OUSIA CLINIC – Beauty within and without

OUSIA CLINIC is a bold, innovative and holistic approach to aesthetics medicine. Having opened in March, it is probably the most sophisticated and technologically advanced clinic in Portugal. Essential Business talks to co-founder Dionisia Ferreira.

Text: Chris Graeme Photos: José Ferreira, Chris Graeme and OUSIA CLINIC

I walk into OUSIA CLINIC, Portugal’s most sophisticated and technologically advanced medical aesthetics establishment, and immediately sense a complete and radical departure from anything I have experienced or seen before.

Standing in the ample and open-plan foyer, it is difficult to put your finger on the difference, but something intangible is. Is it the fresh woody aroma, the flood of light reflecting off white walls and white marble floors that convey a sense of levity and spartan cleanliness?

Nothing is dark and cluttered here; all is light and space combined with the natural non-affected attention from the staff who are polite, subtle, attentive but not intrusive. This myriad of sensations is at once calming and reassuring and provides the confidence that you are in the right place to be taken care of holistically.

We are met by a tall, elegant, and tanned woman in a striking yellow trouser suit that offsets a shock of voluminous jet black hair which frames a flawless complexion with no makeup whatsoever. This lady greets me with hand extended and exudes self-assurance and presence. This is entrepreneur Dionisia Ferreira, who has just embarked on the adventure of her life, embracing the challenge with gusto and relish. I have just been inducted into a concept that seeks to reach the essence of each individual, to help them find a better balance between body, mind and spirit.

I am taken through to the reception area and offered a coffee at the nutrition bar. “A healthy, balanced nutrition is one of our core concepts. I believe what we eat and how we sleep is key to our overall health. What we eat, how we eat, when we eat and how it is prepared is extremely important,” she reflects. “You may not eat much, but if what you do eat is not nutritionally sound then it amounts to eating badly.”

Dionisia says that when looking at the business, which officially opened in March, she knew she had to look at it as a whole and from various perspectives which, in her mind, are all interconnected.

“When we thought about the interior design, we wanted clients to feel comfortable and relaxed, to take advantage of all the different treatments, go to the gym and have lunch all under one roof without having to leave the building,” she reflects.

After the initial phase, when the business is fully up and running, OUSIA CLINIC plans to widen the choice of treatments and already has the space to introduce more treatment rooms, and not just for adults. The founders are already looking at children’s services in terms of nutrition, fitness and exercise, and weight loss.

“If someone were to ask me what the age range is for our clients in terms of treatments, I would say from adolescence to old age,” adding that they have a very effective treatment for teenage acne and already have clients who are 85 years old or more.

A small but growing market

Portugal’s small but burgeoning aesthetics medicine sector is currently valued at around €46 million. This includes all aesthetic and beauty treatments but does not include plastic, post surgery and enhancement treatments, which brings the total market to €120 million, according to a market study carried out for the founders of OUSIA CLINIC.

Of course this is a drop in the ocean when compared to the larger and highly sophisticated markets of the United States and Brazil, which between them probably have the lion’s share of the world’s market, which is expected to grow to almost €16Bn by 2025 and €46Bn by the end of the decade. In the case of Brazil, the market share was valued at €1.8Bn in 2022 but is set to quadruple to €8.6Bn by 2033. In Europe, Spain’s market in 2019 was €2.8Bn (+5.8%) on 2018.

Nevertheless, Portugal’s market has grown at a more modest rate than other European markets and less than Greece, while many Portuguese opt to undertake treatments in neighbouring Spain despite the costs for the same treatments being higher.

“The Portuguese are quite conservative and reticent in all areas of health. They don’t like changing their doctor, particularly if they are happy with them. Then there is the typical characteristic that whatever comes from overseas is better,” says Dionisia Ferreira, adding that this attitude is changing among the younger generations.

“Obviously, when we look at Europe overall it is well below the growth seen in the United States and Brazil over the past few years, but what is interesting is that this growth is not in the plastic surgery segment, but rather in the non-invasive treatments areas,” says Dionisia Ferreira who, together with business partners Miguel Raposo and her husband Markus Kemper, have invested just over €4 million in setting up Portugal’s most sophisticated aesthetics clinic to date.

And during the long months that refurbishment works had been going on, Dionisia worked hard to build up a list of clients so that when OUISIA CLINIC opened, the appointment book was healthy.

This investment is immediately apparent when you visit the 14 treatment rooms and see the sophisticated state-of-the-art digital software-operated equipment for LED photobiostimulation, hyperbaric oxygen therapy, Fotona 4D synergised non-invasive laser, radiofrequency and high-intensity focused ultrasound (HIFU) treatments, among others.

The trend for less invasive

Dionisia Ferreira points out that the plastic surgery market has shrunk over the past two years by between 1-2%, while non-invasive and minimal invasive treatments have grown on average by between 10-18%, depending on the country.

“Up until now, most medical aesthetics clinics in Portugal were started from the basis of plastic surgery as the core business model. OUSIA CLINIC is different because it has focused more on what its competitors in the market do not have. According to the latest trends, people want less mystery and more science; they don’t want to go under the knife, and increasingly they want treatments that are based on natural products,” explains the entrepreneur.

Genesis

Dionisia Ferreira has a long track record of 16 years in finance, having worked for some of Portugal’s top banking establishments such as Barclays and Millennium BPC, before moving on to the Portuguese postal service CTT – Correios de Portugal to a C-level position, where she was, amongst other responsibilities, also responsible for the company’s privatisation in 2013, which at the time was one of the biggest IPO flotations on the Euronext Lisbon stock market.
“Obviously working for 17 years in the banking sector has given me an advantage on how to manage banks and loan portfolios, starting off in branch management, becoming a commercial director by the age of 28 at BCP and the Managing Commercial Director at Barclays a few years later.

“I’d been working in these areas for such a long time that I felt I needed a change. I no longer wanted to work for other companies, and decided I wanted to open a business and work for myself,” she explains.

But going from finance to postal services and then to medical aesthetics is a radical change, which Dionisia puts down to “a sector that I like and which thoroughly interests me”.

“I was fascinated in part because it was an area about which I knew little. I, for obvious reasons, didn’t want to be a doctor, but wanted to get a better grasp of this world of medical aesthetics which seems so vast, but mostly how it interlinks and blends with our interior world and our appearance.”

Like with several other entrepreneurs in Lisbon, the Covid-19 pandemic was a wake-up call for Dionisia to rethink her life and business.

“The idea came to me whilst I was on my way to a meeting in Lisbon. At the time I didn’t have the exact business model in mind, but I knew there had to be a market for a clinic that went beyond the traditional scalpel and beauty treatment models and procedures I knew.”

A holistic approach to health and wellness

Dionisia refers to a 360º holistic approach to health and wellness. “We all want to look good on the outside, but if we’re not eating the right foods, drinking the right amounts of fluids and we’re not happy and well in ourselves, that sadness will show through the eyes, posture and facial expressions even if we don’t have any wrinkles and look young.”

The entrepreneur points out that this has nothing really to do with a spiritual glow – although people who practice a particular faith can tend to be happier and less self-conscious –, but rather a phenomena that’s noticed by both men and women during the lockdowns of 2020 and 2021 and the widespread use of online meetings such as Teams and Zoom.

“People could see themselves and often didn’t like what they saw and rushed to make improvements. In fact, I know at least one other competitor in our area who said that their clinic had never done such brisk business in such a short period of time as when society was closed down due the Covid-19 pandemic,” she recalls.

Part of this, she says, has to do with our packed and busy rush-around lifestyles where we don’t have time to care for our appearance and how we look; time to even think about the dark circles under our eyes or the blemishes on our skin.

“We cannot be physically beautiful on the outside if we don’t take care of ourselves from within and this has to do with lifestyle, nutrition, sleep, exercise and mindfulness.”

In essence, the beauty concept that Dionisia and her team have developed starts with a basic and fundamental truth: beauty begins when you decide to be who you are and the very best version of who you can be. This means understanding a person’s identity on several levels: beauty, health, wellness, and mind.

OUSIA – a brand that defines the essence of who we are

The periods in lockdown enabled Dionisia to not only formulate the business plan but also design the core concept and the brand.

The name OUSIA CLINIC was chosen from the Greek word essence – Ουσία – because the concept is designed to help clients find their essential essence of who they are, both outside and from an aesthetical standpoint.

“I first began working on the brand, and then in the first phase of Covid I stopped, put the project on the back burner, because I wondered if this was the right time to push the business forward, before realising it actually was,” Dionisia explains.

One strong point in the partnership’s favour is that both Miguel and Markus are “born entrepreneurs”, as Dionisia puts it.

A proven track record in terms of experience and knowledge was fundamental when carefully selecting the staff. OUSIA CLINIC currently has 24 professionals in order to provide all the aesthetic treatments and services at the best quality.

During the first Covid year in 2020, Dionisia took an intensive one-year Health Management course, both in person and online at Universidade NOVA, not just to learn the business side of running a clinic, but to understand how doctors and nurses think. “I think they are a class of people who are different when it comes to handling them within the context of the business on a daily basis.”

The entrepreneur also took the time to study the market and see what services they could offer and how they could be delivered in a way that was different from the competitors in the market.

Of course, after hiring the services of a consultant, the next step was to find a premises that was large enough to cater to the 35 different face treatments and therapies and 50 body treatments.

The choice fell on a large and well-appointed premises in the upmarket Restelo area of Lisbon, a stone’s throw away from the city’s iconic Torre de Belém landmark; a neighbourhood packed with upmarket mansions and international consulates and embassies.

The building covers 1,500 square metres and comprises three floors and an underground garage which can be used by customers.

Next came the design and finding an interior architect that specialised in hospitals and healthcare clinics. The choice fell on a design studio in Porto, Medd, which was founded in 2004 by Miguel Moura e Castro and today is a reference in Europe, particularly in France, in construction and refurbishment projects in the health sector, including health centres and clinics, dental clinics and pharmacies.

“I told him I wanted a clean and open space where clients would feel good, with light colours and private areas with sofas as waiting areas all designed in such a way that if people were circulating in the main areas, the clients waiting for treatments would not be seen.”

I am given a guided tour of the premises. In the central area on the first floor I immediately notice how it is cleverly and tastefully divided with sofas and screens to give maximum discretion and privacy for those waiting for appointments. As we stroll along the corridors to the treatment rooms, I ask Dionisia what kind of beauty treatments she favours and how she manages to look so good.

“Today I’ve got no makeup on, in fact I hardly ever do. I’m careful with what I eat and take physical exercise. As for creams, I simply use moisturiser. However, I’m not a fundamentalist. When I want to eat something I fancy, which might not be low calorie or even that good for you, I do so, but in moderation,” says Dionisia.

I also ask her if it was challenging getting planning permission from Lisbon City Hall given the current stream of complaints from developers and opinion columnists, as the original building was designed as an office block and is a listed building because of its architectural merits — it was a candidate for the Valmor Prize in the category Honorary Mention. As a listed building it meant that the original façade had to be maintained. But getting a change-of-use licence and refurbishing the interiors was relatively plain sailing.

“Of course we had to go through the whole set of procedures to turn this into a clinic, particularly to meet the requirements of the Directorate-General of Health. The latter was a more bureaucratic process, but from the conception of the clinic to opening it, we had 30 months to meet all the demands. Having said that, it is true that it is not easy to get a licence to open a clinic in Portugal,” she muses.

And indeed, there were a lot of things to think about in terms of regulations, such as air-conditioning, refrigeration, sterilisation, the circulation of patients, the length and width of the corridors, the configuration of the stairs, and the fire hazard safety requirements.

A non-invasive strategy

Given that the aesthetics sector has generally grown by two digits worldwide over the past few years, with demand growing for non-invasive treatments, Dionisia explains that this was in part because of advances in technology, which make invasive treatments involving surgery less necessary, and partly because people today would rather opt for non-scalpel procedures.

“Today, with the technology, you can do things that a couple of decades ago would have been impossible. For example, you can make a scar less visible using laser treatments or even create a lifting effect on the face. This means that having a traditional face lift involving surgery is no longer always required,” she points out.

Part of this is also to do with those people who have had cosmetic surgery in the past and may not have had a positive experience delivering the desired results. “Such clients obviously have some fears about plastic surgery,” Dionisia says.

And the technology is so advanced — some of it even uses Artificial Intelligence and sophisticated software — that the machines can work out skin types and suggest the correct treatment and within specific parameters.

Nutrition and fitness

OUSIA CLINIC has three nutritionists, each one qualified to design a tailor-made diet programme after one-to-one consultations. For example, one has the necessary experience to treat people with conditions such as diabetes, chronic kidney disease or autoimmune disorders. Another nutritionist has a specialisation in treating thyroid problems, and finally one who specialises in digestive conditions, as well as people who simply want to lose weight. Here, blood and DNA analyses will prove useful when designing a bespoke diet regime.

“This weight-loss diet can also be accompanied by an exercise and fitness regime in our own gym, accompanied by a fully qualified instructor and a lymphatic drainage message, which can also help in cases where medical treatments, like chemotherapy or certain illnesses, block the lymphatic system,” Dionisia explains.

Aesthetic and post-surgery medical tourism

Tourism represents around 12% of Portugal’s GDP, and one area of this market which has mushroomed in recent years is the concept of health tourism, and this means post-operative recovery and the whole range of different aesthetic and physiotherapy treatments that OUSIA CLINIC provides.

When it comes to healthcare, Portugal inspires confidence and is increasingly sought after. For many people, Portuguese healthcare offers an excellent value-for-money alternative where the medical and rehabilitation care, kindness, climate, direct contact with nature and Portuguese hospitality makes for a rewarding experience.

“We do have clients who are or have been treated for cancer. Obviously, the patient must inform their medical consultant if they can undergo the therapy or not. One such treatment that has to do with well-being and helps considerably, even though it has not been totally clinically tested but is well studied, is oxygen therapy in our Hyperbaric Oxygen Chamber,” says the OUSIA CLINIC co-founder, adding that this treatment is particularly useful for treating several conditions.

Most illnesses and injuries occur in the tissue level, within the cells. In cases of non-healing wounds, strokes or problems with blood circulation, not enough oxygen can reach the affected area and, as a result, natural healing does not happen. Hyperbaric Oxygen Therapy provides an increase in oxygen naturally through 50-minute sessions and is excellent for anti-aging, accelerated post-surgery scar tissue production, stroke recovery, improved circulation and immunity, among a whole host of other benefits.

OUSIA CLINIC also has a specialist in osteopathy to help treat problems such as osteoporosis and osteopenia, as well as having a physiotherapist. Oxygen therapy also helps with healing fractures and torn, sprained and inflamed ligaments and muscles.

Other treatments are indicated for cellulite, treating flaccid skin and other dermatological problems, reducing abdominal flab, improving skin elasticity, reducing wrinkles and removing unsightly spider veins from the whites of the eyes using laser treatments. 

OUSIA CLINIC has invested in the very latest state-of-the-art equipment and technological solutions that one would expect in much more advanced markets like the United States, and is staffed by highly qualified professionals in each treatment speciality.

“Of course we’ve set up in Lisbon, but we plan to expand to more cities in Portugal. This will be our ‘flagship’ and first we have to consolidate our business model here, but we hope to be able to eventually expand nationally including the islands of Madeira and the Azores.”

Target markets and going forward

According to the partners’ business case, 70% of clients are expected to be Portuguese and 30% overseas citizens. These foreigners will mostly be non-Portuguese nationals who are resident in Portugal.

At the moment, OUSIA CLINIC has Brazilians and some Spanish on its books, as well as Americans and a spattering of French clients. In terms of sex ratio, 70% are women and 30% men, although when they first opened their doors, the first clients were men.

Dionisia is also of the firm conviction that the Portuguese are no different to other nationalities in more developed markets in terms of medical aesthetics when they are well informed. “The Portuguese are equally or better aware than other nationalities.”

But in terms of clinics, she says the market is less developed in Portugal partly because of its size and smaller population. But those who do have the financial wherewithal to access these treatments, particularly the ‘Google it’ generation, she points out that they are all well gemmed up on the latest developments in aesthetic and wellness treatment options.

“We get people asking if we have a certain treatment or machine because they’ve heard about it in the UK or Brazil. People today are ‘in the know’ and much better informed than they were 10 years ago. It’s so different now there’s no comparison.

“Another thing I’ve learnt in this area, which was surprising to me, is that a person who is well informed really knows about it inside out, and when they want a specific treatment they’ve already researched it,” says the entrepreneur and founder of OUSIA CLINIC.

As to the future, Dionisia and her co-partners have ambitious plans, but first they want to establish the Lisbon venture before expanding in a sustainable way.