Patients who began injectable treatment after a 17-clinic Australian group introduced a formal facial assessment and structured treatment plan were about 2.5 times as likely to be retained at six months as patients who began before it in the authors' adjusted model, according to a study of 14,916 patient records. The paper's raw patient retention percentages point the opposite way.

The paper, "Enhanced Patient Retention With Formal, Structured Facial Assessment and Treatment Planning: A Multi-Clinic Real-World Analysis," was published in the Journal of Cosmetic Dermatology in February 2026. Its authors are Andreas Fox and Louise Guest of Artisan Aesthetics Group, which operates the clinics in New South Wales and Queensland, and Tara Telfer of Galderma Australia. We read the full open-access text.

Nobody was randomized. The authors pulled de-identified records from the group's shared customer relationship management database, taking adults whose first cosmetic injectable treatment fell between April 2019 and January 2025 and who had at least two treatments in all. In March 2022 the group introduced one protocol across every clinic: clinician observations and questions to the patient were used to identify priority concerns, and the patient received a structured, stepwise treatment schedule. Patients were then sorted by whether their first visit came before or after March 1, 2022.

What the patient retention numbers show

The simple estimate of six-month retention was 84.8% for patients who started before the plan and 71.0% for those who started after it. Lower, not higher.

Those crude figures, the authors say, are distorted by unequal follow-up windows and by patients whose treatment history straddled the changeover. So they fitted a time-dependent Cox model, a method that splits each patient's follow-up at the date the plan arrived and compares the rate of dropping out on either side, adjusting for age, sex and how often the patient was assessed. That model produced a hazard ratio of 2.53 (95% confidence interval 2.43 to 2.64). The authors describe it as a 153% higher likelihood of retention under the plan.

By product type, the pattern repeated. Hazard ratios were 2.17 for neuromodulator patients, 2.24 for dermal filler and 2.89 for biostimulators, though fewer than 10% of patients had received a biostimulator at all. Brands weren't analyzed.

Two covariates also moved the result. Each additional scheduled assessment was associated with about a 25% better chance of retention (hazard ratio 1.25). And men, roughly 5% of the sample, were 17% less likely to be retained than women.

Limits the authors acknowledge

One network, one country. The authors say that may limit how far the result travels to other health systems or cultures. Retention was inferred from treatment records and used as a stand-in for satisfaction; no patient was asked anything. And the model could not account for practitioner experience, clinic environment or patients' socioeconomic status.

Then there is the funding. The work was paid for by an educational grant from Galderma Australia, one of the three authors is a Galderma employee, and the same grant funded professional writing assistance for the manuscript. The authors say they were responsible for the content and the decision to publish.

What it means for a practice

The study stops at six-month retention inside one Australian group. Everything below is our analysis, not the authors'.

For an owner, the first thing to see is who was left out. It matters. A patient needed two treatments to enter the dataset, so the person who came once and never returned isn't in these numbers at all. The paper can't say whether a structured plan turns a first visit into a second, and that is the drop-off most practices worry about.

There is also the matter of how much weight a single model can carry. When raw figures and adjusted figures disagree on direction, the 2.5 is better treated as a hypothesis to test against your own records than as a forecast. Testing it is cheap: a documented plan with review dates costs a template and some staff time, and rebooking by first-visit month is a report most practice-management systems can already run.

The assessment-frequency result deserves a second look as well, because it is partly circular. A patient with more scheduled reviews has more reasons to be on the books in month six. Retention is also the figure a membership gets priced against, which we work through in our guide to membership pricing.

Fox and his co-authors call for prospective studies, and for follow-up to 12 months and beyond.

The paper offers neither.

Sources