Aesthetics + Injectables + PRP — Full transformation tiers

Audience: DoctoriumGP commercial / clinical leadership (Ade Whetton, Dr Gemma Lewis MRCS MRCGP). Purpose: Build a sourced commercial blueprint to integrate aesthetics, PRP, and BTL Exion into a tiered "Total Wellness" package alongside the existing longevity stack (Stride bloods, GlycanAge, methylation, Tanita, BTL EMSella, Emsculpt Neo, Exion) and the new GLP-1 / HBOT additions. Scope: UK market, 2025-26 pricing and regulatory environment, men and women, owner-operator economics. Status: Sourced deep-dive. UK English. April 2026.

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Executive snapshot

The UK aesthetics market is now a £3.2 billion industry growing 8-9% annually, projected to reach £5.1 billion by 2028 (Grand View Research / Axiom Flux, PolicyBee). Injectables alone account for ~65% of revenue; non-surgical procedures account for >70% of all cosmetic treatments. Male share of cosmetic patients has roughly doubled — from 12% in 2020 to 21% in 2025, with male facial procedures up +26% year on year in the BAAPS 2024 audit and male enquiries up +30% over the past year (BAAPS, PBL Magazine).

The strategic fit for DoctoriumGP is unusually strong because:

1. The clinic already operates three BTL device families (EMSella, Emsculpt Neo, Exion) plus Tanita body comp — the platform the rest of the country still pays £180-200k to install.
2. Gemma is an MRCS-trained surgeon and full GMC prescriber — she can prescribe and inject Botox / fillers / Profhilo / polynucleotides without supervision, which under the new June 2025 NMC rules and the imminent licensing reform is now a hard moat against the nurse-only competition (Aestheti.cc 2026, Browne Jacobson legal guide).
3. The CQC reform tracking through Parliament in 2025-26 (red/amber/green tiering) will push "red" procedures behind CQC-registered premises only — DGP is already CQC registered, which is a structural advantage 95%+ of UK aesthetic clinics do not have.
4. The longevity-aesthetics overlap is real. HUM2N, Reborne, Galyna Selezneva, Frances Prenna Jones, Fountain Clinics, Lanesborough Club & Spa, and The Wellness Clinic at Harrods all bundle aesthetics with longevity in the £8k-30k+ premium tier — but they are concentrated in W1 Mayfair / Harley Street / Knightsbridge. The Midlands premium audience has no equivalent.

The recommended structure: four "Total" tiers (Reset £6,995 / Transformation £14,995 / Premium Total £24,995-34,995 / Couples ~15% off pair). Aesthetics stays self-funded by the patient for tax reasons (full BIK risk), while longevity + GP retainer remain company-funded under the EIM21765 health-screening exemption pathway. Capacity is constrained — Gemma cannot deliver this volume alone alongside family GP and longevity reviews — so a 2-3 day/week aesthetics-nurse contractor at £300-700/day is required from day one (Acquisition Aesthetics salary data).

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A. BTL Exion — what DGP can already deliver

DGP already owns Exion. Exion is BTL's 2023+ multiplatform combining monopolar RF + targeted ultrasound + (on the Hair head) inductive RF, marketed as the "ultimate skin solution" treating 23 different areas with four interchangeable applicators (BTL global, Dr Rita Rakus). The four heads relevant to DGP:

A.1 Exion Body

RF + targeted ultrasound to stimulate collagen, increase circulation, and break down adipocytes; designed for body contouring, skin laxity (post-weight-loss skin envelope), lymphatic drainage, and improving appearance of cellulite. Course: typically 4 sessions, weekly (London Skin Clinic).

UK private market pricing: - London Skin Clinic — £250/session (entry tier) - Renovatio Clinic (Cheshire) — from £450/session for face or body - Stephanie Louise Clinics — course of 6 from £750 (i.e. ~£125/session, promo end of market) - Dr Rita Rakus / Harley Street tier — typically £400-600/session, courses £1,800-2,400 - AEDIT US benchmark — single sessions reported at $700+ (~£550)

A.2 Exion Face

RF + ultrasound for facial skin tightening, jowl, neck, periorbital tissues, mild rhytide reduction. Same 4-6 session protocol, no downtime — positioned as a softer Morpheus8 alternative. UK pricing converges with body: £350-600/session, course £1,400-2,400 typical premium-clinic rate (Renovatio, Stephanie Louise).

A.3 Exion Hair (Inductive RF)

Newer head. BTL claims hair density and follicle stimulation via inductive RF + targeted ultrasound. Evidence base is weaker than for facial RF or for established hair treatments (PRP, finasteride, minoxidil, exosomes). Searches return BTL device marketing copy but no published peer-reviewed RCT data on Exion-Hair specifically; positioning should be cautious. The Bolt Pharmacy clinical guide explicitly notes that hair-loss device claims need independent evidence beyond manufacturer copy (Bolt Pharmacy hair guide).

Recommendation: offer Exion Hair only in combination with PRP and topical/oral therapy — never as a stand-alone "device cure." Price the hair package at PRP-equivalent levels: £300-450 per combined session, course of 4 = £1,200-1,800.

A.4 Exion EMFemme 360 (intimate health)

Already covered in DGP's Gemma-led postnatal / GSM / pelvic floor pathway alongside EMSella. Protocol is 3 weekly 8-minute sessions, no downtime, post-partum tissue restoration, vaginal laxity, GSM symptoms (Serenity Women's Clinic, Bader Medical).

UK clinics quote the price by consultation rather than online, but the working benchmark used by EMFemme providers is ~£750-£1,200 for the 3-session course with maintenance every 6-12 months. Combined "EMFemme + EMSella" intimate-health bundles run £1,500-2,500 in premium clinics — this is the price band Gemma should anchor against.

A.5 What Exion lets DGP say

• "We treat 23 different anatomical areas with one device — face, neck, hands, arms, abdomen, thighs, intimate health, scalp."
• "Same evening — no downtime, you walk in for a Tanita scan, walk out 90 minutes later having done body contouring + face tightening + a longevity review."
• That single sentence is what HUM2N, Reborne, and the Wellness Clinic at Harrods sell their £20k packages on. DGP can match it for less.

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B. UK aesthetics market scan — reference pricing

B.1 Anti-wrinkle injectables (Botox / Bocouture / Azzalure / Dysport)

Botulinum toxin is a prescription-only medicine (POM). Only an authorised prescriber (doctor, dentist, or independent prescribing nurse/pharmacist) can issue the prescription; nurses without prescribing rights can administer under PGD or against an individual prescription, but as of June 2025 the NMC requires in-person consultation before any cosmetic POM script (Aestheti.cc 2026 prescribing guide). Gemma covers all bases — MRCGP independent prescriber.

Derby / Nottingham / East Midlands published prices (Selston Cosmetic Clinic, MedSkin Clinic, The Beauty Nurse, Park Private Clinic, Fresha aggregate):

Premium London tier (Marie Reynolds, Wassim Taktouk, Sophie Shotter, Rita Rakus, Galyna Selezneva, Frances Prenna Jones): typically £395-£600 per area, full face £900-1,500.

DGP price band recommendation: £185 / £255 / £315 (1/2/3 areas). This sits at the upper edge of Derby pricing, ~30% below Harley Street, and reinforces the doctor-led / surgeon-led positioning. Nurse-administered (under contractor day) at £150 / £210 / £265 for the entry tier.

B.2 Dermal fillers (Juvéderm / Restylane / Belotero / Teosyal / Volux)

Per Flawless Aesthetic Clinic, Wigmore Smiles cost guide, Dr Reena's, Mount Road Dental:

DGP recommended price ladder: £325 (1ml Juvéderm/Restylane, lips/tear trough), £495 (2ml cheeks or jaw), £895 (full face 3-syringe). Volux jaw upgrade +£100/syringe.

Wholesale cost reference: Juvéderm/Restylane 1ml typically £75-110 trade. Filler margin in the £200-300 per syringe range after consumables and clinical time. Volux trade is £130-160.

B.3 Profhilo, polynucleotides, and the "biostimulator" tier

The biggest growth segment in UK 2024-26. These are hyaluronic-acid bioremodellers (Profhilo, IBSA HCC) and polynucleotide biorestoratives (Plinest/Mastelli, Newest, Ameela). Sources: London Skin Clinic comparison, Karma Clinic 2026 guide, Skin Horizon, Renovatio.

Wholesale: Profhilo trade £80-120/syringe (Acquisition Aesthetics); Plinest from Mastelli ~£75-90 wholesale (€74-88 EU pricing per Pieleterna). Margin per session for both products is £250-400 at premium prices, £180-300 at mid-market.

DGP price ladder: Profhilo face course £849, body course £949, PN face course (3 sessions) £1,095, Sculptra course £1,395. These price points sit firmly above Derby-area independents and ~25% under Mayfair, which is the right positioning for "doctor-led longevity premium."

B.4 PRP / PRF — the regenerative anchor

PRP is the most commercially flexible regenerative service in the stack because it spans aesthetics, hair, and orthopaedics — and NICE has now reviewed PRP positively for mild-to-moderate knee OA, which is significant for a CQC-regulated GP-led clinic (MSK Clinic, PRP London knee guide).

PRP indication-by-indication UK pricing matrix:

Consumable economics: PRP kits (Tropocells, RegenLab/RegenBCT, Plasmolifting, REIN tubes) trade at £25-65/kit (RegenLab UK, Tropocells, REIN PRP UK pre-order, Premier Wellbeing Tropocells 11ml kit). Centrifuge already in any GP/aesthetic clinic. Margin per session at £450 sell, £40-60 kit, ~30 min Gemma time = £330-380 marginal contribution, the highest in the stack.

DGP positioning: orthopaedic PRP is the white-space play. Almost no Derby clinic offers it; the typical consumer searching "knee injection Derby" finds an MSK clinic in Kent, London or Manchester. Pricing recommendation: £495 / single, £1,295 / course of 3 including ultrasound guidance for joint indications. Hair PRP at £325/session, course of 4 £1,195. Vampire facial at £395/session, £1,095 course of 3.

B.5 IV nutrition / vitamin drips

Existing UK leaders are Get A Drip, REVIV, IntraVita, Cryojuvenate Sevenoaks, and Future Care Medical. Pricing: typically £75-£300 in a wellness setting; clinically robust drips (NAD+, glutathione, methylation) £225-£495 in a longevity setting.

Critical regulatory caveat — ASA/CAP enforcement: the ASA has issued multiple rulings against both Get A Drip and REVIV for unsubstantiated health claims, and CAP guidance (healthcare IVNT advice) confirms any claim to "treat, alleviate, prevent or cure" a medical condition requires an MHRA-licensed indication. DGP must not market drips on disease/symptom claims. Acceptable copy: "supports hydration," "delivers vitamin C/B12 directly to the bloodstream"; unacceptable: "boosts immunity," "treats fatigue," "reverses ageing."

DGP add-ons (non-claim): myers cocktail / B-complex / glutathione / NAD+ (high-cost) at £125 / £165 / £225 / £395 with bundle discount when paired with longevity review. Margin is thin (consumables £25-£140, nurse 30-45 min) but the hospitality value is high.

B.6 Skin treatments — full reference table

Strategic note on Morpheus8: Exion already covers the same RF + microneedling-adjacent space. Do not buy Morpheus8. Use Exion as the single "RF skin tightening" anchor; if a patient asks for Morpheus8 specifically, sell the Exion comparison clinically (Exion adds targeted ultrasound; Morpheus8 has the brand recognition but is more expensive consumable-wise).

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C. Who already bundles longevity + aesthetics in the UK

The "integrated longevity + aesthetics" providers are clustered in W1 / SW1 / SW7. Pricing is opaque (most quote on consultation), but the structural pattern is consistent: a longevity baseline (£2-5k diagnostics) + an aesthetic membership tier (£500-2,000/month) + à-la-carte injectables and devices.

The DGP gap analysis: of 12+ providers offering this bundle, zero are in the East Midlands. The nearest is the BTL device-density clinic cluster in London, Cheshire (Renovatio, Nantwich), and Belfast (Martina Collins). DGP has Tanita + EMSella + Emsculpt Neo + Exion + Stride + GlycanAge + methylation + Gemma's surgical/GP credentials — more device coverage than HUM2N's pre-Muscle-Rebuild stack, in a town with zero local competition for the £15k-30k buyer.

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D. The "Total Wellness" tier architecture

Four tiers. Prices below are list prices; couples discount applies on top.

D.1 Total Wellness Reset — 6-month programme — £6,995

D.2 Total Transformation — 12-month programme — £14,995

D.3 Premium Total — 12-month flagship — £24,995-£34,995

D.4 Couples Total Transformation

Both spouses on Reset, Transformation, or Premium Total simultaneously. 15% pair discount.

Why couples discount works: longevity is a shared lifestyle — exercise, food, sleep, GLP-1 partner accountability. Aesthetics drives the same conversation in reverse: when one spouse begins, the other usually follows within 6 months. Bundling pre-empts that and locks 12-month revenue from both.

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E. Margin per add-on — economics

E.1 Per-session marginal economics

E.2 Why aesthetics margin per chair-hour beats almost everything in DGP's existing book

A 90-minute aesthetics block of "anti-wrinkle 3 + Profhilo 1 + Exion Face 1" delivers list revenue ~£1,090 with consumables of ~£140 and clinical time mostly Gemma + 30 min nurse. Marginal contribution ~£900 in 90 minutes — roughly 10x the per-hour return of a £99 menopause consultation. The aesthetics layer is therefore the financial engine that makes the longevity stack viable; longevity is the anchor that makes the aesthetics defensible (clinical, science-led, not "filler factory").

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F. Regulatory & compliance — what changes 2025-26

F.1 The CQC reform pathway (this is the big one)

Per Browne Jacobson, Markel UK, House of Commons Library briefing, DHSC consultation response Aug 2025, HUK Aesthetics 2026 update:

The DHSC published its consultation response in August 2025 introducing a red/amber/green tiering system: - Green (low risk — e.g. micro-needling, LED): any licensed practitioner. - Amber (medium risk — most injectables, RF, light therapy): non-healthcare practitioners only under named regulated-healthcare oversight; healthcare professionals can independently if appropriately trained. - Red (high risk — Brazilian butt lift-style, ablative laser, advanced fillers in danger zones, threadlifts, possibly polynucleotides depending on final list): CQC-registered premises only, regulated healthcare professional only. - Non-surgical Cosmetics Procedure Bill introduction: autumn 2025, phased implementation 2026 with Scotland leading.

Strategic implication for DGP: DGP is already CQC-registered and Gemma is a regulated healthcare professional. When red-tier procedures move under CQC-only delivery, every Derby-area clinic that is not CQC-registered loses the right to perform them. This will compress competition dramatically. DGP should track and respond by adding red-tier capability (advanced fillers, polynucleotide eye, threadlifts on advice) ahead of the regulatory cut-over.

F.2 Voluntary registers — JCCP & Save Face

• Save Face — register for regulated healthcare professionals only (Save Face context via JCCP/Aestheti.cc)
• JCCP — broader register, requires demonstrated competence (JCCP)

Recommendation: Gemma joins Save Face (regulated-healthcare-only register has clear premium positioning); the aesthetic-nurse contractor joins Save Face + JCCP. Make register membership a marketing pillar — the moment red-tier regulation lands, "Save Face registered + CQC registered + GMC-registered surgeon" becomes the only legitimate way to advertise injectables in a 50-mile radius.

F.3 Prescribing & PGDs

Per Aestheti.cc 2026 prescribing guide: - Botox/Bocouture/Azzalure are POMs — only authorised prescribers can issue scripts. - NMC ban on remote prescribing for cosmetic POMs from June 2025 — every Botox script now requires in-person consultation. - Beauticians/aestheticians cannot operate under a PGD. - "Appropriately trained" is interpreted as Level 7 in injectable aesthetics plus ongoing CPD. - Gemma can prescribe and administer everything; an aesthetic nurse without prescribing rights administers under PGD or against Gemma's individual scripts.

F.4 ASA / CAP code (advertising)

• Botox/Bocouture cannot be named as a treatment in consumer-facing ads (use "anti-wrinkle injections" or "wrinkle-relaxing treatment").
• IV nutrition: no disease/symptom claims unless MHRA-licensed indication.
• Before/after photos must comply with ASA realism rules.

F.5 Insurance

Hamilton Fraser is the dominant UK aesthetic medical-malpractice insurer (since 1996; first to market). 2025 published packages: - Beauty: from £112 - Beauty+ (medical needling, LED): from £224 - Essential (peels, shockwave): from £478.80 - Essential+ (cryolipolysis, sculpting, 3D Lipo): from £728 - Cosmetic doctor / surgeon-led with full injectables + devices typically £1,200-£3,500/year depending on procedure mix. Standard limit £5m, zero excess.

DGP's expected combined longevity + aesthetics premium with full injectables + Exion + EMSella + Emsculpt Neo + HBOT + GLP-1 is in the £2,500-£4,500/year band. PolicyBee or Markel are alternatives. Quote both, but Hamilton Fraser is industry default.

F.6 Medicines handling

• POM cold-chain (botulinum toxin: 2-8°C; HA fillers: room temp/15-25°C; Profhilo: same).
• Expiry tracking — already in place for DGP's prescribing operation.
• Sharps + clinical waste contract — already in place under CQC.
• Full controlled-drugs SOP if using lidocaine compounds.

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G. Tax position — where the BIK trap lives

G.1 The clean rule (longevity / GP retainer = company-funded)

Per HMRC EIM21765 and Tolley guidance: - Employers may provide one health-screening assessment + one medical check-up per employee per tax year with no BIK. - The exemption applies across a corporate group (so multiple-company directors get one set, not one per company). - The exemption does not cover treatment — only assessment and screening.

This covers DGP's longevity baseline + annual reviews comfortably. GP retainer is more nuanced (it spans assessment + occasional treatment) but the consensus interpretation is that the screening element is exempt and any reactive treatment is BIK on actual cost.

G.2 The aesthetics rule (personal benefit — full BIK)

Aesthetics is virtually never "wholly and exclusively for trade." A director paying for their own Botox / fillers / Profhilo / PRP via the company creates a full benefit-in-kind on the cost, plus Class 1A NIC (currently 13.8%, rising to 15% in some scenarios). Spouse aesthetics is the same — the BIK lands on the director, not the spouse.

The trivial benefit exemption (£50/event, £300/tax year director cap for close companies) is too small to matter for aesthetic course pricing.

G.3 Worked example — £100k director, £4,000 of aesthetics through company

The saving is real but small — and HMRC scrutiny of director-cosmetic-spend is rising. Recommendation: position aesthetics as "client self-funded but bundled for convenience and price." Longevity stays company-funded; aesthetics is on the client's personal credit card. This is honest, compliant, and avoids the tax-tail-wags-the-dog problem that derailed several B2B "exec health" plays in 2023-25.

G.4 The right pitch to a £150k+ owner-operator buyer

"Your longevity diagnostics, GP retainer, and HBOT are company-funded — under HMRC EIM21765 the screening assessments and medical check-ups are not a BIK, and the GP retainer is treated similarly to private medical insurance. Your Botox, fillers, Profhilo, and PRP are personal spend on your card. We invoice cleanly so your accountant can handle both correctly."

This is the line that closes accountants. Every other UK longevity-aesthetic clinic gets it wrong, claims more, and creates downstream tax exposure for the buyer.

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H. Audience overlap — the cross-sell economics

H.1 Headline UK statistics (sourced)

• UK aesthetics market: £3.2bn 2024, projected £5.1bn by 2028, CAGR 8-10% (Axiom Flux, PolicyBee)
• Injectables share: ~65% of total aesthetic spend
• Non-surgical share: >70% of all cosmetic procedures
• Male share of cosmetic patients: 12% (2020) → 21% (2025)
• Male enquiries growth: +30% YoY
• Male facial procedures: +26% YoY (BAAPS 2024)
• British College of Aesthetic Medicine survey: men receiving aesthetics +70% vs 2021

H.2 Average UK premium-client annual aesthetic spend

Triangulating BAAPS audit, Axiom Flux 2024 market report, Wifi Talents UK aesthetics data, and provider tier indices: - Mid-market (Botox + 1 filler/year): £600-1,200/year - Active aesthetic patient (Botox 3x + filler 1-2x + 1 skinbooster course): £1,800-3,500/year - Premium aesthetic patient (Botox 4x + filler 3-4x + 2 Profhilo + microneedling/Hydra + 1 device course): £4,500-9,000/year - Concierge aesthetic patient (London W1 tier): £10,000-25,000/year

H.3 Cross-sell rates (longevity → aesthetics)

There is no single published UK study on conversion, but provider testimonials consistently report: - HUM2N-style integrated clinics: ~60-70% of longevity patients also receive at least one aesthetic service within 12 months (HUM2N profile). - Reborne / Fountain / Galen tier: ~50-65% cross-sell to aesthetics from longevity intake. - Pure-aesthetics → longevity reverse cross-sell: 25-40% (lower because aesthetics buyers don't always want diagnostics).

This is why the longevity-front-door / aesthetics-back-end stack works: longevity intake is the commercial gateway; aesthetics is the recurring-revenue cash flow.

H.4 Bryan Johnson / Hooke / male-tech-bro longevity benchmarks

• Bryan Johnson Blueprint — explicitly anti-aesthetic-injectables in marketing (no Botox, no fillers; goes hard on red-light, peptides, plasma exchange). But sells PRP/PRF and red-light at premium tier.
• Hooke (Brian Cardella's clinic, UK link via tech overlap) — combines longevity diagnostics with growth-factor and PRP-style aesthetics, no public price grid.
• Bryan Johnson read-through for DGP: the male buyer now does want regenerative add-ons (PRP joint, PRP hair, peptides, NAD+) but is less warm on Botox/fillers stigma. Therefore for the male tier, lead with PRP / Profhilo / Exion / HBOT and treat injectables as discreet upsell.

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I. Operational delivery — Gemma alone vs. with an aesthetics nurse

I.1 Gemma's ceiling

Gemma is MRCS + MRCGP + IPS. Surgical training means tissue planes are second nature — she can credibly deliver everything in this report including filler in danger zones, Profhilo body, PRP joint with USS guidance, and supervise "amber tier" delivery by a nurse.

But the constraint is chair time, not skill. A realistic Gemma calendar: - 2 days clinical longevity reviews (~6 reviews/day @ 45-60 min each) - 1 day aesthetics + injectables (~8-10 patients) - 0.5 day family GP / concierge - 0.5 day admin / CPD / business

That gives ~30-40 aesthetic slots/week max in Gemma-only mode — not enough to deliver Premium Total volume to 30+ flagship clients.

I.2 The required hire — aesthetic nurse contractor

Acquisition Aesthetics 2026 salary data and Indeed UK injectable nurse jobs: - Salaried full-time: £25-50k (£50k requires prescribing rights) - Contractor / freelance: £300-700/day commission-based, top end £1,000+/day for elite injectors - A 2-3 day/week contractor at £400/day = £40-60k/year cost depending on retainer vs commission

Recommended structure: fixed retainer £200/day for cover + 35% commission on aesthetic revenue they personally deliver. At £4,000/day delivered revenue (achievable on a fully booked aesthetic day), that's £1,400 commission + £200 retainer = £1,600/day; clinic keeps £2,400/day net of commission. Fair and scalable.

I.3 Allocation of work

This split lets Gemma's 1 day of aesthetics per week act as the prescribing + complex-case anchor, with the nurse delivering the volume.

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J. Financial projection — 12-month and 36-month

J.1 Assumptions (conservative)

• 80 longevity patients on baseline tier at any time
• 15% convert to Reset at month 6 (flat membership, not fixed cohort)
• 8% convert to Transformation
• 3% convert to Premium Total
• Standalone aesthetic walk-ins (non-tier, à-la-carte) — start at 5/week, ramp to 25/week by month 12
• Couples discount applied to ~20% of tier sales

J.2 12-month revenue projection

J.3 Year-1 cost overlay (incremental for aesthetics layer only)

Net aesthetics contribution year 1: ~£364k (£556k - £192k). Add this to the existing longevity P&L.

J.4 36-month projection (steady state)

Net contribution after consumables / nurse / insurance / marketing (call it 35% direct cost + 15% opex overhead) = ~£900k-£1.0m EBITDA contribution at year 3 for the combined longevity + aesthetics + regenerative line. This is the financial case for hiring a second aesthetic nurse and a part-time aesthetician at the 18-24 month mark.

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K. Cross-sell architecture — how the funnel actually works

The flow Gemma should script:

1. Entry: Foundations longevity baseline (£995-2,500). Stride bloods, Tanita, GlycanAge, methylation review. This is the front door.
2. Month 1 review: Gemma surfaces a finding (high ApoB, methylation polymorphism, body comp drift, postnatal pelvic floor, perimenopausal vasomotor, fatigue + low B12). The finding becomes a plan.
3. Plan triggers tier upsell. Reset is the natural sit-down: "your inflammation profile + skin laxity + body comp suggests we package GLP-1 + Exion + Profhilo + a PRP for that knee that's been bothering you."
4. Month 6 review: quantified outcomes (Tanita drift, biomarker improvement, photographic record). Conversation shifts to "do we extend / step up?" → Transformation tier.
5. Year 1 review: for top performers / financially comfortable clients → "this is what Premium Total adds: unlimited HBOT, monthly Gemma touchpoint, family GP retainer for your spouse."
6. Cross-sell to spouse: at any tier, the couples discount is offered. Conversion rate from "I'm in" to "my wife/husband is in" within 90 days is the single biggest revenue lever.

The aesthetics-first reverse funnel (for walk-in Botox patients): 1. Walk-in for £185 anti-wrinkle. 2. Gemma's intake includes: BP, weight, BMI, brief history. Free Tanita scan offered as part of the consult. 3. Tanita reveals a finding (body fat 32%, low muscle index). 4. Soft pitch: "would you like us to extend the picture? Stride bloods + GlycanAge for £375 as an add-on." 5. From there, longevity review → tier conversion. Industry conversion rate from cosmetic-only to longevity-bundle is ~10-20%, and even at 10% the LTV uplift is enormous (£185 → £6,995+).

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L. Final recommendations

1. Hire an aesthetic nurse contractor immediately. £300-400/day retainer + commission. Save Face / JCCP registered. Level 7 holder. Without this hire, capacity is the constraint and the Premium Total tier cannot be delivered.
2. Brand the offer "Total Wellness" or "Doctorium Total." Build the four-tier ladder: Reset / Transformation / Premium Total / Couples. Publish prices. Premium-anchored pricing publicly differentiates from Derby competition; couples discount is the cross-sell engine.
3. Lead with PRP for the male audience and Profhilo for the female audience. Anti-wrinkle and fillers are the discreet upsell, not the headline. The public-facing copy should be "regenerative medicine + longevity + body composition + skin health" — never "Botox clinic with bloods."
4. Stay clear of Morpheus8 and Sofwave/Ultherapy capex. Exion already covers the RF + ultrasound space; don't fragment the device offer.
5. Add Exion Hair only paired with PRP. Stand-alone Exion Hair has weak independent evidence; combination protocol mitigates clinical exposure and lifts ticket from £325 to £650+.
6. Save Face + Hamilton Fraser before launch. Budget £4-5k year-1 for combined regulation/insurance overlay. Hamilton Fraser combined policy ~£2,500-3,500.
7. Prepare for CQC red-tier reform. The 2025-26 reform almost certainly moves polynucleotide eye, advanced fillers, and threadlifts to CQC-only. DGP is already CQC registered — every Derby competitor is not. Make this a marketing pillar from launch (legitimately): "CQC-registered premises, GMC surgeon-led, Save Face registered." That single line erases 90% of local competition.
8. Tax framing: longevity company-funded, aesthetics personal-funded. Stop short of any director-perk aesthetic claim. Position cleanly to accountants. EIM21765 covers screening; aesthetics does not qualify.
9. First 90-day campaign: "Longevity + Skin + Strength." Test the bundle on existing 80 longevity patients. Expected conversion to Reset within 90 days: 8-15%. Expected uplift to clinic top-line: £45-90k inside the test window.
10. Couples-tier launch event. A single curated dinner for 12 existing patients + spouses, Gemma walks through the longevity + aesthetics integrated model, presents the couples discount. This is the highest-ROI activation the clinic can run in 2026 and aligns with how W1 competitors (HUM2N, Reborne, Galen) acquire couples-tier members.

The combined longevity + aesthetics + regenerative play takes DGP from "menopause clinic + premium dashboard provider" to a credible East Midlands answer to HUM2N / Fountain / Reborne — at a fraction of the W1 capital base, with a stronger device stack and a better-credentialled clinical lead.

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Sources

• BTL Exion — official BTL multiplatform
• Dr Rita Rakus — Exion clinical pages
• London Skin Clinic — Exion
• Renovatio Clinic Cheshire — Exion
• Stephanie Louise Clinics — Exion course pricing
• PHI Clinic London — Exion
• Serenity Women's Clinic — EmFemme 360
• Bader Medical EmFemme 360
• Selston Cosmetic Clinic — Botox pricing East Midlands
• MedSkin Clinic Derby
• The Beauty Nurse Aesthetics Derby
• Park Private Clinic Nottingham
• Fresha Nottingham aggregate pricing
• Flawless Aesthetic Clinic — UK filler costs
• Wigmore Smiles dermal fillers UK pricing
• Mount Road Dental — Restylane vs Juvéderm
• Dr Reena's Facial Aesthetics — UK fillers cost guide
• Karma Clinic — Polynucleotides vs Profhilo 2026
• London Skin Clinic — Profhilo vs polynucleotides
• Skin Horizon — Profhilo vs polynucleotides London
• Renovatio — Profhilo vs polynucleotides UK
• Bolt Pharmacy — PRP for hair loss UK guide
• The Wellness London — PRP for hair loss 2025 review
• Wimpole Clinic — PRP hair treatment costs
• PRP London — knee PRP guide
• MSK Clinic — knee injection costs UK
• Manchester Shoulder & Elbow Clinic — PRP
• Orthobiologics Clinic Macclesfield — PRP tennis elbow evidence
• Orthobiologics Clinic Macclesfield — PRP Achilles evidence
• The London Orthopaedic Clinic — PRP/ACP
• Doctor Alex — Vampire Facial / Dracula Therapy
• PRP London — Vampire Facial cost UK
• Leeds PRP Clinic prices
• RegenLab UK — PRP supplier
• Tropocells PRP system
• Premier Wellbeing — Tropocells 11ml kit retail
• REIN PRP tubes UK
• Get A Drip — IV vitamin drips
• REVIV memberships UK
• ASA ruling — Get A Drip
• ASA ruling — REVIV UK
• CAP — IVNT advertising guidance
• Future Care Medical — vitamin drip price list London
• Harley Street Skin Clinic — HydraFacial UK cost
• sk:n full body laser hair removal
• MedSpa Clinics — laser hair removal cost UK 2025
• Centre for Surgery — Morpheus8 cost UK
• Omniya — Morpheus8 fractional RF microneedling
• Illuminate Skin — Sofwave vs Morpheus8
• HUM2N Longevity London
• HUM2N — Muscle Rebuild Programme
• Longevity.Technology — HUM2N profile
• Reborne Longevity Harley Street
• The Galen Clinic / Reborne
• Fountain Clinics London — longevity + weight + aesthetic
• Kuer Clinics Harley Street — longevity + aesthetics
• The Ardour Clinic Marylebone
• UK ALM Health — wellness consultants + medical aesthetics + longevity
• Harrods — The Wellness Clinic
• Lanesborough Club & Spa — Galyna Selezneva consultant
• The Tweakments Guide — Dr Galyna Selezneva profile
• Dr Frances Prenna Jones Clinic
• Wallpaper feature — Dr Frances Prenna Jones
• London Regenerative Institute
• Browne Jacobson — UK cosmetic procedure licensing rules 2025 legal guide
• Markel UK — shifting landscape of aesthetic regulation
• House of Commons Library briefing — non-surgical cosmetic procedures regulation
• DHSC consultation response — licensing of non-surgical cosmetic procedures Aug 2025
• HUK Aesthetics — UK aesthetics regulation 2026
• Aestheti.cc — prescribing Botox & fillers UK 2026
• JCCP — Joint Council for Cosmetic Practitioners
• Hamilton Fraser cosmetic insurance
• Acquisition Aesthetics — UK aesthetic nurse salary 2026
• BAAPS — Cosmetic Surgery Trends 2024 press release
• PBL Magazine — BAAPS 2024 men +26% facelifts
• Axiom Flux — UK Aesthetic Industry Market Report 2024
• PolicyBee — UK aesthetics industry statistics
• Wifi Talents — UK aesthetics industry data 2026
• Hessington Health — EIM21765 tax relief health screening
• Tolley — medical and optical check-ups tax guidance
• Carpenter Box — medical BIK tax implications
• Vale & West blog — health screenings tax-efficient employee benefit
• Pieleterna — Plinest / Mastelli polynucleotides EU pricing
• Injectual — Plinest polynucleotides UK