payments and to keep track of your business ingoings and outgoings which you will require to complete a self-assessment tax return at the end of the tax year. From experience, Starling bank comes out highly rated for sole trader accounts. 

Sole trader has the advantages of being low cost and low maintenance. When starting out and dipping your toe in aesthetics, you can easily manage your accounts and file the self-assessment tax return yourself or use your existing dental associate account without electing a separate accountant. Many practitioners chose to start as a sole trader then switch to a limited company at a later date. 


Limited Company 


So, if, sole trader is the more flexible and straightforward route, why do so many aesthetics companies opt to be a limited company? First of all, it may be easier to start by explaining what a limited company is. A limited company is a separate legal entity that separates you from your business affairs. Therefore the debts are limited to the company and what the share holders (ie you) have initially invested. To put it simply, in the unfortunate situation where it all went tits up (and lets face it the best way to describe 2020 would be 'tits up'). As a sole trader, if your business were to get into debt, you personally, could be liable to repay that debt and your assets eg car, home, favourite cat, could be repossessed to pay that debt if required. 


Obligations of a limited company, including registering yourself as a company on Companies Houses. Companies Houses is a government organisation that incorporates and dissolves companies. There are plenty of companies out there who are out there who will charge a few hundred pounds to set up your limited company for you, or, you can do it yourself on the Companies Houses websites, it costs £15 and takes 15 minutes (thank me later).  


On a yearly basis, you will require an accountant to help you submit your annual accounts to companies houses and HMRC. I would strongly advise using an accountant that specialises in or, is experienced in dealing with aesthetic businesses.  


Also, as the company director, you must submit your Confirmation Statement yearly - this updates Companies Houses of your current address, officers, and shareholder information. Companies Houses makes company information available to the public; therefore, you may choose to register your company name under a different trading name if your company is to be registered to your home address. This, can help maintain the privacy of your companies accounts and addresses, for example, you may trade under the name "New Aesthetics" but be registered on Companies Houses as "NA ltd".

As previously alluded to, a limited company is owned by its shareholders and run by its officers. When registering the company, you can appoint yourself as the companies director and allocate 100% of the shares to yourself. Alternatively, if you are entering into the company as a partnership, you can decide how to split the shares between yourself and partners.  

A separate business bank account is mandatory with a limited company - so business and personal transactions are always independent. Setting up a business bank account can be slightly more time consuming than setting up a regular personal account and can take several weeks to approve. For a comparison of the best business accounts, click here.

Registering as a limited company has its advantages, including, protecting your personal assets, looking more professional and giving you credibility as a business company. However, most notably for most aesthetic practitioners is the tax advantages of working as a limited company can bring. Although this is beyond the scope of this post to discuss - when considering your options it would be highly advisable to talk through your options with an accountant to see which option is most viable for your personal situation. 

" ​Lets face it the best way to describe 2020 would be 'tits up'"

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3. What are you going to call yourself?

This can depend on the above question - if you are going to register as a limited company consider a name that isn't your own in case in the future you recruit other practitioners. Whatever you choose think long and hard about it because chances are you'll be stuck with it. I'm actually not the biggest fan of the the name Paragon Aesthetics now, but that's my brand and an elective name change at this stage isn't great for delivering a clear and concise brand message.  


4. Logo design and branding 


"Branding" wasn't something I considered or had even heard of when I set up. But branding and logo design can be key to the success of a company. Find a graphic designer who's style of work you like, and you think you'd like your own imagery to be similar to. Think about how you want to style yourself, who is your ideal clients, how old are they, what's their budget, where do they shop. Now think about how you will brand yourself to attract that person. Think about Ryanair's branding (yellow and navy - typically colours associated with budget brands), compared to that of Emirates (gold red and regal) - and think about what that logo and colour scheme alone make you feel about that company. 


If you're stuck take a listen to the Audible "Building a Story Brand by Donald Miller.

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My logo was originally designed by Australian Designer called Poppie and Peaches. I loved the logo to start with but soon realised that the flowery motive was not only potentially gender stereotyping my business but also confusing as a brand message. I've since choosen to rebrand to present a more luxurious high-end, unisex brand message.


​5. Buying stock
Although you can't order stock until providing a training certificate you can register with a stockist in preparation. The three I choose to order with are Dental Directory (medFX), Wigmore medical and Healthxchange. 

Why use three different suppliers?
 
 Dental Directory (DD) (which is also Medfx) I would have classically called my all rounder - if you're starting out and you want an all rounder that will stock absolutely everything from fillers to gloves to numbing cream to disposable syringes and anaesthetic, Dental directory (DD) will have it. The online ordering system is easy to navigate, and next day delivery is free over £40. They can, however, be head banging against the wall frustratingly terrible at not sending orders, missing items off orders or sending deliveries to the wrong place. DD(medfx) are the only recommended stockist of Galderma products including Azzalure for toxin and Restylane for dermal fillers. 


Alternatively, for users of Juvederm, I recommend Healthxchange. Although they do not stock Merz or Galderma products, they are the only website that liase with the Allergan reps so if you're going to order a lot of Juvederm and Botox stock eventually you will be rewarded with discounted products and potentially free training by the manufacturer. Personally, I don't like being told where I should buy my filler from, but no one can say no to discounted filler. 


Finally, Wigmore Medical, I love for their reliability and product selection. They are the preferred stockist of Merz products (Belotero fillers and Bocouture toxin) and stock nearly all dermal fillers. They also have a wide range of skincare products, just don't judge them for the terrible choice of delivery companies. 

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​6. Social media and website

Whether you do it yourself or employ someone to do it for you, start a social media page on your selected platforms. Whether you want to reach clients of all ages and backgrounds (facebook), share video or promote app downloads (snapchat, tik tok), target image-conscious millennials (instagram) or professionals (linkedIn) decide on a strategy of where to play and how to win. Not all content works best across all social media networks; so decide what works best for you. When I started out, I focused too long on producing my website although this is still key -anyone can have a social media page but having a website makes your company look and feel more professional my only regret is not starting my social media pages sooner. 


7. Patient Records 

Any aesthetics procedure requires taking of medical histories, informed written consent, photography consent and photographic evidence of treatment provided. Whether you decide to go for good old fashioned paper records or to use an app is down to you. However, a lot of apps offer free trials to start, full access if often charged as a monthly payment. If you opt for paper copies, there is plenty of material online about what to include and adapt to create your own. Reps for the filler companies will provide you with free consent and medical history forms personally, I think it looks more professional to compile your own records with your own branding on them.

I started on paper records for the apparent reasons of it being cost-effective and the most straightforward option. However, having worked on paper records for the last four years and recently switched to digital records my only regret is not doing it sooner. The main advantages of digital records are:

  1.  Digital records can be with you where ever you go - so no more concerns regarding notes being locked in practice X when you are working in clinic Y.  
  2. It negates the concerns regarding GDPR and protection of your patient's data. My paper records now are stored in a locked cabinet in a locked room and will remain there for 12 years.
  3. Sustainability - for apparent reasons digital records are more sustainable, with the digital system we email out aftercare instructions as well to reduce the paper we use in the clinic
  4. Time-saving - ahead of a busy 12-hour clinic it could take me several hours to pull all the patient records I required and attach the relevant consent forms and documents I required for that day and another several hour to file them on the night. 
  5. Medicolegal reasons - Notes are time-stamped, secure, cloud-based and keep you accountable for maintaining contemporaneous notes 
  6. They allow for easy automation - literally anything that I can automate - I will. The digital record-keeping system we use sends out booking confirmations with medical history forms to fill out ahead of patients appointments. After appointments patients, aftercare instructions are sent via the application, including patient feedback surveys, to allow us to monitor the service we provide. 


8. Sharps waste 


As you begin to work in aesthetics, if you opt to work independently in a salon you will need to arrange collection of your clinical waste and sharps. I found my provider by googling hazardous waste collection in my area. As an idea on cost, in my first year a requested to have swabs bins changed every other month and for 2 x 4L sharps bin a year which including a mandatory hazardous waste consignment note cost £125 for the year. 

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9. Business phone 
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Personally, I cannot recommend having a separate work phone to a personal phone, partly for GDPR compliance but secondly to separate work from play. It avoids the risk of important messages from clients going missing and also means you can have downtime with hours to choose to allocate to respond to business enquiries. I link my iPhone messages to my laptop and desktop and also use WhatsApp desktop. Instagram DM's are my absolute nemesis - can anyone relate? I find the messages very difficult to track, and messages often get lost. If your Instagram is a business account, it can be linked to your Facebook page allowing you to consolidate the messages you receive to your facebook page with your direct messages so you can answer on a laptop.  


If you are like me and have lost the ability to communicate with out the use of emoji's (🌚), when using a Mac control-command-space opens up the emoji alphabet. 


If you are wondering what expression I am pulling right now after I've dropped that absolute game changer it's sort of similar to this guy  🦦 ​

"I cannot recommend having a separate work phone to a personal phone, partly for GDPR compliance but secondly to separate work from play"

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10. Decide how you are going to take payments
 
 If you're going to alone, it is likely you will be taking your own payments. Although the allure of being cash only is appealing - avoiding card charges and the cost of a card machine, the convenience to your clients of offering to take card payments must be considered. Aesthetics treatments often come with a price tag, with clients not wanting to carry about or not able to withdraw in one day the cash value of treatments; often the maximum daily withdrawal is £250. There are plenty of different mobile card machines out there and are great when starting. Here is a link to a great blog that compares the different options out there. You receive a card reader that links to an app on your phone, allowing you to take payments easily with many depositing the money into your chosen account on the same day. I started with PayPal - probably the most expensive machine out there, which we later switched to a sum up machine.  


The mobile machines are great the start with, but once you start grossing over £2000 a month, it is significantly more financially beneficial to get a world pay or Valitor machine. I made the switch over a year ago and it, literally, saved me thousands. I couldn't recommend my provider more highly - reach out if you would like advice. 


11. Bookkeeping and accountancy
 
When I was 10 in school, we were given an idiom to draw. Mine was "a stitch in time saves nine" - dumbfounded by what it meant I was blissfully unaware this saying would describe a good portion of my adult life.


Being on the ball with recording all your business ingoings and outgoings from the very start will save you from a considerable undertaking later on. My first two years, I recorded every payment by hand - only to curse having to write them all up for my accountant at the end of the tax year.  


I cannot recommend enough good records keeping from the very start, a very simple spreadsheet will suffice. For every payment taken simply record the date, the treatment, the amount and the method of payment. Keep track of all your cash payments and consider giving cash receipts as proof of payments taken. For every invoice received, save them and file them by year and month.


With regards to VAT - it is far beyond the scope of this article to go into the incredibly complicated VAT and aesthetics discussion, especially when this is a guide to starting out. However, to keep it simple, until you are turning over over £85,000 in any 12 rolling months (not a tax year) you do not have to register for VAT. This means that's you will pay VAT on all products you buy and do not charge VAT on your services.

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12. Cosmetic Insurance

Before practising, it is essential that you take out cosmetic insurance.  I have always used Hamilton Fraser from the very start and have never had a reason to change.  Over providers include Insync and Cosmetic Insure to name a couple.  Compared to the hefty prices you can expect to pay as an associate Dentist, cosmetic insurance is much more reasonable.  You can typically expect to pay around £500 a year.  Each time you train in a new procedure be sure to inform your provider what treatments you are providing, whereas this will not likely affect your premium its never a bad thing to ensure you are fully covered.  

An alternate option is to consider taking insurance through your current dental indemnity provider. This may be a considerably higher price point after often you will only be covered to work in a dental practice.  TDS include aesthetic insurance up to a specific annual value within their standard insurance.  If you decide to take out separate cosmetic insurance (eg if you wish to work outside dental practice or to do a reasonable amount of aesthetics), you must have the aesthetics insurance removed from your cover.  You cannot be dual covered by two different providers and not doing so with result in both becoming void. 

So there it is, in 12 steps and a cool 3190 words there are my words of wisdom about starting in aesthetics. I hope this has been helpful and I didn't lose you in the sole trader vs limited company debate. Unfortunately, there is no medal for finishing but these are all things I didn't know when I started, and I wish I had. 


Any questions? Drop me an email, I'd love to hear from you. ​​​​​​

    Ask me about starting a career in medical aesthetics

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1 Comment
Sadie Chambers (Sage Facial Aesthetics) link
12/8/2020 06:49:07 pm

Dr Elle Reid,

Just wanted to leave a reply to your blog about starting out as an aesthetics business, to say THANK YOU!! What a truly helpful and informative post, and lots of good starting out advice for me to take forward with my new business venture. I am booked onto the Acquisition Aesthetics training (foundation and advanced) course in January so look forward to that and hopefully see you there to pick your brains for more of your wisdom.

Thank you again,

Sadie

at
Sage Facial Aesthetics

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    Dr. Elle Claire Reid 

    Clinical director of Paragon aesthetics, Dentist and medical aesthetics trainer 

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