April 05, 2009

Operations Management – Lesson 2

Plastic Surgery


Advances of sience and technology has significantly lowered the costs of "procedures" which has contributed into the increase in demand (volume) whilst at the same time the "variety" of procedures being offered have also increased and simplified which has reduced the end-2-end time ("speed"), which basicly makes cosmetic surgery for some clients has become as routine as going to the dentist.

The wider accessibility and affordability has lead to a wide expansion of clinics and franchising clinics branching out to various countries (Poland, Greece..) whilst a few are including a holiday into package as part of the recovery process.

The term “plastic” comes from the Greek word plastikos which means to mold or to give form falls into 2 subdivision;

1.       Reconstructive surgery and

2.       Cosmetic surgery

"Variation" in Product offerings is determined by the type of treatment requests;

[1] Reconstructive procedures ;

these are performed with the goal of restoring form and in many cases function of body parts that are abnormal due to - few examples;

  • burns - traumatic injuries, such as facial bone fractures- congenital abnormalities, such as cleft lip, or cleft palate - developmental abnormalities- infection or disease-removal of cancers or tumors, such as a mastectomy

[2] Cosmetic procedures;

are performed done purely to enhance the appearance of body parts such as - few examples;

Source: http://encyclopedia.thefreedictionary.com/Plastic+Surgery

Operations Process (high level)

7 steps of cosmetic surgery - Management System

From a high level "End-2-End" process point of view the overall process can be high level be split into 7steps. These steps need to be perfectly integrated into the Operation Management System to ensure a smooth flow, as the patient wants to "come in and get out (with results)" in the shortest of time (speed) possible.

[1] Meet The Surgeon -> [2] Nurse Review -> [3] Consent Form -> [4] Estimation of Costs -> [5] Pre Operation Exam. -> [6] Operation -> [7] Recovery

Source: http://www.mayoclinic.org/cosmetic-surgery/process.html

Strategic Objective

Strategicaly clinics advertise in the media (see next example) – where the attention of the potential client is captured by displaying details aimed at tempting the client to contact the clinic (demand generation).

Flawless pictures and mentioning of Awards won etc.. and also view of the facilities. Most important the website comes complete with photo galleries and prices etc... (references...)

TORONTO COSMETIC CLINIC' s website information


[a] Home Page


[b] The Facilities


[c] Pricelist


[d] Patient Stories (customer satisfaction)

Patient Feedback

Performance Objectives;

Apart from executing the the 7-steps with military precision it is critical to understand and set the Performance Objectives are clearly established levels and communicated through all levels of Operations.

  • Quality – the is clearly the most e most important  as it has direct impact on customer satisfaction and "word of mouth" contributes to a clinic's reputation. After breast enhancement the client expects both breast to be perfectly aligned and of similar size.

  • Speed – both client and clinic would like to see the process executed at the agreed pace, meaning if the procedure is offered at 3 hours and leaving the clinic after 6 hours - these are targets which need to be met as this impacts both customer satisfaction and 7-steps process and the pipeline of clients needs to be processed through the system, hence time is critical.
  • Cost – as the market becomes commoditized prices are falling, hence offering attractive prices is critical as several clinics are quoting prices which are sometimes at 50% of the level of competition.
  • Dependability – the 7steps process will have a predefined time-line and for the client this is crucial as this forms part of the expectation and most important "mental and psychological" preparation.
  • Flexibility – with each client having unique needs the clinic needs to be ready to offer for example "breast increases in various sizes", however most procedures are standard with little room for flexibility in applying variety.

Rating of importance (based on personal interpretation of the matter);






short term results, flaws can be repaired


long term results, dont want to come back for repair job - scars, longer healing process





4 low budget

5 high budget





3 simple/routine procedures

5 routine procedures which could require creative solution to nature of patients medical and physical characteristics

Polar diagram reflecting the Performance Objecitves

Polar - Costmetic vs Reconstructive

solid line = cosmetic

dotted line = reconstructive

[2] 4 V's

The plastic surgery clinic will require experienced and highly skilled surgeons combined with latest technology of equipment which require huge capex.

  • Volume increase will require more focus on the 7-steps Operations Management and execution, however as the procedures as all "hands-ons" an increase in volume means increase in both headcount/staffing and increased facilities.
  • Variety in the form of offering a wide range of procedures enables the clients to create a kind of "Roadmap" which could mean, 2009 (breast enhancement), 2010 Tumy Tuck, 2011 (Liposuction) etc.... and in between Botox. With the wide variety clinics have the power to actively promote this and lead the client into long term "relationship"
  • Visiblity - the results of the procedure and photo galleries showing Before and After pictures are a strong tool in making the clinics efforts "visible"
  • Variation in Demand - with obesity having increased focus, clinics can increase their skills on offering liposuction and other weight/fat reduction procedures and with Botox being wide made popular, timely responding to this demand is critical

The next diagram shows the 4V's for the Reconstructive and Cosmetic Procedures


[4] Process Type vs Performance vs Layout Type

Combining the Process Objectives with the Volume nd Variety dimensions it shows that we are looking at a mix between Fixed and Functional layout - as the patient will in the early part of the 7steps be moving around (functional) the clinic, however during, after (recovery) of the Opeation phases we can see the patient being visited by specialist (fixed)

Process + Layout


Botox Before and After


Steps of the Facelift process




Slack et al, 2006, "Operations and Process Management", Prentice Hall

Wally, 2009, Warwick MBA Study note on "Operations Management"



Source: http://encyclopedia.thefreedictionary.com/Plastic+Surgery



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