How I Became an Aesthetic Nurse pt. i

Nursing has many trajectories and possibilities

The main keypoint to understand and realize is that everyone’s path and journey is so unique. 

I did not go to nursing school initially dreaming about the aesthetics world. Honestly, I only discovered it the last semester of my schooling through instagram. At that point, being an aesthetics nurse, cosmetic nurse, beauty nurse, medspa nurse (there was no set description) was a daydream. I remember one time I was “joking” to my classmate friend and said, maybe I’ll be a cosmetic nurse one day – just to test out the water. Although that day I said it quietly, I think saying it out loud still helped cement the thought into manifestation. My curiosity and secret aspiration was growing and nurturing.

I thought I could become a seasoned, passionate educator and provider in the ICU or ER world, and envisioned traveling around the world to help save lives. All in all, you may not know where your path takes you. But I do believe that there are many opportunities of niches for nurses to discover – which is so amazing and magical!

Get Experience, NETWORK, put yourself out there

During my last year of nursing school, I worked as a student nurse worker at LAC+USC. I would typically work on some Fridays from 3pm-11:30 pm after a half day of lecture. However working in the hospital with a flexible schedule allowed me to float to so many different units (PCU, ER, ICU, SICU, PACU)  and network with the nurses as well as the nurse managers. One nurse manager bestowed wisdom by telling me to remember to always work hard and humbly as you would in this profession, and it will be noticed. Never forget that.

My immediate goal after passing the NCLEX was to get a registered nurse job in medsurg, ER, or OR. Though meanwhile I also looked at medspas around my neighborhood that maybe would want to train a freshly minted, bright-eyed new grad nurse. I scoured through craigslist, ziprecruiter, indeed, monster, and glassdoor.

While I was waiting for job interviews, I still worked as a student nurse worker. It was one day in the ER when I talked to one of the nurses and found out she used to work at a medspa and loved her experience there! I asked where she worked, and applied there. It just so happened that I got my job interview for the medical spa before any interviews from the hospitals I applied to.. And well I took that as a sign and started working less than 2 months after I passed my NCLEX. 

Learn Constantly, add to your toolkit

Since I worked at a chain medspa, I was able to work in Hollywood, Beverly Hills, Pasadena, Brea, Palo Alto, and Los Gatos. You can imagine the range and diversity of clientele with personalities, age, and preferences. I think this has helped me improve on my communications & people skills, and diversify in providing procedures & recommendations.

I grasped all the opportunities I could to build up my own foundation of aesthetics. In my toolkit I started out with:

  • Laser hair removal
  • Laser tattoo removal
  • Clear and Brilliant
  • Coolsculpting
  • Laser facial
  • IPL
  • Skin care regimen

Then gradually added:

  • Botox and Xeomin
  • Lip, Nasolabial, and Cheek fillers
  • Thermage

All the while learning and understanding the rationales of every procedure to always educate the patients in providing safe & effective results. This allows you to collaboratively come up with a treatment plan to give the patient the best outcomes! I also enjoyed asking the more senior providers and nurse directors of their own experiences, paths, and tips so I could learn and take notes and continue dreaming :).

Pt 2 coming soon, talking about how to passion plan and pivot to your next stage.

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Profound pt. iii

How to Prepare for Profound

 

Pre-Procedure

  • Hydrate sufficiently for the week prior to procedure
  • Consider prepping your skin beforehand, as in moisturizing it
  • Eat a substantial meal before coming in
  • Avoid alcohol and NSAIDS to decrease risk of bruising 
  • Discontinue retinoids and similar active ingredients for at least 3-5 days prior
  • Avoid sun exposure and use spf 30+ 

What to expect after treatment

Immediately after the treatment, we cleanse the face with sterile normal saline. Then we typically apply Alastin Nectar + Balm.

 
  • Wash face gently with a gentle cleanser 2x/day. Pat face dry (no rubbing or exfoliation, absolutely no picking as this can cause PIH!). Let the skin heal on its own
  • Apply Alastin Nectar & Balm at least twice a day to have a consistently glazed appearance. Liberally do this for 1-2 weeks
  • Sleep with head elevated for the first 2-3 nights can help with swelling. Also try not to sleep on side of the face while making sure pillowcases are clean each time
  • Redness can be reduced with our recommended post-care skincare
  • Bruising can be mitigated quickly with a laser in office
  • There is also the post-injection serum by Alastin that can help with bruise reduction and swelling as well
*Remember, the first 1-3 days may be the worst of the swelling
 
Areas that can be treated

Face, neck, chin, jawline, abdomen, inner & outer thighs, arms, skin above knees!

Please Profound me everywhere right? hahah

 
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Profound pt. ii

How does Profound work

Radiofrequency + Microneedling

There are microneedle electrodes that deploy into the dermis or subcutaneous tissue to precisely deliver fractionated zones of thermal injury without thermal impact to the epidermis. The thermal injury is the radiofrequency aspect – it stimulates a strong wound healing which naturally creates new elastin, collagen, and hyaluronic acid formation: *cue in dermal remodeling

With the real-time temperature feedback, the system allows the microneedles to reach optimal temperature, of a specific time duration, in the depth of treatment.

 

Temperature (RF), Time, Depth – What do all these factors do? With the right combination, we are controlling the thermal injury to partially denature collagen, which is effective in triggering a strong wound healing response that addresses the full dermal structure, generating all three vital components of youthful skin: COLLAGEN, ELASTIN, HYALURONIC ACID. 

* Partially denatured collagen can heal 38% faster than fully denatured collagen. It is crucial to reach optimal temperature and time, which the Profound system is precisely designed for.

There are 2 different tips (Dermal & Subcutaneous)

1) For DERMAL tip, the deep dermis is targeted, as this is where concentration of collagen is the highest. This treatment addresses facial wrinkles and skin tightening. Here we see one of the needles penetrating the deep dermis at depth of 1.0-2.0mm. The tip is where the bipolar RF energy is delivered into our deep reticular dermis. Meanwhile the green part of the needle is insulated as to protect the epidermis from thermal damage. The blue part is also the cooling plate at the surface of the skin for protection. 

 

There are a total of 5 pairs of these 32 gauge microneedles (thinner than a hair), to allow for precise fractionated treatment within the dermal tissue = Induce neoelastogenesis and neocollagenesis, renewing skin to look younger, smoother, and tighter

 


2) For SUBCUTANEOUS tip, the subcutaneous tissue is targeted to address cellulite. The fractionated injuries increase dermal thickness, remodel septae, and decrease adipose volume. There are a total of 7 pairs of the 32 gauge microneedles, which are oriented at a more perpendicular insertion angle to ensure deeper penetration into the adipose tissue.

The RF energy targets the adipose tissue to coagulate and remodel cellulite. This tip can even be used to debulk pockets of fat (such as in the renowned “double chin”).

 

As you can imagine, there is a lot of purposeful injury to the areas of treatment

Expect a social downtime of at least 1 week.

  • At least 3-7 days of swelling & redness, as well as bruising (I honestly tell patients they will look like a chipmunk – remember when you got your wisdom teeth taken out?)

  • Appearance of tiny dotted insertions on treatment area

As the body replaces the skin with new collagen and elastic tissue, you will see an improvement over several months. Dermal remodeling can continue for 6-12 months, with improvements seen at 3-6 months post treatment. But, may start noticing a difference even around week 2!

 

Next I’ll talk about how to prepare for your treatment (Pre and Post care) 🙂

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More Miradry questions

Ok so now you’ve hopefully gotten about an 80% reduction – that bone dry underarm. The magical part is that those sweat glands are destroyed permanently and can’t produce odor anymore. You’ll also notice some patchy hair loss since the microwave energy heat from Miradry disabled some hair follicles, a pleasant side effect!

What else to expect right after the procedures?

You will most likely have some pretty sizeable swelling and lumpiness. Patients have stated it kind of feels like you have golf balls under your underarm. Also expect bruising as well, therefore coordinate the scheduling of the procedures AT LEAST 2 weeks before any important event or vacation where you plan to wear something sleeveless – this is wholly for aesthetic purposes since you probably will not feel comfortable with swollen armpits in say… like a wedding dress :P. I like to recommend my patients to look at youtube videos of people’s personal journeys with miradry so they can visualize the process and see what to expect afterwards.

Do expect tenderness, tingling, and numbness of the underarm, which could last for weeks. As well as potential loss of sensation in the area.

Post care

  • No intense exercise/sweating for 1 week
  • Massage and stretch to reduce swelling and tightness
  • Ibu + ice for 72 hrs
  • Wash underarms gently twice a day with gentle/mild soap.

Another question I had about Miradry, does it increase risk of cancer?

It is deemed an extremely safe treatment and there is no evidence that Miradry causes any type of cancer. The microwave radio waves target areas that produce sweat, which is directly below the layer of the skin. Thus the breast tissue and lymph nodes are located much deeper and are not impacted. 

Hope this gives more peace of mind and answered some more questions! Let me know if you can think of other questions 🙂

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Miradry

Summer is basically here, with spring 2020 just literally skipping over us huh. 

Now that we are slowly returning back to society coming out of quarantine, we are reminded that we should probably wear deodorant and maybe shave when we are wearing our sleeveless outfits.

 

I personally sweat easily. Especially when I’m feeling warm, or even flushed with embarrassment or stress. I would absolutely love to have the miraDry treatment one day.

What is Miradry?

SWEAT, ODOR, HAIR

  • FDA approved in 2011 for treating excessive underarm sweating
  • Also cleared in 2015 to permanently eliminate underarm hair of all colors, as well as odor glands
  • For optimal results, it is recommended to treat 2-3 times, at least 3 months apart
  • However even with 1 treatment, it is clinically proven to have an average of 82% sweat reduction and 89% odor reduction

Of course results can vary from patient to patient

 

How does it work?

  • Noninvasive procedure that uses electromagnetic energy which target and destroy sweat gland via thermolysis – aka “microwave” technology
  • The energy works in depth of 2mm-5mm below skin’s surface where most sweat glands reside
  • Local anesthesia is injected for numbing as well as padding the nerve bundles farther away from the energy
  • There is a vacuum suction which stabilizes the skin and brings the sweat glands closer to the energy
  • The skin is also cooled with a cooling plate and temperature sensor to monitor and protect the dermis

It is about an hour long treatment where you can get to know your provider or listen to music and podcasts.

 

Is it bad to destroy the sweat glands in our armpits??

Nope not at all. We have ~2 million sweat glands throughout the body, and only 2% exist in our underarms. Sweating will be normal elsewhere and will not affect your body’s ability to regulate and cool off.

 

PRE-Procedure:

  • Shave your underarms at least 4 days prior, to prevent small cuts and infection. We also want to see some hair growth by the time you come into office to determine area of treatment
  • Don’t wear deodorant to the office
  • Wear a loose tank top and/or sports bras for easy access to underarms

*Note: Make sure to not schedule the procedure when you are planning to wear a sleeveless outfit within the next 1-2 weeks, for aesthetic reasons. So, obviously don’t do this treatment before a tropical vacation.

 

RESULTS + AFTERCARE and expectations:

Sweat glands that are targeted are permanently  destroyed and do not regenerate!

Results begin immediately, long-lasting, and are often permanent results.

You may notice 100% dry with no sweat, however after 2-3 weeks some sweat will return.

  • There will be bruising, swelling, and lumpiness 

  • Numbness and tingling can last for 5 weeks

  • Localized soreness and swelling – can gently stretch out armpits

  • ICE + IBUprofen to manage pain & swelling

 
That was a lot of information, but what questions do you have? I’m a visual person, so here are a couple of clips to show the general progress of what to expect 🙂

You can soon kiss your deodorant good bye! No long worry about ruining your outfits with sweat stains, and definitely go in for the big bear hugs at summer weddings without a care for sweaty, wet armpits.
 
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Moisturizing Skincare ASMR

I’ve been obsessed with skincare routines for a long while. It’s silly right, watching other people put on products on their face. It made me wonder why, why does this innately just spark joy for me.

Essentially, I think self care and pampering is delightful. I would absolutely love if someone else massaged my face, but who else can cherish you (and your skin) the most other than yourself?

I then delved further, and came to a realization that listening to the clinks of skincare & makeup takes me back to when my mom would get ready in the mornings. Especially on Sunday mornings when you wake up and sleepwalk towards your parents’ bed and just cat nap there again. Waking up to the relaxing sounds of nostalgia is so much better than from the uproar of a vacuum lol.

All in all, these skincare rituals are a form of meditation I suppose. It is a commitment to yourself, even if for 5 minutes. If only workouts were shorter, maybe I can commit to that too heh..

Products used:

These tend to constantly be in my usual rotations!

Obagi Nu-derm foaming gel: love this nice foamy lather for my skin. This cleanser removes impurities and pollutants from your pores with a gentle complex of oats amino acids. It also contains alfalfa extract which detoxes the skin to prevent breakouts, as well as aloe vera gel to sooth inflammation and cools redness. It is perfect for normal to oily skin; to note I have combination oily/dry skin. I feel like it is very gentle and does not leave my skin feeling stripped at all. My skin feels smooth and pure afterwards – perfect canvas for applying products on right afterwards

Mario Badescu facial spray with aloe, herbs, and rosewater: This spray is definitely refreshing and hydrating. I absolutely love the smell of rosewater which is not pungent at all. It really is a pick me up boost when I feel like my skin is dry and wants some dewy radiance. It’s a great way to wake up when you spritz it on in the morning to signal your brain to wake up beautifully, let’s refresh for a new day

Origins ginzing eye cream: This energizing eye cream has ginseng and caffeine that helps diminish dark circles and depuff undereyes, as well as brighten and restore glow to tired looking eyes. This has a subtle shimmer-tint that adds sort of like a very very light concealer that easily blends into skin. I think this shine helps reflect light so that we look more energized & bright

Ole henriksen truth serum: Contains vit C serum that helps brighten and firm the skin with its antioxidant properties as well as promoting collagen. It does have a silky as well as sticky texture, along with a citrus aroma.

Caudalie polyphenol antiwrinkle defense serum: Ok I did not realize that this product is discontinued. This is a testament to when I had a phase of buying too many skin products at once and I am still working on depleting them loll. Don’t be like me and don’t go gung-ho on skincare products like a junkie. Anyways, I love that this claims to protect your skin from harmful environmental factors, and the antioxidants help correct wrinkles.

Another tip: You can use your products pretty liberally by also addressing your neck & chest and even back of hands, areas that are often neglected and forgotten. However, these areas DO show our age with time.

Herbivore orchid facial oil: This is one of my favorite oils. The jasmine scent itself is so divine and I feel exquisite while using this golden hued oil in such beautiful packaging. Definitely needed in skincare toolkit for the dewy glow

Project Inner & Outer Beauty, Diana

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To Dew & Go, or Not to Dew

What kind of question is that? Of course I will say To DEW & GO.

 It only took  being quarantined for me to finally bring out the Dew & Go, don’t ask me why I took so long!

What is it. It’s a microdroplet microneedling-stamper that infuses the skin with serum. The do it at home Ritual Kit comes with a set of 4 skin hydration ampoules (Skin Brew – snail mucin + moringa leaf). Snail mucin has HA + glycolic acid and the moringa leaf is a superantioxidant common in Filipino beauty treatments as well as remedies, a nod to the founder’s heritage. You can find it at TheThingsWeDo.

The Founder, world-renowned medical aesthetic provider is Vanessa Lee, RN who I am a HUGE fan of not only for her medical aesthetic talents, but for her genuine dedication and contribution to the specialty as well as her super funny and cool sense of humor on her Instagram. Before I started in my career trajectory, I read her blogs and followed her to be constantly inspired, motivated, and enlightened. It’s truly been insightful to see someone that leads with so much vitality and genuineness.

Directions to help you get started:

⭐ Make sure to thoroughly cleanse your face and hands prior

⭐ Twist open the chamber, fill it up with 1 ampoule of Skin Brew. Leave upside down for 2 minutes

⭐ March along and stamp across your face with a 50% overlap

⭐ After the 1st pass, I dispersed the skin brew on my face and went off to do 2-3 passes total on each area. You can focus more on areas you want to plump and have collagen production such as under eyes, perioral region, nasolabial folds, and even neck & chest!

⭐ Let the skin brew absorb into skin and do not rinse off until the next morning

 

The treatment was a bit spicy, but definitely manageable. I had slight “sunburn glow” afterwards which cooled down quickly. Very minimal downtime, but of course you absolutely do NOT want to be outdoors with your skin unprotected.

After-glow: I love it! I looked glowy, hydrated, and DEWY right away. My skin was feeling tighter as well.

 

Definitely, Project Inner & Outer Beauty obsessed

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Who am I, and Why am I blogging

Hello Lovelies,

 

Welcome to my first post, which will be a little intro to what may come.

Life is about discovering your journey and where you aspire to venture to, it’s a continuous evolution. This blog may be that adventure.

 

Being in quarantine since March 2020 has allowed me to seek ways to progress in innovative ways that were not necessarily the norm pre-Covid. I’ve realized that the experts in my speciality are so willing and passionate to educate. The world of aesthetics actually loves to showcase their expertise, in hopes that we can all discover a more natural beauty while being safe. It’s been eye-opening and brain-lickingly amazing. I’m in awe of how much camaraderie there can be in the medical aesthetics world and I am all here for it!

Who am I? I am an Aesthetic Registered Nurse at a multi-specialty plastic surgery-dermatology office. I feel very fortunate to be a part of a team that has the best of both worlds in the medical aesthetic specialty! Before I started working here, if you asked me what my dream job was, I would not have been able to describe to you what I actually am doing. I also realize that this is a coveted career, and maybe one day I can help someone, just as others have when they wrote their own journeys and taught the knowledge they have acquired.

A little bit more about me. I’m a true introvert, but sometimes I’m a social one.

Pre-Covid hobbies: hiking but mostly especially to waterfalls, kickboxing, Rumble boxing, traveling, eating and being a foodie.

Current-Covid hobbies: watching instagram lives and studying modules, listening to podcasts while playing animal crossing, attempting to bake, and applying skincare and watching ASMR skincare videos.

 

Why am I starting this blog. I am by no means an expert nor master at my craft, yet. I’ve been in this amazing niche for almost 3 years now and have learned so much while still constantly absorbing even more. 

But truly, when can you self-proclaim as an expert when trends are changing, techniques are evolving, and technology is advancing? I believe we will always be students, as well as advocates and educators.

 

I know that medical aesthetics is my hobby and life-long passion project. My ideology is to always embrace and enhance natural beauty as well as bring out the confidence from within. I aim to stay up to date with non-surgical rejuvenation with evidence-based practices.

And you can learn along with me by joining me on this project inner and outer beauty 🙂

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