· By Your Fren Nancy
Meet Lauren Mitschrich PA-C
How long have you been a provider?
Lauren: Almost 10 years as a PA in dermatology and plastic surgery!
What made you want to specialize in aesthetics?
Lauren: Honestly, it fell in my lap. I was trained as a surgical PA. I wanted to do reconstruction - humpty dumpty type stuff. I joined two plastic surgeons early in my career who sold me on doing reconstruction, but were more of an aesthetic practice. Not long into my time there, I was bored of suturing tummy tucks. I wanted more. They had some old lasers in a closet. I decided to learn how to use them and my practice began. Injectables came naturally with that. And I haven't stopped from that day. HAH! I have now practiced in a dermatology setting, a surgical setting, a non-surgical "plastic surgery" setting, in 3 major cities!
When someone is new to injectables, how should they choose a provider?
Lauren: Experience, education, mindset, results. There is no formal training process, experience and investment in education is how "injectors" become experts. Time. Choose a provider who has invested in a lot of education. Choose a provider with more experience. Then evaluate the mindset. This comes quickly during an in person meeting.
Are they selling you on treatments? Are they taking a less is more approach? Do they care what you have to say? Or are they clearly pushing themselves onto you? Finally, look at their results. Yes, it can all be faked and edited. But look at their face - that can't be faked. Are they over injected or weird looking? If yes, well that's the look they like for you too.
If a patient came in with a small budget of $1000, what would you recommend?
Lauren: This really isn't an easy answer. How old is the patient? What are their concerns? What are their problem areas? Here is how I would approach it. Start with home runs. What can you knock out of the part and stay well within the budget. Trust is extremely important. If you can knock something out of the part, for a reasonable price, they trust you and trust the process. This then will allow them to feel safe investing in more over time.
Here's an example. A patient comes in for a "full" toxin treatment, but they have a budget of $150. Do 1 area really well. Don't try to subdose the entire face, because their results will be underwhelming and they will think you scammed them. Do just the eyes or the glabella and treat it to full correction. They will trust you and the results in the process. Back to your question. If you have a limited budget and you are young. Do skincare really well. Do a high ROI laser treatment, clean up the blemishes. Maybe a microneedling treatment for collagen induction. Start with wins.
Do you have a favorite part of the face and tweakment that you love to do?
Lauren: I think this is a bit more complex than a "favorite." I love to put people on a high ROI skincare routine. I ask them to give me 4-6 months of "struggle" and then at the end, when they glow, there is no better feeling. The best part about it is its not the Botox or the filler. It's their skin that is making them confident. That is a great moment.
What do you encourage people to do in preparation for their appointment?
Lauren: Read. Read the good and the bad. Figure out what makes you nervous and ask. I love the over-googled clients. They know what to ask. They are sometimes too educated for their own good. BUTTT this is me. I'm that client, so I understand them.
What kind of tweakments are requested from you the most lately?
Lauren: Lately, "I don't want to do anything unnatural, but I want to look better than my peers." That's the idea of it at least. So high ROI skincare, homerun laser treatments, Sculptra or collagen induction therapy, and toxins are trending.
In one of your IG stories, you mentioned you do lips differently. Can you break it down for us?
Lauren: Ooooooo, ok. I'll try to keep it short. Lips are so much more complex than the industry makes them out to be. The pharma companies taught us all "this is the one product for everyone," but that is just simply false. The lips are one of the most complex anatomic areas with high variability.
So I developed an algorithm. This algorithm starts with an evaluation of their tissue. What kind of lips do they have? What kind of skin texture or quality? Then it addresses their goal. Do they want a big change? Do they just want subtle hydration? I use photos to discuss lip qualities. There are 10 in the algorithm. Then, and only then, do I go to product choice. It is framed by the previous questions.
Lastly, this process is not a single step. Often I do 2-3 treatments in the first 18 months. Then, on average, we do maintenance about every 18 months after that. So, I don't necessarily inject in any groundbreaking way - I simply use way more data to make decisions around technique and product choice than most injectors out there.
I actually teach a full day course on this algorithm called "Power of the Pout."
What trends do you see coming up in this industry?
Lauren: I live in Colorado, so take the following answer with that in mind. Colorado is a few years behind in beauty trends, but often errors on the side of "natural" to a fault. What I'm seeing a lot of here is "I don't necessarily want to inject my face with a bunch of foreign stuff, but I want to combat this aging thing." Biostimulators are a category of injectables that stimulate the body to do something instead of necessarily leaving something behind. This is where we are going. "Bio-filler" is a made-up product name that people are using, but is ultimately made out of the person's own blood. Sculptra stimulates neocollagenesis, the formation of new collagen. Microneedling is also called collagen induction therapy and stimulates new collagen formation. The goal here is something similar to biohacking - getting the body to combat the aging process without outside products that stay inside. This is the current frontier in aesthetics.
What are some of the stigmas you’d like to debunk about tweakments and this industry as a whole?
Lauren: Ohhhhh, I have two.
First - The character the industry portrays is something like Jessica Rabbit injector edition. Not all injectors are social media influencers who carry Gucci bags and wear designer jewelry with their designer, pink scrubs. Most of that is for show and isn't real. This profession got the reputation of rags to riches healthcare edition. Also not real. Most of the "rags to riches" stories in aesthetics are people who married money, had family money, or just started wealthy.
Second - This industry has lost its conscience. Consumers are not wrong to be hesitant to trust anyone. Be hesitant. There are many many people trying to capitalize on the growth of the industry and the vulnerability of the client. It is super easy to see when you meet someone, so do a consult, always. That isn't the entire industry. I promise, there are real people out there. I'm a mom, I'm a wife, I'm a nerd, I'm a sweatpants or pajamas on most days kind of woman. I'm never going to be over injected. I'm never going to carry a Gucci bag. I'm too practical (and can't afford) those things. I'm a real woman, working hard, making a real living trying to help my fellow women feel great about themselves by taking care of themselves.
How often should clients come back for each treatment?
Lauren: This really depends on your injector. Good injectors build a foundation in a few visits close together, then don't see you for a while. Toxin is an exception. It takes consistency - so average would be about 4 months. Everything else depends on where we are in the process.
What are the common misconceptions you hear new clients are nervous about?
Lauren: All filler is bad filler. The truth is you can't see good filler, so the only filler you see is bad filler.
Once you start Botox, you have to keep going forever. False. You can stop any time. A stat that most people don't know is the average person does toxin less than 2 times per year. One of the big pharma companies produced that stat. The average person isn't getting treatments done on a monthly basis. Real people have real lives.
Injectors are just sales people. Honestly, this is true about 75% of the time. So find a 25%-er. They exist. Here in Denver, I can give you three off the top of my head. They are doing it for the right reasons, with the right mindset, and an appropriate background and training. It shouldn't be this rare.
Like everything else in life, there are risks. What are some of the risks involved when we come in for a tweakment and what precautions do you take?
Lauren: This is a hugeeeee point. Every single treatment offered has risks. Doing anything to your body carries risks. That said, finding the right person to go on the journey with is 90% of the risk. The discount, undertrained professional exponentially elevates your risk. Be a smart consumer and you can trust the person you choose to guide you.
Do your clients have realistic expectations when coming in to see you?
Lauren: That is actually a necessary requirement to be my client. The most powerful word in the vocabulary of any injector is "no." Because I've been in practice a few years here in Denver, I have the option to be picky, but every injector should be anyway. Two of my well respected colleagues did studies on body dysmorphia in the aesthetic client. Both of them found that the amount of body dysmorphia in our clientele is almost double that of the normal population. It is the responsibility of the injector to HELP patients. A patient with unmanaged BDD is not a candidate for aesthetic treatments. It is our job to remember these are whole people, not just faces or bodies to be altered. We have a social and medical responsibility to IMPROVE health, no matter what that means for our bottom line.
Do you have a dream client who you would love to work on?
Lauren: 1000%, but it is more of working 'with' rather than 'on.' We all want the same client. An intellectually mature, hard-working, self-respecting, grounded woman (or man). She gets it, she gets you. She has realistic expectations. She loves herself for who she is. She respects herself for who she has built. She is driven and knows what she wants, but understands that she is seeking advice from an expert to help guide her journey. She takes ownership in her role as your partner along on her journey, both aesthetically and just in life. She is a smart consumer and a loyal person. She is not afraid to spend her money, but only responsibly. She has a long-term mindset over an instant-gratification need. She isn't afraid to be vulnerable with you and share her real reasons and concerns. She isn't afraid to say or hear the word 'no.' She is open to discussing, curious to learn, and comfortable with her boundaries.
I think I just described someone who doesn't exist, but man she would be my woman crush. HAH!
What are some of the things you do to help ease new nervous clients?
Lauren: I think the key to success is establishing trust. The deep anxiety comes from a fear of bad outcomes. No fancy gadget for pain or distraction actually eases the anxiety. Building a relationship first, before every touching someone is the only thing that can erase the anxiety. My consults don't include treatment for this reason.
If there was one thing you can fix/solve in this industry, what would it be?
Lauren: Integrity. So many providers and industry companies lack integrity. They give all the rest of us collectively a bad reputation. A lack of integrity leads to greed, which leads to poor decision making, which leads to bad outcomes. Simply put, it all comes back to a character problem.
Thank you so much for sharing all of this valuable information, Lauren! Where can we find you if we wanna see you for a consultation?
Lauren: You can find me on social media at:
or here in Denver located at Beauty By Buford, beautybybuford.com