Building an empire

We sat down with Dr Zack Ally, founder and medical director of Derma Medical, to talk about building a global empire, the recent acquisition by private equity firm, PEAL, and the journey in between

Dr Zack Ally was destined to become a medic. “Every member of my family is a doctor,” he tells Aesthetic Medicine.

A qualified GP, Ally became a rebel of the familial status quo when he saw physician Leah Totton win the apprentice back in 2013. Here was a trained doctor with a vision of creating a chain of doctor-led aesthetic clinics in what was, and largely still is, an unregulated industry.

Seeing a junior doctor carve out a successful career in aesthetics was a lightbulb moment.

Throughout his life, Ally observed his nearest and dearest follow the beaten track to becoming academic doctors in their respective specialities. After graduating, he immediately disliked the lack of flexibility and freedom.

“You get shifted left, right and centre – all over the country, different hospitals, different rotations, long hours and little profit generation,” he says, citing not having enough time for patients as another caveat.

“The bureaucracy and politics” of becoming a doctor are not covered in the curriculum, he says, meaning many junior doctors end up suffering similarly under the rigidity of the role.

“But they’re tied into this career,” Ally adds. “They’ve done six years of medical school and still have to progress to a consultant.”

MAKING THE MOVE TO AESTHETICS

Taking a chance, the young entrepreneurial doctor embarked on aesthetic training, but found the offering lacking.

“There wasn’t anything except the odd clinic where you just observe, get a certificate and go home”, he says.

Other courses only had mannequins to practice on instead of real people, which did not leave him feeling equipped to see patients.

Some required doctors to find their own models willing to go under the needle for the purposes of training – adifficult feat for an overworked junior doctor.

None of the courses included prereading materials or follow-up, and there was little in the way of support.

“These experiences left me wondering if I should really pursue this career”, he says. “There was no real pathway, yet, industry figures were growing.”

Ally decided to ‘just go for it’ and start injecting. He applied to local clinics and soon developed his own techniques.

“It was almost an apprenticeship model, and I was learning on the job”, he recalls.

Ally’s wife, physician Sanah Qasem, started working in the field and training alongside him. They quickly saw a gap in the market – the aesthetics industry desperately needed a route to becoming a successful and safe practitioner.

“When you put in a catheter or do a lumbar puncture, there’s a pathway and a system to do it,” he says. “We created a pathway and a standardised, landmarkbased approach for every part of the face.”

A LANDMARK CURRICULUM

The couple started to recreate their landmark (face mapping technique) on all patients and found it to be repeatable, reliable and consistent.

They created a curriculum dividing the approaches into different course levels – from beginner to masterclass, and in 2015, Derma Medical was born.

It wasn’t long before anothergap in the market occurred to them – all ofthese students would need realfaces to practice on.

“We would see lots of clinics, but never anywhere to get hands-on training. So, we created Derma Models.”

Derma Models gives live patients the opportunity to pay discounted rates for treatments fordelegated learning purposes in an environment that is still very much medical.

“That quickly grew because there was nothing like it,” says Ally. “We were seeing up to 30 models a weekend.”

Then came a pathway to teach the business side of aesthetics – how to set up a practice and get insurance. Ally’s mission was to show doctors how to balance their careers and do both.

They targeted dentists, doctors, dermatologists and nurses.

“That’s one of our strengths – we’re not just an academy of one type. We’ve got every specialty in medicine that can contribute their skillset.”

GOING GLOBAL

Business exploded, and delegates started rolling in. Derma Medical courses expanded to all major cities across the UK and Scotland. As the firm grew, students from across Europe, Australia and the Middle East started travelling to attend courses, so hubs were set up in these locations.

“The pathway was there; the model was ready,” says Ally.

With demand growing fast, the firm began hiring more trainers – “we didn’t just become a training academy, we became a trainer academy.”

Derma Medical now has more than 80 trainers globally, with people travelling from all over the world to attend courses from foundation through to masterclass.

Level seven training allows students to get an accredited qualification by OFQUAL, IQ and OTHM. They are also objectively assessed and examined.

Masterclasses are for those who have experience injecting and want to level up. “These teach the off-label treatments – the face-changing stuff that people really want to learn.”

These are the showstopping transformations that we are starting to see online. “They teach how to really transform faces safely, effectively, and artistically.”

Using anatomical knowledge, we created a curriculum based around vessels and safe areas, so that it can be repeated, displayed and taught.”

Ally says that social media was invaluable to their growth. The company now has almost 100,000 followers across Instagram, Twitter and Facebook, and Ally says that the company’s online work became even more prevalent during the height of the Covid-19 pandemic.

PEAL CAPITAL ACQUISITION

Caring for three kids during the pandemic was a mentality reset for the doctor duo.

Ally recalls thinking, “Do I want to be working hard, or do I want to be working smart?”

“I was hiring MDs and CFOs, trying to get people to take some work off me. The company outgrew me”, he says.

Ally realised they needed outside involvement from people who knew how to scale and take the business to the next level. After meeting with many interested parties, it became clear that private equity firm Peal Capital had that vision.

“It stood out because the team is handson, they understand healthcare, and they’re a female-only team – something really rare in the industry.”

Peal Capital acquired Derma Medical in May this year. Their focus will be to continue to grow and expand the business through innovation. and professionalising the company ready for global growth.

Since then, Ally has been able to take a step back, becoming more managerial. He now runs one course called Artistic Facial Transformation.

Aesthetics should be medicalised. In future, I want to see all medical treatments held in CQC clinics and fillers being made prescription-based in the UK as with other parts of the world

“Now I’m able to focus on the things I enjoy,” he says. “Peal is revamping and polishing what I’ve created and making the offering even better.”

THE REGULATION CONVERSATION

On the hot topic of regulation, Ally says: “I’ve spent 12 years investing in becoming a doctor and specialising in my field, yet we still see people with no medical background or regulatory body getting into aesthetics.”

He adds that a beautician, hairdresser or tattoo artist cannot compare. “Nowadays, we’re even seeing Love Islanders performing treatments”, he says.

Being accountable to a regulatory body like the general medical council (GMC) means Ally and peers have an organisation to answer to, while an untrained nonmedical person has no accountability. “If there are complications, the patient is vulnerable because there’s no regulation,” he says.

“Aesthetics should be medicalised. In future, I want to see all medical treatments held in CQC clinics and fillers being made prescription-based in the UK as with other parts of the world”, he says.

“Right now, we’re in an unregulated market. Anyone can pick up a needle, attend a course, and get hold of fillers. That process needs to be tightened up.”

In 2013, surgeon Sir Bruce Keogh released the Keogh review, designed to help steer the process of procedures and, from this, guidelines for cosmetic procedures training were established by Health Education England (HEE) and later the Joint Council for Cosmetic Practitioners (JCCP). While this may have helped move the needle in a more regulated direction, the guidance is currently not compulsory. For Ally, however, it was a no-brainer to build these standards into Derma Medical’s courses on top of other interpretations of guidance.

“Having a regulated qualification and platform distinguishes the medical from the non-medical – those able to understand what can go wrong and how to deal with it if it does.”

Ally says that psychological assessment is a hugely important element of this.

“Poor mental health is rife right now, and aesthetics is strongly linked to that.”

“The Government needs to step up. It’s been too long, and nothing is really happening.”

The founder says that Derma Medical is keen to join the fight and get more involved in lobbying for change in the industry. “It shouldn’t be like an MOT with people only coming in when there are complications. We should prevent problems from happening before they arise.”

CHANGING THE FACE OF THE INDUSTRY

Ally says ultrasound-guided injectables, while not essential to the practice, are the future.

“Many interventional procedures in medicine are performed using ultrasound guidance. It acts as our eyes and helps reduce the risk in dangerous areas. Incorporating this into aesthetic medicine creates more confidence amongst patients and injectors, because ultimately, a fear of injecting is due to a fear of anatomy”.

While standards and technicalities are important, Ally says, today, creativity is becoming increasingly crucial to success.

“Injectors also want to learn to be artistic and deliver results for patients. You won’t survive in this industry if you’re too technical and lack artistry.”

On the other hand, Ally says artists lacking knowledge and technicality will be unsafe. “The results may be nice, but the complication rates will be high.”

“We’re trying to create this marriage of art and science – something clinically safe, but visually artistic,” he adds. “That’s why I believe we’ve been successful and why people travel the world to see us.”