In the world of beauty, cosmetic injections are some of the most popular treatments on the market. Injectables like wrinkle relaxers and volumizers are medical treatments that must be administered by a licensed medical professional, for example a Registered Nurse (RN), Nurse Practitioner (NP), or Physician's Assistant (PA).
Nowadays it’s easier to find a tenured injector, but it hasn’t always been that way. Laurie Peterson, RN, CANS started her career before the medical aesthetics industry became as robust as it is today, she learned the trade as it was coming up.
Now an expert injector at Portrait in Southern California and an esteemed trainer for Allergan Aesthetics and Revanesse USA, Laurie knows the business inside and out. In this article, she speaks with us about her career as well as what it’s like to break into the growing aesthetic industry, including tips for rising injectors.
Tell us your background story, including your nursing education and what your career path has looked like since then.
To introduce myself, I’m Laurie Peterson RN, CANS. I graduated from nursing school in 2000 in Wisconsin, at that point I had a passion for oncology. I traveled to California many times for snowboard competitions and knew it's where I wanted to live. So once I could become a travel nurse I was off to San Diego. There was a huge need for them back then so I got in early and got some great learning experience. From there I worked in different departments in the hospital such as oncology, pediatric oncology, telemetry, ER, OR, and PACU (post-anesthesia care unit). PACU is where I was recruited by a plastic surgeon, and that's when aesthetics opened up to me.
I was in my 20's suffering from cystic acne, I was a patient in some of these medspas and doctor's offices trying to get some help. It opened my eyes to realize that some of the nurses were just "pressing buttons" - they needed to have a better understanding of what they were really treating. I felt like I wasted a lot of money and never got my acne cured. So once I got into the other side of the medicine and learned the lasers, I used the IPL’s to cure my acne. Now people don’t believe I ever had acne!
Once I got the syringes of filler and Botox in my hand the rest was history! It was funny too because when I worked in the hospital, everyone was like “Laurie can you do my IV?”, I just really got into it and liked using needles and injecting in the first place
I had my very first dose of Botox® at a medspa in La Jolla. Then I went to see the doctor at Ageless and Beautiful, at his old office in 2005, when I saw him and told him I had some experience and he said why don’t you work for me. So then I started working there and it really opened the door to more opportunities.
Aesthetics has come a long way! We didn’t really have the full-scale training we have today. Doctors trained us hands-on and even the pharmaceutical reps trained us. I remember one rep training us to do lips. A male, non-medical, not knowing the proportions of lips, just where the product should go. It's funny when you think about how far aesthetics has come.
I worked at Ageless and Beautiful for a long time, probably until 2009 or 2010. I then had started working at Del Mar Aesthetic in 2008 and after a couple of years, I just got too busy and had to decide where I wanted to "hang my hat".
I worked there for almost 12 years until I moved to Portrait in 2020. Since working full time in Aesthetics can be challenging as you build your practice, I also worked per diem. And how could I forget my experience as a manager/injector of a medspa in Fashion Valley, wow, the craziest job I ever took, but I learned a lot.
That was me trying to achieve full-time work in the industry. What I quickly learned was big businesses like that company, that came and went, were just trying to make money. What they didn't realize is they are providing a medical service. If money is your bottom line, you will lose because there is so much more than providing a service. It's providing trust, outcomes, and a plan of care for a patient. With that comes a happy patient, who refers their friends and the revenue will grow organically out of good ethics and great treatments. This "turn and burn" company was not a fit for me and needless to say they went under shortly after.
Since most of my time was working in the Del Mar area, which seemed to be a base, however, I really have patients from all over. I even have patients in Mammoth Lakes, I started injecting there about 8 years ago. Since snowboarding has always been a passion of mine I figured I might as well take some work and play all in one.
What is your work schedule like now at Portrait? On days that you’re working what is a typical day like?
I work Monday, Wednesday, Friday, and it’s 11-7, sometimes Fridays are longer. It looks like no lunch, just go straight through. Protein bars. I just schedule back-to-back patients. It’s one in, they’re out and I clean, then the next one. Nonstop.
But it’s not as crazy as it sounds. I make my own schedule, I’m not forcing myself to do something beyond my means. It’s pretty awesome. I have a 5-year-old at home. I make a full-time living working 3 days a week. I'm blessed to have the clientele I have.
You’re also a trainer, will you tell us about that?
Yes, for Allergan and Prollenium that makes Versa®! I was actually asked by some of the reps back in the day to "train". There really wasn't much for trainers yet. They were more asking if I could help them with some of their accounts because the cosmetic injectors didn’t really know what they were doing or how to use the product and I could give them my experience.
It was funny because I was helping but I didn’t exactly know how to train or have the tools of training, I only could tell them what I knew and how I was doing it. We were just figuring this out as a community so that’s really how the aesthetics industry grew more knowledge.
Anyhow, moving forward things are now really structured which I like because it keeps me in check. I love teaching. It has its challenges though. Sometimes I will have a group of experienced injectors asking questions that almost stump me, and then someone who's just injected once and taking me back to basics.
For me, the reason I want to do it is that I don’t want aesthetics to have a bad name. If there’s something I can do to try and make everyone a better injector, that’s my goal. I wish I could make everyone successful and an amazing artist but I can only manage one thing at a time.
I just want everyone to be safe. If I really think about why I do this, the bottom line is that I care about people. I care about everyone getting injected, not just my patients. I'm just looking out for the patient and making sure the nurse knows the proper technique, anatomy, and to really be aware of everything they are doing.
For new injectors, I try to stress you should know exactly how you would successfully fix what you are about to inject if something goes wrong. If you don’t know how you would take care of that, then don’t do what you’re about to do. If they don't know the answer, then they are not ready for it. I want people to be more cautious and to think.
As a nurse, you go to school and take an oath to protect patients and people. I feel like that gets a little lost in aesthetics, and it’s really important to me that patients have a voice. Especially when I talk to patients and I ask what was put in their face or lips, they’re like “I don't know, they didn’t tell me”. It’s like having an ultrasound and you don't know why. It’s important, they’re medical products so patients need to know. They need to know why you chose that product for them.
What have been the biggest challenges you’ve faced in the aesthetics industry and as part of your career as a cosmetic injector?
I think just how fast it is. I’m so blessed that I’ve had this opportunity to see each product and grow and understand it, where I think new injectors just get it all at once. I don’t even know how to comprehend that all at once, that would be insane.
So I’m glad that I’ve had the chance to grow with these products, see things over time. For example, Juvéderm® Ultra Plus in the lips. I don’t know if you saw that photo I just posted on Instagram, but it can migrate, and usually if someone tells me that they’ve had Juvéderm® Ultra Plus in the lips from another injector I ask if I can see the inside of the lip, and I’ll see the lumps. Now I'm not saying Juvéderm®® Ultra Plus can't be injected into the lips, but what I have experienced is that when it first came out we were told to inject this product "deep" in the tissue. After years of learning that this product could accidentally be injected into the orbicularis oris muscle because it was injected "too deep", migration occurred and the lumps formed. I still think it's an amazing product but it's important to make sure it gets injected properly to avoid any undesirable side effects.
That’s just something that I know from being in the industry for so long but a new injector may not know that. It’s like, how do you know what products do over time? You wouldn’t know because you just don’t have the time.
What do you consider to be your primary resources for continued training and development in injecting?
In person training, and I like to read articles. I am a member of ISPAN (International Society of Plastic and Aesthetic Nurses). I like reading dermatology articles . I like real facts and true information. That’s what I’m always looking for.
Sometimes I feel like I have my own lab in my treatment room, just years of seeing things happen with patients, putting together my own theories when we don't have the actual research on some things yet. I would love to start my own study! For example, I would love to have more facts about neurotoxin resistance.
Laurie’s top resources for staying up to date in injecting techniques, products, and trends:
- In-person training
- Professional Societies
- Reading online articles
- Dermatology books
- Observing outcomes over time
What advice do you have for new nurses struggling to start out as a cosmetic injector?
Social media can make it look like you’re going to just get right in there, have people lining up to be injected and start making all this money. There is a lot to learn and it really takes a while to build a clientele.
Sometimes I hear, "I'm sick of working in the hospital and I think aesthetics would be fun". I'd caution going into aesthetics because you are burnt on your current job. I hope you really have a passion for your new career change. Some nurses don't realize the new challenges they face trying to break into this industry. There is a lot of training!
Many nurses are expected to do their own marketing. It's also funny that you are entering a world of "sales''. I know I didn't go to school for those things, that's why I became a nurse. However, I have learned a lot. I learned that some of these clinics and doctors can push you to have to make sales. You can't push me to do anything, but I will gladly "sell" what I believe to be true and honest. I get excited when I save my patients money on an amazing treatment. I feel like I'm more of a "sales advocate" for my patient, by figuring out what is best for them. With that comes trust and I do well in sales of fillers, neurotoxins and other aesthetic treatments.
I use the nurse in me to teach, educate and advocate for my patients. Fortunately, I feel like it works better than coming on with pushy sales, and I sleep better at night, knowing I'm doing the best for my patients.
Back to starting out, it’s really hard to get your foot in the door without any knowledge. It's also very unusual to find a full time gig as a new injector, so if you’re in the hospital, stay in the hospital and cut back your hours if possible. Try getting any aesthetic experience you can, it may be unpaid or you may have to pay for it.
I hope I don't sound too discouraging, but I want to be realistic. I feel like a lot of times people say “go for it”, and then new injectors are let down because clinics and med spas will only hire experienced cosmetic injectors. How are you supposed to get experience?
So it’s one of those things where if you really want it, you’re going to have to put yourself out there and invest in yourself again, just like you did in nursing school. It’s like an unpaid internship or maybe you would get a paid internship, but that’s how you have to look at it. Many of the injection academies cost money and a new employer will want to see you have attended one or several. It's not uncommon for an employer to have you go to trainings and not pay you for them. I know this can seem crazy, coming from hospital life.
Even me, when I was doing it in the beginning, it’s not like I was killing it, I worked in the med spa and hospital until I had enough to start making it solely in aesthetics. I always notice that newer cosmetic nurses typically work two or even three places. Why? Because they’re trying to find as much work and experience as possible
Laurie’s tips for breaking into the medical aesthetics industry:
- Give yourself time to learn about all of the different products and techniques. Study facial anatomy, and study again.
- Don’t expect overnight success, it can take years to build a clientele that supports a full income.
- Invest in yourself. Be willing to pay to shadow an experienced nurse. You may even consider volunteering to get yourself in the door.
- Network and put yourself out there.
What are some of your favorite treatments to administer?
I love doing threads. We don’t do them but I do like doing them. It’s just there’s something about it, it feels like surgery so it’s fun. I guess I always wanted to be a surgeon. I also love doing Sculptra®. Sculptra® is one of my favorites. I just love the gratification you can get. Another favorite is jawline and chin, I think it’s pretty fun.
Oh, I love injecting lips. I actually even love challenging lips. I will take lopsided, tiny/non-existent lips, or "filler gone wrong" problems. It feels good to have gained the experience to fix the problem and make someone feel like they can smile again. For patients who didn't have lips to begin with, it’s just so great to see them start to show. I get all excited, like oh "they’re coming"!
I feel like sometimes people have to smile extra or do different things to compromise for their lack of lip. So when the lips are just present and in proportion, it’s a nice feeling of confidence. For example, my patient last night just texted me a picture of herself when she got home. It’s so flattering to me because she’s an older woman and usually older women don't send selfies. But she did because she felt so good!
How to connect with Laurie
A wealth of information in the industry, speaking with Laurie Peterson is educational for anyone interested in entering the medical aesthetics industry. Laurie is now practicing out of her suite in Carlsbad and hosting trainings for Allergan Aesthetics and Revanesse USA.