I Caused a Vascular Occlusion: Kristin Dobry on Clinical Transparency in Aesthetics

[#49] Vascular Occlusion (VO) is the scariest phrase in medical aesthetics. In today's episode of Fill Me In, Jon and Nicole go behind the scenes of a viral filler complication with Kristin Dobry (@ConfidenceByKristin).

Kristin breaks down exactly how she managed a vascular occlusion in a patient’s temple. We discuss what caused the VO, the importance of an emergency kit, and the step-by-step protocol used to ensure a full recovery with zero scarring. Whether you are a seasoned injector or a patient curious about dermal filler safety, this episode covers:

• Filler Safety: The debate between 22g vs. 25g cannulas.
• VO Symptoms: How to spot a reticular rash and delayed capillary refill.
• Anatomy Expertise: Why even the best injectors face complications.
• Patient Communication: The RIGHT way to discuss filler risks during consents.

Follow Kristin on Instagram: https://www.instagram.com/confidencebykristin/?hl=en

Book with Kristin:
https://www.theconfidencebar.com/

**DISCLAIMER**

The content of this episode of Fill Me In: An Aesthetics Podcast is intended for educational and informational purposes only and does not constitute medical advice. The hosts, guests, and producers of this podcast do not endorse or recommend the use of any medical product, procedure, or treatment without proper clinical training, patient assessment, and full informed consent. Listeners are strongly advised to consult with their healthcare providers and adhere to all applicable laws and regulatory guidelines. We expressly disclaim any and all liability for any outcomes related to the use or misuse of the information presented in this episode.

Fill Me In is hosted by Jonathan LeSuer, MSN, NP-C and Nicole Bauer, MSN, APRN, FNP-BC.

Follow Fill Me In on Instagram!
https://www.instagram.com/thefillmeinpod/

Follow Nicole on Instagram:
https://www.instagram.com/aestheticnursenicole/

Nicole's Patreon:
https://www.patreon.com/aestheticnursenicole?utm_source=search

Exhibit Medical Aesthetics website:
https://exhibitmedicalaesthetics.com/

Follow Jon on Instagram:
https://www.instagram.com/injectorjon/

Jon's Patreon:
https://www.patreon.com/Injectorjon?utm_source=search

Tox and Pout Aesthetics website:
https://toxandpout.com/

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Producer of Fill Me In: Joey Ginexi

Transcript

[01:00:00:00 - 01:00:02:23]
 (Upbeat Music)

[01:00:05:06 - 01:00:15:02]
Speaker 1
 All right guys, welcome back to another episode of the Film Me In podcast where we dive deep into the world of aesthetics. We have a special guest on today. I am injector John. And I'm aesthetic nurse Nicole.

[01:00:15:02 - 01:00:17:15]
Speaker 2
 Yes, yes. And I'm, yes, yes, yes.

[01:00:17:15 - 01:00:18:03]
 (Both Laughing)

[01:00:18:03 - 01:00:24:13]
Speaker 2
 We do this every time, every time this happens. We have Kristin Dobry with us today. Yes, yes. Welcome Kristin.

[01:00:24:13 - 01:00:32:07]
Speaker 3
 Thank you for having me. What's your ethnicity, are you Irish? So that's my married name. My maiden name is Horny.

[01:00:33:23 - 01:00:34:03]
 (Both Laughing)

[01:00:34:03 - 01:00:38:07]
Speaker 1
 Oh my God, I love you so much more.

[01:00:38:07 - 01:00:39:12]
 (Both Laughing)

[01:00:39:12 - 01:00:43:01]
Speaker 3
 I know, I tell people that and they're just like, no. No way.

[01:00:43:01 - 01:00:53:22]
Speaker 1
 Kristin. Yes. And you just, I don't even know you yet. And you come across as this like nice, genuine, like pure of heart. So like, I love that your last name's Horny.

[01:00:53:22 - 01:01:00:20]
Speaker 3
 So funny. It was, I grew up with five siblings. So I'm one of five and I have three brothers and they loved it.

[01:01:00:20 - 01:01:01:13]
Speaker 4
 Oh, I'm sure.

[01:01:01:13 - 01:01:03:04]
Speaker 2
 I'm sure they did.

[01:01:03:04 - 01:01:10:09]
Speaker 3
 And my parents put me through like Catholic school. Oh, you poor thing. Guys, it was a hard life, okay. I went through Catholic school too.

[01:01:10:09 - 01:01:11:09]
Speaker 1
 So you know.

[01:01:11:09 - 01:01:14:05]
Speaker 3
 Not the last name Horny. I do, not the last name Horny. Yeah, it's literally, yeah.

[01:01:14:05 - 01:01:17:03]
Speaker 1
 But your parents are Horny because they had five kids.

[01:01:17:03 - 01:01:33:01]
Speaker 3
 Oh my God, yeah, obviously. It's actually so funny that you say that because yesterday was their 40th wedding anniversary and I'm in charge of like a party for them. And I put like on the card, they don't even know. No idea what I've done, but on the card it said 40 years and still Horny.

[01:01:33:01 - 01:01:36:11]
Speaker 2
 Oh my God. That's so good. It's incredible.

[01:01:36:11 - 01:01:41:05]
Speaker 1
 Does Rana love this? She was shocked.

[01:01:42:09 - 01:01:52:06]
Speaker 3
 Like she told me, she's like, if that was my children, we would have changed that last name. And I'm like, come on. Yeah, I get to be a really good character. It made me so funny.

[01:01:52:06 - 01:01:54:19]
Speaker 2
 Yeah, you just have to go with it.

[01:01:54:19 - 01:01:59:07]
Speaker 3
 So it's fine. Now that's what everybody calls me still. I love it.

[01:01:59:07 - 01:02:00:15]
Speaker 1
 What's your sign?

[01:02:00:15 - 01:02:04:23]
Speaker 3
 Pisces. Happy birthday. What's your birthday? Today.

[01:02:04:23 - 01:02:06:05]
Speaker 2
 Oh no way.

[01:02:07:07 - 01:02:11:01]
Speaker 2
 It's a birthday. I would have gotten a cake if I knew that. Happy birthday.

[01:02:11:01 - 01:02:13:15]
Speaker 3
 It's so funny that you said that. Yeah, it's today.

[01:02:14:22 - 01:02:15:18]
Speaker 3
 International Women's Day.

[01:02:15:18 - 01:02:16:22]
Speaker 2
 I love that.

[01:02:16:22 - 01:02:17:20]
Speaker 1
 I love it.

[01:02:19:00 - 01:02:20:01]
Speaker 1
 How old are you? 29?

[01:02:20:01 - 01:02:20:21]
Speaker 3
 33.

[01:02:22:06 - 01:02:22:11]
Speaker 3
 Wow.

[01:02:22:11 - 01:02:24:07]
Speaker 4
 We're all the same age. We're all the same age.

[01:02:25:17 - 01:02:29:08]
Speaker 2
 And we look good. We look so good. Not a day over 28.

[01:02:29:08 - 01:02:31:12]
Speaker 1
 That's right. Oh my God.

[01:02:31:12 - 01:02:34:15]
Speaker 3
 I'm happy with 29. You can tell everybody I'm 29. So it's great. Thank you.

[01:02:34:15 - 01:02:35:22]
Speaker 1
 Seriously, I love it. Great.

[01:02:35:22 - 01:02:41:15]
Speaker 2
 Kristen, what is your Instagram handle? It's confidence by Kristen. Confidence by Kristen. She is in Chicago.

[01:02:41:15 - 01:02:47:09]
Speaker 1
 Yes. She works at the confidence bar with Ronna. If you don't know Ronna, who the hell are you?

[01:02:47:09 - 01:02:48:03]
 (Laughing)

[01:02:48:03 - 01:02:49:08]
Speaker 2
 How do you not know Ronna?

[01:02:49:08 - 01:02:50:03]
Speaker 1
 Seriously.

[01:02:51:08 - 01:03:01:21]
Speaker 1
 I love it. And how long have you been injecting now? Five years. A little bit over five years. That's amazing. I've been injecting for a little over six years. And how long have you been injecting now?

[01:03:01:21 - 01:03:03:06]
Speaker 4
 About eight. Like right over eight.

[01:03:03:06 - 01:03:07:21]
Speaker 1
 That's awesome. Isn't like the five year mark, Kristen, like it's fun.

[01:03:07:21 - 01:03:12:08]
Speaker 3
 Like things are really-- It is fun. Everything makes way more sense. Clicking, right?

[01:03:12:08 - 01:03:13:03]
Speaker 4
 It does. It clicks.

[01:03:14:11 - 01:03:39:03]
Speaker 3
 It's just wild. I think that especially in aesthetics, it's the wild, wild west. Like, I mean, getting into it, everybody has a completely different story of how they got in, right? And I look back on when I started and I just were very, the first time I realized that a lid ptosis was different than like, brow ptosis. Brow ptosis, yeah. And you're just like, oh my God, they're not the same thing.

[01:03:40:08 - 01:03:42:12]
Speaker 3
 And you're just like, wow, I'm really stupid.

[01:03:42:12 - 01:03:45:12]
Speaker 2
 Like, I could potentially fix one over the other.

[01:03:45:12 - 01:03:51:22]
Speaker 3
 Yeah, yeah, absolutely. So yeah, it is. It's wild, but yeah, five years. It's been crazy. Yeah, time flies.

[01:03:51:22 - 01:04:11:22]
Speaker 1
 That's so awesome. And you, okay, so you've obviously grown your social media over that course of time. I feel like you really, I mean, I knew who you were before, but I feel like over the past week or two, we've gotten to know you way more. And it's because that you posted a reel that went viral. Do you wanna talk about it a little bit?

[01:04:11:22 - 01:04:12:23]
Speaker 3
 Yeah, absolutely.

[01:04:14:13 - 01:04:22:11]
Speaker 3
 I had a vascular occlusion in a temple. I love this. It's like, I am a person and I had a vascular occlusion. I don't know if you've heard about it,

[01:04:23:13 - 01:04:40:09]
Speaker 3
 yeah, so I caused vascular occlusion in a temple. It is my first one I've ever had. And I think that, for me, in working at the confidence bar, I just feel like I look at things very differently. A lot of people maybe wouldn't wanna admit that or put that out there, but we share everything.

[01:04:41:14 - 01:05:05:22]
Speaker 3
 It's very important. We have a preceptorship program. And so everything that we do is always being shared in order to benefit everybody else. And so it made note, it was not even a question in my mind that this was gonna be something that I was gonna share about because I think it scares everyone. I mean, how many times are you doing temples and you still clench your butt cheeks? I know I do. Every time.

[01:05:05:22 - 01:05:12:00]
Speaker 1
 My butt hole clenches tighter. I mean, I don't even think 100 units of Botox could even pucker.

[01:05:12:00 - 01:05:15:16]
Speaker 2
 Especially in its training when you're doing a temple, even more.

[01:05:15:16 - 01:05:16:15]
Speaker 1
 Yeah, it was, oh.

[01:05:16:15 - 01:05:22:00]
Speaker 3
 Exactly, oh, it's, yeah. And so, as soon as it happened,

[01:05:23:18 - 01:05:52:08]
Speaker 3
 we have a whole process and everybody I'm sure has their emergency kit and everything that they plan on doing, right? So we just had her come in and I walked in and we filmed the whole thing because we felt it was so important, especially for our preceptees. These are mostly people that have never done any of this. They have no idea, right? And so this is the scariest, one of the scariest things that can happen in aesthetics. And it's really good that we had it in real time, that people can really learn from it.

[01:05:52:08 - 01:06:02:14]
Speaker 1
 So explain kind of what happened. So like you had a patient that came in, or like you had a consultation, so kind of describe the whole kind of everything.

[01:06:02:14 - 01:06:42:02]
Speaker 3
 Yeah, so I had a patient that came in and she's been my patient for a while. So she's phenomenal. She's just one of the most wonderful people and she works out a lot. She's very thin, she runs. And so we needed like pretty significant volume restoration. And so we did temples, we did pre-irricular, like we did a full face treatment for her. And she also has very reactive skin, but she takes really good care of herself and her skin. And so, I had treated her right side, moved on to her left temple. What products were you using? Restylane, oh, not Restylane, RHA2, was what I was using in the temple.

[01:06:43:12 - 01:06:47:00]
Speaker 3
 And I've been trained in many different ways, right?

[01:06:47:00 - 01:06:47:16]
Speaker 4
 Yeah, of course.

[01:06:47:16 - 01:06:50:15]
Speaker 3
 Gun shot method. This time I was doing,

[01:06:52:01 - 01:06:57:14]
Speaker 3
 going from the temporal crust, tap periosteum, turn the cannula down towards,

[01:06:58:22 - 01:07:51:12]
Speaker 3
 and just to like kind of put it into layer four, interfacial, because we know that it's really supposed to be a vascular as long as you're in layer four, which it's also probably wasn't, which is what it turns out. But I placed probably 0.3 to 0.5 retrograde threads used to 25 gauge cannula, 50 millimeter. And what I first noticed with her, it was just like almost like a little bit of swelling, just right here. And I was like, "Mm, you know, but we have the sentinel vein in that area through here." And so how many times have we treated temples? And you're like, "God, that looks awful." Because we've hit the vein and now we are gonna have a huge hematoma, or it can cause like engorgement within the veins in that area.

[01:07:51:12 - 01:07:52:23]
Speaker 1
 Vascular congestion, yeah.

[01:07:52:23 - 01:08:19:15]
Speaker 3
 Exactly, and so I think that that made me just be like, "Oh, that's probably just what it is." But you know what? And like I said, at the confidence bar, we're an open door policy. We have people come in all the time. We have preceptives, so we have people training 24 seven. I just brought in one of my coworkers and was like, "I just want you to just double check." We always do that. Sometimes it's just good results. And we're like, "Please come see. Look how great she looks."

[01:08:19:15 - 01:08:19:21]
Speaker 2
 Right, check it out.

[01:08:19:21 - 01:08:24:05]
Speaker 3
 And so I had her come in and she's like, "Yeah, no, let's try."

[01:08:24:05 - 01:08:25:00]
Speaker 4
 Who was it that came in?

[01:08:25:00 - 01:09:02:20]
Speaker 3
 Lemia. Oh, Lemia. Oh, yeah. So cute. I mean, if anybody knows Lemia, she's one of the most brilliant minds. And I just, she's incredible, so smart. And so she just came in, she's like, "Yeah, I think it looks fine." The cap refill looked good. It wasn't like super sluggish, anything like that. She wasn't in any pain. So there was nothing that I was like, "Oh, yeah, no." But I did tell the patient, "Hey, I wanna keep an eye on this." But it's a temple. I always am gonna keep close eyes on a more high risk area. And so I always follow up with my patients the next day. She actually followed up with me that night.

[01:09:03:21 - 01:09:07:05]
Speaker 3
 And then the next morning, she's like, "Yeah, it's a little tender."

[01:09:08:07 - 01:09:18:17]
Speaker 3
 And I'm like, "Is it tender at rest? Is it hurting when you're not moving?" She's like, "No, it's really just when you, if you were to palpate it." And I was like, "Okay, well, that's normal." Right.

[01:09:20:01 - 01:09:45:06]
Speaker 3
 And then she sent me the photo and it was a reticular rash. And I was like, "You need to come in." I need to see you right now. I need to see you right now. And so she came in and honestly, it was less than, it was less than, it was within about 12 hours because I had seen her at the end of the day. And then I saw her in the morning. And so we dissolved it right away. We started with three MLs of Hyalenex or three vials and just flooded the entire area.

[01:09:46:11 - 01:09:49:03]
Speaker 3
 Ended up using eight vials in total that first.

[01:09:49:03 - 01:09:50:20]
Speaker 1
 Did you use a cannula to flood the area?

[01:09:50:20 - 01:09:51:19]
Speaker 3
 I used a cannula.

[01:09:51:19 - 01:09:52:09]
Speaker 1
 Okay.

[01:09:52:09 - 01:10:15:23]
Speaker 3
 And you just went that whole- From here and from the zygoma up and just kind of flooded all the way into the hairline, just the whole area. And I marked it out just to make sure that we were covering everything afterwards. She was like, "Yeah, I had a little bit of pressure and I'm not feeling that pressure anymore." So it was- Wow. Yeah. Wow. It was very quickly resolved.

[01:10:17:03 - 01:10:19:20]
Speaker 3
 But then we brought her back in and back in and we

[01:10:19:20 - 01:10:22:21]
Speaker 2
 ended- When did she develop the pustules?

[01:10:23:22 - 01:10:24:14]
Speaker 2
 Two days later.

[01:10:24:14 - 01:10:37:11]
Speaker 3
 Wow, yep. Really? I know, it's so surprising because typically it takes a significant amount of time. I would say what, 24 to 48 hours of a true VO for those to develop.

[01:10:38:16 - 01:10:42:21]
Speaker 3
 But we had already had it resolved by the time that it was developed, it was about three days later.

[01:10:42:21 - 01:10:44:13]
Speaker 2
 Very interesting. Wow.

[01:10:44:13 - 01:10:45:08]
Speaker 3
 Yeah.

[01:10:45:08 - 01:10:45:21]
Speaker 1
 That's crazy.

[01:10:45:21 - 01:10:50:23]
Speaker 3
 Yeah, it was really interesting and just walking through all of it with her, but yeah.

[01:10:52:01 - 01:10:53:12]
Speaker 1
 What artery do you think it was?

[01:10:53:12 - 01:10:58:18]
Speaker 3
 I think that it was the zygomatic orbital artery actually.

[01:10:58:18 - 01:10:59:09]
Speaker 4
 Okay.

[01:10:59:09 - 01:11:51:20]
Speaker 3
 I do. Because it's extremely variable in patients. Some people don't even have it. I think there was a study by Codafana that showed that one in five people, that's how variable, don't even have one. And that it changes based off of where it comes across the temple. And it's really interesting because for a lot of people, you don't have that issue at all. It just, it really depends. But based off of the way that she was having this kind of reticular rash as well as the delayed cap refill when she came back, you could see that it was kind of right around the orbit and across through here. And so where that zygomatic orbital typically comes off is right at that arch and then it comes up through here.

[01:11:51:20 - 01:11:52:22]
Speaker 2
 And so that's-- Right, it follows the rim.

[01:11:52:22 - 01:12:04:21]
Speaker 3
 Yeah. Follows exactly. And so that's what I think. We can't confirm, right? We didn't use ultrasound. Right. So it's hard to say, but just based off of the pattern, that's what it looked like to us. Right.

[01:12:04:21 - 01:12:08:13]
Speaker 1
 Hey everyone, it's Jonathan, also known as Injector John.

[01:12:08:13 - 01:12:11:10]
Speaker 2
 And I'm Nicole, or aesthetic nurse Nicole, if you follow me online.

[01:12:11:10 - 01:12:14:21]
Speaker 1
 We are so excited to let you know that we've launched our Patreon.

[01:12:14:21 - 01:12:23:21]
Speaker 2
 Yes, it's on there. We'll be sharing exclusive content you won't find anywhere else, our own injecting techniques, advanced education, and even some behind the scenes business advice.

[01:12:23:21 - 01:12:30:12]
Speaker 1
 If you're an injector, aesthetic professional, or just curious about the industry, it's the perfect place to learn and grow with us.

[01:12:30:12 - 01:12:34:23]
Speaker 2
 So head over to Patreon, search for us, and make sure to subscribe to get access to all that extra content.

[01:12:34:23 - 01:12:37:12]
Speaker 1
 And don't forget, you can find me at Injector John.

[01:12:37:12 - 01:12:40:10]
Speaker 2
 And me at Aesthetic Nurse Nicole. We can't wait to see you there.

[01:12:40:10 - 01:12:41:10]
Speaker 1
 Love you guys.

[01:12:42:21 - 01:12:53:12]
Speaker 2
 And I think that's important to mention too. So like, you were able to resolve this occlusion without ultrasound. Ultrasound is a great tool, but it's not always necessary. And high legs and all of that remains our top priority.

[01:12:53:12 - 01:13:16:21]
Speaker 1
 I don't carry it in my practice. I thought about it, but honestly truthfully, if you know how to manage a vascular occlusion, and you have your emergency kit, and you have your own protocol, you can manage a VO. It's just perfectly fine in my opinion. And for me, I look at my day, I see 20 to 25 patients a day, if I were to use ultrasound on every patient, I couldn't see that many patients a day.

[01:13:16:21 - 01:13:26:14]
Speaker 3
 Yeah, absolutely. I think that that's been the biggest, I mean, you get it, right? If you have, if things go viral and you have enough people looking at it, you're gonna get seizures.

[01:13:26:14 - 01:13:30:08]
Speaker 2
 Oh my God. I can only imagine what you're going through.

[01:13:30:08 - 01:13:38:16]
Speaker 3
 Oh my God. Some people are like, you're negligent. And I'm just like, I mean, I understand where you're coming from. But like,

[01:13:39:18 - 01:13:47:09]
Speaker 3
 it's just, yeah, it's crazy. And yeah, and ultrasound is an incredible tool, but unless you're using it 24 seven, they're very expensive.

[01:13:48:11 - 01:13:56:23]
Speaker 3
 And, you know, we actually have, we have not, I don't think we have that, we don't have the mind, right? But we have like the, Clara, I think that's what it is.

[01:13:58:04 - 01:14:14:20]
Speaker 3
 And it's just not used, right? It's only as good as it is in the hands of the right person. And guess what? I'm not ultrasound trained. And so the biggest thing was dissolving. We just need to make sure that we restore blood flow and tissue perfusion.

[01:14:14:20 - 01:14:21:03]
Speaker 1
 Now, after you dissolved her, is there any other protocol you do? Do you do antibiotics? Do you do any like steroids or anything like that?

[01:14:21:03 - 01:14:22:23]
Speaker 2
 Yeah, or like any other medications to support?

[01:14:22:23 - 01:14:59:22]
Speaker 3
 We did for her. And so she came in, we gave her, we have aspirin in our kit, right? So we gave her aspirin immediately and had her continue taking that for a few days afterwards. We started around 50 milligrams of prednisone just to help decrease some of that swelling because you can imagine the trauma that this is now, she's gone through with all of these pokes and this cannula and going through all of the layers. You know, we really wanted to help in any way that we could to assist her in healing as well as we could and decrease any extra inflammation that can be caused by the trauma of it all.

[01:15:00:23 - 01:15:26:08]
Speaker 3
 And then we ended up putting her on a topical antibiotic, just an ointment, right? Basatracin, I mean, we did, I think it was gentamicin topically. And it was fine. You know, we just did that because at the end of the day, she did have pustules, but we know that those pustules aren't actually infectious, right? It's actually, they're typically sterile pustules that are just caused from trauma.

[01:15:27:11 - 01:15:34:15]
Speaker 3
 So we just put that on there just because we had some broken skin because of it, right? So we just wanted to ensure that it was gonna heal well.

[01:15:35:16 - 01:15:45:16]
Speaker 3
 But other than that, we didn't give her any other medications. And she did heal no scarring, right? No scarring, healed beautifully. They're very superficial. It was nothing like,

[01:15:47:01 - 01:15:55:23]
Speaker 3
 super scary, looked awful to a lot of people. And I think that that was one of the reasons that it went viral because it's a scary looking, you know,

[01:15:57:08 - 01:16:04:10]
Speaker 3
 result. Complication, yep, absolutely. Complication, but it healed beautifully. And she's coming in next week for me to refill the tempo.

[01:16:04:10 - 01:16:05:12]
Speaker 2
 There we go.

[01:16:05:12 - 01:16:09:04]
Speaker 1
 But you know what though? She trusts you.

[01:16:09:04 - 01:16:09:10]
Speaker 2
 Yes.

[01:16:09:10 - 01:16:17:09]
Speaker 1
 And that's like such a- And develop that connection and that trust with her. And I just, I love that so much. And I can't express to you, like you're real.

[01:16:18:20 - 01:16:43:15]
Speaker 1
 I didn't even know who you were, but it made me love you even more. And I never even met you. So thank you for posting that and for sharing that. And because it just makes us as providers look more human and that these things can happen. And honestly, I think it lessened the stress and anxiety for other injectors that are also stressed about causing a VEO, knowing that it can happen. And you documented your story and you were just so transparent about it. Yep.

[01:16:43:15 - 01:17:36:15]
Speaker 2
 And if you guys follow Confidence Bar, Rana, and any of these girls, I mean, they're like the top tier. You guys are anatomy and they all, it's crazy. They all like train on the anatomy and they know it like the back of their hands. So it's not if, it's when. It will happen, unfortunately, to all of us, especially if you are a high volume injector. And I think whether you use ultrasound or not, it's still something that can happen. And yes, it is a tool, but there's so many other tools and we have to know how to deal with complications. And I think that's why your story is so important because I think a lot of people will say they know how to deal with it. But if it comes up, then it's like, it's this big scary thing and it's like, oh my gosh, wait, wait, maybe I don't know how. And it's just cool to kind of see how you went through every step and how you guys were able to get here to a full recovery with no scarring and no issues and no blindness and it's incredible.

[01:17:36:15 - 01:17:47:21]
Speaker 3
 Totally, and I think that the reason, well, I think it's just so important that yeah, the confidence of our is known for our education, our focus on anatomy.

[01:17:49:08 - 01:18:07:07]
Speaker 3
 And I think that's why it's also just- Ethical too, you guys are just saying ethical. Huge, yes, and integrity, right? And so I think it's just really important for people to see that it can happen here too. It can happen anywhere. It doesn't matter how experienced you are.

[01:18:08:13 - 01:18:26:06]
Speaker 3
 And a lot of it's, I think like I said, it's just so important that there is transparency because a lot of people wanted to come and say that I could have done it differently or this or that, but hindsight's 20, 20, of course I could have, right? But until you're in that situation,

[01:18:27:16 - 01:18:49:06]
Speaker 3
 you don't know how you're gonna handle it, right? You really care about these people. And there really is an emotional toll that it takes on you because we're all nurses at the end of the day. We went into this to help people and causing issues or vascular occlusions, it really takes a toll on you because we never wanna hurt anyone.

[01:18:50:16 - 01:18:57:15]
Speaker 3
 And I don't think people really realize how emotionally scarring it can be for the provider.

[01:18:57:15 - 01:19:16:08]
Speaker 1
 Absolutely. Hey guys, just popping in. If you're enjoying filming in, we would absolutely love it if you could leave a review wherever you're listening. You can also follow FilmeIn on Instagram at the FilmeIn pot. And don't forget to follow us on Instagram and Patreon at injectorjohnanestheticnursenicole. Thanks so much for listening.

[01:19:17:11 - 01:19:19:11]
Speaker 2
 I had a very minimal,

[01:19:20:11 - 01:19:24:12]
Speaker 2
 and she healed fine. I ended up doing a second round, but it was like a laser burn,

[01:19:25:12 - 01:19:51:18]
Speaker 2
 right at the middle of the forehead, of course. And I remember calling John, it was right before Christmas and I couldn't even enjoy the holidays. I was like a wreck. I was like, how am I walking around, enjoying my life? And this poor lady has pigment changes on her forehead. And it was totally fine. We did a second round and she looks amazing and incredible, but it does, it takes this huge mental toll on you. And that no one even knows because you're not gonna post on Instagram, like, hey guys, I'm spiraling right now because XYZ is going on, you know?

[01:19:51:18 - 01:19:58:20]
Speaker 1
 And always around the holidays, there is something that happens. I don't know what it is. And it stresses you out the entire, there's just.

[01:19:58:20 - 01:20:11:03]
Speaker 3
 Totally, it's either something happened or like a patient's upset. I don't know what it is about the holidays, but everyone's mad. Everyone's mad. And you're just like, what? It's going up, Merry Christmas. Yeah, seriously.

[01:20:12:07 - 01:20:32:08]
Speaker 2
 Yeah. Oh my God. No, but it's so true. And same thing, that patient was such a good patient of mine. She trusted me and like we held her hand through the entire, and again, she healed beautifully and she looks incredible now. And she won't, she's not afraid of lasers and neither am I. It's just that, you know, she had a little residual tan left and I didn't catch it. She didn't catch it. And she just had a very good result in certain areas.

[01:20:32:08 - 01:20:42:12]
Speaker 1
 And if you did think that it was the zygomatic orbital that you're thinking it could be, that's very, very tiny. Isn't it? Extremely. So like,

[01:20:43:16 - 01:20:46:13]
Speaker 1
 I mean, you never had a flash of blood in your hub.

[01:20:46:13 - 01:20:46:22]
Speaker 4
 No.

[01:20:46:22 - 01:20:54:11]
Speaker 1
 You never had anything like that. And I mean, so like maybe the smallest amount could have, you know, who knows?

[01:20:54:11 - 01:20:56:07]
Speaker 3
 Who even knows if it was in there, if it was just compressing.

[01:20:56:07 - 01:20:57:16]
Speaker 1
 Right, what if it was just compression?

[01:20:57:16 - 01:20:59:07]
Speaker 3
 We don't know. What if it was a spasm? We don't know.

[01:20:59:07 - 01:21:02:03]
Speaker 1
 And it sounds like it was more compression to me.

[01:21:02:03 - 01:21:22:05]
Speaker 3
 Yeah, totally. I don't know. I know, that's the hard part. And that's another thing is a lot of people are like, okay, you used a needle. No, I didn't, I used a cannula. And yes, I think that it's really important that we talk about that because these are safety devices. Don't let it give you false confidence. Absolutely.

[01:21:23:21 - 01:21:31:13]
Speaker 3
 Because, you know, that's, that I think everyone just assumed, oh yeah, well I don't use needle and temple. And I'm like, well neither did I. So,

[01:21:32:16 - 01:21:46:09]
Speaker 3
 you know, just- It still happens to me. It still happens. And the other thing is, is there's so many people being like, hey, well, why didn't you aspirate? Well, we know with cannula, if you're constantly moving while you're injecting-

[01:21:46:09 - 01:21:49:00]
Speaker 1
 You're gonna cause more trauma, you might poke something or yeah.

[01:21:49:00 - 01:22:07:20]
Speaker 3
 If you're continuing to, I mean, is it gonna be a true positive aspiration? It's moving. We can't do it for every spot that it's moving, right? It's just, so it's, yeah, it's just a conversation. I think people really need to realize that, you know, it can really happen with anything to anyone.

[01:22:07:20 - 01:22:32:06]
Speaker 1
 There's also so many ways to treat the temple. I mean, there's patients that come in and I'm needle to periosteum. Then there's other people, it's just depending on like how big that ice cream scoop is, right? Or like if it's just barely a little bit, then I'll just glaze it with some redensity. Or, but like you said, RHA2, I've used that. RHA4, or, you know, or I use voluma and then I mix it with saline. I don't know. There's just different ways of- Totally. Everybody's anatomy is so different.

[01:22:33:12 - 01:22:33:16]
Speaker 1
 Yeah.

[01:22:33:16 - 01:23:25:02]
Speaker 2
 I do want to touch on, because we did recently purchase the mind ray and we had Clarius beforehand ultrasound and I thought that I was just stupid. Like I could not figure out how to ultrasound anyone. And I'm like, I can't do this. Like I just can't. But the mind ray, the picture is so much clearer and we can actually like see what we're doing. And we've done two trainings on it so far. And now for like these more high risk areas, I will just do a little like mapping scan. Just so, and again, it's not like I'm using it while I'm injecting. So it's really not like this huge safe, you know, fallback. But it does give me a little bit of like, okay, I've marked where I think these vessels are. And that's something that I only do for like, honestly, the temple area. Yeah. And that's something that I've added on because the temple, again, it's so funny. I feel like when I first started doing cheeks, even that maybe clenched my,

[01:23:26:05 - 01:23:26:05]
 (Laughs)

[01:23:26:05 - 01:23:30:06]
Speaker 2
 Like you do it for years and years and years and you just like, yeah.

[01:23:30:06 - 01:23:37:21]
Speaker 1
 Especially the laterals like go, Yes, yeah. She thins out as you go out. My God, sometimes you're going and you're like, oop.

[01:23:37:21 - 01:23:43:15]
Speaker 3
 Yeah, where is it? There can be so many accessory for Raymond through here.

[01:23:43:15 - 01:23:45:20]
Speaker 1
 That's like a matical facial. Yes.

[01:23:45:20 - 01:24:17:05]
Speaker 2
 Well, and John was just talking about the importance of multiple cadavers because they're all different. Yeah, and even how you said like the, I didn't, I'm telling you, I used to buy these, I used to buy books and books and books on anatomy and coloring books even and everything. And I remember like the fourth book I bought, they added in this psychomatic orbital. And I'm like, I had to go back in the books. I'm like, wait a minute, I've never seen this artery. Like, what is this? Where did this come from? No one's talking to this. They made it up. Yeah, I'm like, wait, but it's just, there are so many variations and just because one book has, it doesn't mean another one's not. And it's like, you just have to always be learning.

[01:24:18:12 - 01:24:26:19]
Speaker 3
 Totally, it's constantly evolving. I mean, we're still, when you think of it in the grand scheme of things, new, right? And medical aesthetics is still newer.

[01:24:26:19 - 01:24:27:08]
Speaker 4
 Yep.

[01:24:27:08 - 01:24:32:05]
Speaker 3
 And there's something to be said about like,

[01:24:33:15 - 01:24:42:14]
Speaker 3
 when it comes to just modern medicine currently, right? Like, that's also why I think it's so important to share things is like, you're never,

[01:24:43:14 - 01:24:47:11]
Speaker 3
 nobody's gonna be gatekeeping an asthma medication

[01:24:48:18 - 01:24:57:15]
Speaker 3
 or like how to treat a heart attack. Yep. So why is it that this is any different? This is still medicine.

[01:24:58:22 - 01:25:20:07]
Speaker 3
 And it's so important. They have, you know, M&Ms for doctors to dissect what, to debrief on what went wrong and how we could have done things better. And, you know, that was kind of my goal here is like, this is what went wrong and this is what I did. And this is, you know, if we can, if this can help one person, that's what matters. Yep, and I think it's so important.

[01:25:21:15 - 01:25:23:18]
Speaker 1
 You mentioned some of the comments that you were getting.

[01:25:23:18 - 01:25:23:23]
Speaker 4
 Yes.

[01:25:23:23 - 01:25:31:12]
Speaker 1
 I wanna know what are some of the comments that stood out to you the most that either made you laugh, that made you angry, or made you happy?

[01:25:31:12 - 01:25:41:10]
Speaker 3
 There were so many that made me laugh. You know, here's the thing. The one, somebody had commented, face lift is better. And I was like, yes, yes,

[01:25:42:22 - 01:25:43:03]
Speaker 3
 amen.

[01:25:43:03 - 01:25:45:03]
Speaker 2
 We'll never tell you it's not.

[01:25:45:03 - 01:25:53:23]
Speaker 3
 Yeah, do it. You know, I'm the last person that's gonna be like, yes, no, let's do 10 syringes of filler. You need a face lift. And cancel the face lift. Yeah.

[01:25:56:05 - 01:26:19:02]
Speaker 3
 A lot of it was just funny. And it's a lot of it is like coming from people that have no idea, like aren't in this industry at all. And so there's a lot of like the very wellness influencers that are like shaking my head. I cannot believe that people do this. And I'm just like, don't do it. You don't have to. Then go do it. You don't have to. Yeah. Good for you.

[01:26:20:05 - 01:26:38:13]
Speaker 3
 It's so odd that people come and like shame other people but are so like, oh, you know, whatever organic and everything, it's just very odd. But a lot of, there's just some mean ones where it's the ultrasound, right? People saying that me not using it is negligent.

[01:26:39:23 - 01:27:04:14]
Speaker 3
 And, you know, another one that actually I found was very interesting was somebody had commented asking well, what about re-embolization further down the artery, right? And could that potentially cause, you know, more issues after using Hyalunix? And I think you just really have to consider that like, what's the alternative? Alternative, right, yes. Yep.

[01:27:06:00 - 01:27:07:10]
Speaker 1
 I'm perplexed by that question.

[01:27:07:10 - 01:27:10:10]
Speaker 3
 Yeah, it's just like, well, I mean, what else can we do?

[01:27:10:10 - 01:27:15:00]
Speaker 1
 I mean, you flooded the entire area with-- Exactly. Eight vials of Hyalunix.

[01:27:16:12 - 01:27:22:17]
Speaker 3
 Which, what, decreases the viscosity of the filler, right? That will break it down because it's like an enzymatic reaction.

[01:27:22:17 - 01:27:24:05]
Speaker 4
 It'll convert it to water, it'll pay it out.

[01:27:24:05 - 01:27:32:20]
Speaker 3
 Exactly, your body will get rid of it. And so, I just don't really know, I mean, diving into that that much, it's not,

[01:27:33:20 - 01:27:35:03]
Speaker 3
 what, again, what's the alternative?

[01:27:35:03 - 01:27:40:05]
Speaker 1
 I mean, Kristen, why didn't you aspirate when you were using the cannula?

[01:27:40:05 - 01:27:41:14]
Speaker 3
 The needle, you mean?

[01:27:41:14 - 01:27:43:12]
Speaker 1
 Oh, I'm sorry, the needle.

[01:27:43:12 - 01:28:01:23]
Speaker 3
 The cannula? Yeah, I know, it's so funny. It's really, I'm just, and my friends, I can't tell you how many of my friends were just like, I'm gonna say this, and it's just-- I know, right, they wanna stand up for you so bad. And I'm like, don't even let, it's funny. It's honestly just funny.

[01:28:03:11 - 01:28:22:14]
Speaker 3
 And it's actually really sweet. This is how close my patient is. She was going in there and yelling at people. Aw, I love that. I know, she's like, I trust her, it's great. Leave her alone, I'm like, don't worry about it. I'm like, don't worry about it, it's fine. Stop reading it, stop reading it. I'm not upset.

[01:28:22:14 - 01:28:23:12]
Speaker 4
 Sweet, sweetie, yeah.

[01:28:23:12 - 01:28:34:09]
Speaker 3
 I know, but some people have a room mean. I had somebody that was like, did you guys see my story where it was like, why did you use that F word, technique?

[01:28:35:14 - 01:28:39:14]
Speaker 3
 Dumb technique or something? But that is, so that is a very popular technique.

[01:28:39:14 - 01:28:40:21]
Speaker 1
 What, I didn't see your story.

[01:28:42:04 - 01:28:44:04]
Speaker 2
 Why did you use that Fing stupid technique?

[01:28:44:04 - 01:28:45:08]
Speaker 1
 Oh, oh.

[01:28:45:08 - 01:28:52:18]
Speaker 2
 Yeah, yeah. But that is a very, I think we should touch on that too. That is a very talk technique. Very common technique.

[01:28:52:18 - 01:28:54:17]
Speaker 3
 No one within the industry, yeah, absolutely.

[01:28:56:04 - 01:28:56:15]
 (Laughing)

[01:28:56:15 - 01:28:58:00]
Speaker 3
 Very common actually.

[01:28:58:00 - 01:29:01:21]
Speaker 2
 It's not like you decided to try this. I created it myself.

[01:29:01:21 - 01:29:05:18]
Speaker 1
 You know, Kristen, I knew it was you.

[01:29:05:18 - 01:29:08:03]
Speaker 2
 Can I be honest too? It's called the horny technique.

[01:29:08:03 - 01:29:09:18]
 (Laughing)

[01:29:12:01 - 01:29:18:11]
Speaker 1
 For those of you that don't know, her maiden name is horny, okay? Oh my God, I love that. Let's just break the ice right now.

[01:29:18:11 - 01:29:22:03]
Speaker 3
 That would have been a weird thing to say if people didn't know.

[01:29:23:08 - 01:29:25:19]
Speaker 1
 Yeah, and we're extra horny today, so we wanna talk about it.

[01:29:25:19 - 01:29:41:02]
Speaker 2
 I'm gonna bring it up. No, but even like the layers of the temple, like yes, there's so many layers, but when you think of how thick a temple is, I mean, it is so difficult to genuinely be in that correct way. And no, exactly.

[01:29:41:02 - 01:30:00:21]
Speaker 1
 And how do you know? Like you said, she's very fit, she's very active. Extremely. So like, I mean, her layers are probably, they're so tight. Right, tight, very tight. So it's like, how do you know? Like you hope that you're in that fourth layer, but listen, you did everything so well, so right. I mean, what are you gonna do? It can happen to any of us, right?

[01:30:00:21 - 01:30:06:17]
Speaker 2
 I know you were mentioning like cannula size. People were bringing that up too, right? Oh yeah, that was a big one. But I thought-- What did you use?

[01:30:06:17 - 01:30:09:12]
Speaker 1
 25 gauge. Yeah, that's what I would use.

[01:30:09:12 - 01:30:18:00]
Speaker 2
 Now everybody's saying-- Saying you should have used 22. Yeah, which I've had an issue with. That's big. I've had a temple issue with the 22. It's literally garden hose.

[01:30:18:00 - 01:30:19:21]
Speaker 3
 Guys, I used 22s.

[01:30:19:21 - 01:30:20:18]
Speaker 1
 Oh, sorry.

[01:30:20:18 - 01:30:21:15]
Speaker 3
 Oh my God.

[01:30:21:15 - 01:30:24:22]
Speaker 2
 I mean, you know what? No, I love it because it's that way.

[01:30:24:22 - 01:30:36:16]
Speaker 3
 I hate a 25 because I'm like in there wobbling around. I will say the 25 is more flimsy, right? So it can bend more and then the 20, but then the 23, like we use, we have 23 gauge, which, you know, 23, 22.

[01:30:36:16 - 01:30:40:21]
Speaker 1
 Well, I like a 25 gauge too because you can control a little bit more how much product's coming out.

[01:30:40:21 - 01:30:42:05]
Speaker 2
 Yeah, it's not just a garden hose.

[01:30:42:05 - 01:30:43:21]
Speaker 1
 You know the extrusion force is, you know.

[01:30:43:21 - 01:31:02:16]
Speaker 2
 Yeah, like-- But I had an issue with a 22 in a temple and I pierced right through and I, the blood coming into, I wasn't even aspirating. The blood was just coming into my syringe. So I was 100% in an artery. Like it was, I mean, the hematoma was insane and it was the whole side of her face.

[01:31:02:16 - 01:31:14:21]
Speaker 1
 No, and like, I know people listening in, if you use a 22, great. Like we all have our different sized cannulas, like that we use for different places on the face. I mean, we're all, every provider is not cookie cutter. We're all different, right?

[01:31:14:21 - 01:31:18:03]
Speaker 2
 But my thing is, is like, I don't know that that 22 would have kept her any safer.

[01:31:18:03 - 01:31:18:19]
Speaker 3
 Right.

[01:31:18:19 - 01:31:19:15]
Speaker 2
 Yeah, yeah.

[01:31:19:15 - 01:31:20:08]
Speaker 4
 I agree with you.

[01:31:20:08 - 01:31:25:05]
Speaker 3
 And I understand-- And it's a compression, if it's from compression. It wouldn't, right. I mean, it doesn't matter.

[01:31:25:05 - 01:31:26:00]
Speaker 4
 Right, right.

[01:31:26:00 - 01:31:30:08]
Speaker 2
 Now my question was, would compression, do you think compression would cause the vesicles?

[01:31:31:12 - 01:31:35:02]
Speaker 1
 The pustules? I think if the artery was small enough. Yeah, it would. I think.

[01:31:35:02 - 01:31:37:02]
Speaker 4
 Some extent, yeah. Yeah, exactly.

[01:31:37:02 - 01:31:41:08]
Speaker 1
 Especially if she's a little swollen, like, you know. For 12 hours, yeah.

[01:31:41:08 - 01:31:44:10]
Speaker 2
 Yeah. Who knows. It's enough time to block enough flow, yeah.

[01:31:45:11 - 01:31:50:16]
Speaker 1
 And the hyaluronic does permeate the vessels. It permeates the blood vessel walls, so it can go in, you know, like you said, you never know.

[01:31:50:16 - 01:31:58:07]
Speaker 3
 I think that that's a big thing that a lot of people don't realize, right? Like they're like, well, why didn't you inject it directly into the vessel? Well, one, didn't have an ultrasound to do that.

[01:31:59:11 - 01:32:01:07]
Speaker 1
 Two-- It's the temple, there's so many vessels.

[01:32:01:07 - 01:32:02:20]
Speaker 3
 Do you know how many vessels are in the temple? There are.

[01:32:03:20 - 01:32:04:00]
 (Both Laughing)

[01:32:04:00 - 01:32:04:16]
Speaker 4
 So many.

[01:32:04:16 - 01:32:16:10]
Speaker 3
 And so, yeah, flooding the area is really your option there, and it'll get through everything, and that's why we were doing multiple layers, right? Going from different angles. And then the next day we went in with needle.

[01:32:17:12 - 01:32:20:06]
Speaker 3
 So, you know, it's, yeah, it's--

[01:32:20:06 - 01:32:42:08]
Speaker 1
 I know, like sometimes, like, if there's like a questionable VO in the lower, you know, sometimes I'll go right to that antigoneal notch and I'll find that facial artery or vein and try and I'll do that. Or like sometimes if you're kind of fishing here, you'll get that blood return and, you know, then you could do it. But I feel like in the temple, like you said, it's just a harder, it's much harder to find that exact vessel if you don't have an ultrasound.

[01:32:42:08 - 01:32:48:12]
Speaker 3
 Absolutely, and with how small they get, it's just, yeah, it's strictly impossible.

[01:32:48:12 - 01:32:51:10]
Speaker 2
 And I think you said this, but was this your first occlusion?

[01:32:51:10 - 01:32:57:10]
Speaker 3
 First occlusion. Not first occlusion that I've managed, first one that I've caused. Right, right.

[01:32:59:06 - 01:33:00:07]
Speaker 3
 Yeah, it's much different.

[01:33:00:07 - 01:33:01:12]
Speaker 2
 Yes, oh yes.

[01:33:01:12 - 01:33:06:23]
Speaker 1
 We've all caused them. Yeah. I mean, I've had one, I know Nicole's had one.

[01:33:06:23 - 01:33:09:23]
Speaker 2
 Yes, I was just gonna say, like, it happens to everybody.

[01:33:09:23 - 01:33:10:10]
Speaker 4
 Yeah.

[01:33:10:10 - 01:33:46:10]
Speaker 2
 Absolutely. And that's why it's all about how you manage it. But I just felt like how, I felt like what you did was so important because I love the fact that we all share amazing before and afters and all the exciting stuff in our field. But it's so important for patients, especially to realize that these things can happen and they do happen because even when we're explaining, I'm sure it happens to you guys, explaining the risks and everything, you're like, oh, not gonna happen to me, I don't gotta finish it. And I'm like, it's like, no, I need to tell you everything because these are very possible things that can happen. And I just think it was so important for you to share that because patients, they just think it's all fun and games and it can happen.

[01:33:46:10 - 01:34:12:00]
Speaker 3
 Yeah, and I think it's also shocking to me because that is one of the, I think the reason that this has been so good with my patient, like my patient and I are closer now is because with every patient that I have, if I'm ever doing filler, we sit down and we have that real conversation where I'm like, I am not trying to scare you, but this is a very real possibility that can happen and I have the antidote in the fridge right there.

[01:34:13:01 - 01:34:24:16]
Speaker 3
 And because of that, she knew what to expect, but how many times do you guys do this or have this conversation and your patient has had filler somewhere else and they're like, I didn't even know that that was possible.

[01:34:24:16 - 01:34:25:15]
Speaker 2
 Yeah, they're like, well, wait.

[01:34:25:15 - 01:34:29:07]
Speaker 3
 Nobody's ever talked to me about this before. And that to me is shocking.

[01:34:29:07 - 01:34:50:09]
Speaker 1
 But if you have the conversation with them, if you have that conversation with them, it almost like bypasses the accusation after it happens, like, oh, they don't know what they're doing or like, oh, I don't trust them. But if you have that conversation with them prior, then they're like, oh wait, they knew about it. And that's why they have the antidote in their refrigerator. So yeah.

[01:34:50:09 - 01:35:16:07]
Speaker 2
 I'll never forget a training I went to with Dr. Yulin. I think I've said this on a couple episodes of the pod, but he literally said like, it's only a complication if you didn't tell them it could happen. If they're aware, like you're gonna just have such a more smooth sailing, like, listen, unfortunately, I told you this is a possibility, now we gotta deal with it and I'm gonna deal with it. But it's like, it's the way that you lead up to that. And we have a lot of injectors that listen, would you mind kind of touching base on how you bring that conversation up without it being too alarming?

[01:35:17:11 - 01:36:35:10]
Speaker 3
 Yeah, no, I just, when we are going through the consent form, I sit there and I explain everything. So I will say, listen, any time we have vessels in our face, right? We have vessels throughout our entire bodies. That's why people bruise sometimes. And the reality is not all of ours are exactly the same. And so what can happen with filler is it's a gel. Think of it like a jelly, okay? I'm injecting it into your tissue and it can cut off blood flow by either being injected into or around or compressing an artery. And what that would look like is it would be blanching. And what blanching means, and I'll literally go like this and I'll say, do you see how my tissue is coming back and it's not staying white? If you had blanching where it was staying white, that would be a sign of a vascular occlusion. You shouldn't have a lot of pain, but if you're having pain without pressure or movement or anything, and it's just there and it's really painful, I need to know. This is always a risk every time you do filler. And I just am telling you this not to scare you. It is still rare that it happens, but it does happen and I know how to handle it. And I would never send you home if I thought that's what was going on. And that usually reassures them.

[01:36:35:10 - 01:36:42:12]
Speaker 1
 I love that. You just made that so personable and so nice. Yeah, I think that's what's huge about that.

[01:36:42:12 - 01:36:48:04]
Speaker 3
 It's so important. It is probably the most important conversation you have when you're doing filler.

[01:36:48:04 - 01:36:57:11]
Speaker 2
 And it's not just like you're throwing the risks at them and then that's it. You're saying, I trained and I'm here with you and I would never let you leave. And I think that's how you bring that.

[01:36:58:23 - 01:37:02:07]
Speaker 1
 So when's your first conference talk on this topic since it's become so famous?

[01:37:02:07 - 01:37:04:22]
Speaker 3
 When do we get on stage? I know, right?

[01:37:06:01 - 01:37:14:15]
Speaker 3
 That's a great question, but it will be there. Trust me, people are already like, "Hey, you need to talk about this." And I'm like, "Okay, I will."

[01:37:14:15 - 01:37:15:16]
Speaker 4
 I will.

[01:37:15:16 - 01:37:28:12]
Speaker 2
 Give me a minute. No, I think you should be so proud of yourself because it was a very brave thing to do. And the second I saw it, I was like, "We have to chat with her." Like, it was incredible. Thank you. Really honestly, I think it was very, very brave of you.

[01:37:28:12 - 01:37:34:06]
Speaker 1
 Are you gonna be, yes, it's so important. Are you gonna be at AMSPAW this year? Maybe, we'll see.

[01:37:34:06 - 01:37:47:19]
Speaker 3
 It's not a hundred percent, but like it's a maybe right now. There's so much travel going on at the moment, but I have a couple of conferences in mind that I'm thinking of, at least for next year, to talk about this and really do a deep dive.

[01:37:47:19 - 01:37:52:13]
Speaker 1
 Oh, and I didn't mean like you're gonna speak at it this year, but like, are you gonna, okay.

[01:37:52:13 - 01:37:52:13]
 (Laughing)

[01:37:53:18 - 01:38:00:20]
Speaker 3
 I'm not speaking there this year, no. I have some people that are on my team that are speaking there, so I was thinking of going to support.

[01:38:02:06 - 01:38:03:09]
Speaker 1
 What about Modern Beauty Con?

[01:38:04:19 - 01:38:14:05]
Speaker 3
 Like this year going? I don't think I'm going this year, but that was one of them that I'm like maybe next year. That's actually where I met you guys for the first time. Oh, we look like a

[01:38:14:05 - 01:38:14:10]
 (Beep)

[01:38:14:10 - 01:38:15:01]
Speaker 2
 right now.

[01:38:16:19 - 01:38:16:20]
 (Laughing)

[01:38:16:20 - 01:38:18:19]
Speaker 1
 Kristin, I don't like this.

[01:38:18:19 - 01:38:22:07]
Speaker 3
 Not to call you out, but awkward. Yeah, such a bitch. Awkward.

[01:38:22:07 - 01:38:25:19]
Speaker 2
 Oh my God, I'm crying right now.

[01:38:26:22 - 01:38:29:06]
Speaker 2
 She was like not to call you guys out, but I'm crying now. It was like two years ago.

[01:38:29:06 - 01:38:32:11]
Speaker 1
 It was two years ago, I think. Was it by the bathroom?

[01:38:34:16 - 01:38:38:21]
Speaker 3
 It was, no, I don't know, maybe? There's so many things that go on there. We were at the bar.

[01:38:38:21 - 01:38:40:21]
Speaker 1
 Oh, we were.

[01:38:40:21 - 01:38:49:15]
Speaker 3
 Well, if you were talking to me. We were at a restaurant, like it was one of the afters. Was it the sushi place? Yeah. Oh, no. It was the sushi place. We were sitting in a booth.

[01:38:50:16 - 01:39:00:00]
Speaker 3
 Lights were on. Oh, I remember. Lights were on, no one was on. I was not working at the confidence bar at that time. Oh, really? I wasn't, yeah.

[01:39:00:00 - 01:39:02:21]
Speaker 2
 So maybe we just didn't connect the dots. For sure.

[01:39:04:02 - 01:39:06:15]
Speaker 3
 I've been with the confidence bar for a little bit over a year and a half.

[01:39:06:15 - 01:39:12:18]
Speaker 1
 Oh my God, yeah. Oh, that's amazing. Okay, so I do remember this now, yes. Was that zoomy?

[01:39:12:18 - 01:39:16:16]
Speaker 2
 It starts as a Z, I don't know if you say zoomy.

[01:39:16:16 - 01:39:21:12]
Speaker 3
 Yeah, I think so, and then it was like the little bar and the booths and then you could walk out and it was like.

[01:39:21:12 - 01:39:24:13]
Speaker 1
 It was insane, it was busy. It was so cool, yeah.

[01:39:24:13 - 01:39:28:05]
Speaker 2
 I was taking shots that night, so. I wasn't, I should have been.

[01:39:29:08 - 01:39:33:21]
Speaker 1
 Yeah, well we were with people that were very, oh my, I was like, "Oh, I'm gonna feel like crap tomorrow."

[01:39:36:04 - 01:39:39:10]
Speaker 2
 Oh, well, you should come again this year and we can redo that.

[01:39:39:10 - 01:39:45:22]
Speaker 1
 Yeah. I know. I consider going to AMSPAS, seriously. Me and Nicole will be there. You know, we'd love to see you.

[01:39:45:22 - 01:39:48:23]
Speaker 3
 Yeah, that'd be great. Are you guys presenting? No.

[01:39:48:23 - 01:39:50:08]
Speaker 1
 No, but maybe next year.

[01:39:50:08 - 01:39:50:13]
Speaker 3
 Yeah.

[01:39:51:13 - 01:40:02:00]
Speaker 2
 Well, Rana will be there presenting. I know, I'm so excited for her. She's doing two talks, right? I think so. Yeah, she's doing two. I saw her Instagram and I was like, "Oh my god, these sound like, they're like really good topics." So I'm excited for that.

[01:40:02:00 - 01:40:06:06]
Speaker 3
 Yeah, and then Christina, who is also one of our injectors, is presenting on the platysma.

[01:40:06:06 - 01:40:07:09]
Speaker 2
 Oh!

[01:40:07:09 - 01:40:10:09]
Speaker 3
 Yeah, so she'll be there as well. Very exciting.

[01:40:10:09 - 01:40:10:14]
Speaker 4
 I love that.

[01:40:10:14 - 01:40:11:03]
Speaker 3
 Yeah.

[01:40:11:03 - 01:40:11:18]
Speaker 4
 Yay.

[01:40:11:18 - 01:40:18:23]
Speaker 2
 My esthetician is presenting at Modern Beauty Con. Oh, that's exciting. Yeah, so. We're all going to support that, so. Good.

[01:40:18:23 - 01:40:21:21]
Speaker 3
 Yeah, it's closer to you guys, right? Yeah, we're both in Boston. Yeah, yeah. Yeah.

[01:40:21:21 - 01:40:24:05]
Speaker 2
 We can drive, yep. So that's nice, yeah.

[01:40:24:05 - 01:40:27:09]
Speaker 1
 Okay, so tell our followers where they can find you again.

[01:40:28:14 - 01:40:31:13]
Speaker 3
 I'm at Confidence by Kristin on Instagram.

[01:40:31:13 - 01:40:33:01]
Speaker 1
 Perfect, do you have a TikTok?

[01:40:33:01 - 01:40:35:11]
Speaker 3
 I don't, but I'm gonna get there.

[01:40:35:11 - 01:40:37:00]
Speaker 2
 No, it's like fine.

[01:40:37:00 - 01:40:43:21]
Speaker 3
 She's like, "I just, I need some time." It is a lot, guys. It is a lot. Yeah, it's a whole other job, yep.

[01:40:43:21 - 01:40:44:22]
Speaker 1
 They're both different too.

[01:40:44:22 - 01:40:53:20]
Speaker 2
 Yeah, Nicole, how do you do this? You just had a baby too. Oh my god, everyone laughs at me. I love social media. John is like, I don't know how I do it. I post multiple times a day.

[01:40:53:20 - 01:40:58:07]
Speaker 1
 We're well aware, you post literally two reels a day and it gives me anxiety. Can I tell you something?

[01:40:58:07 - 01:41:12:23]
Speaker 2
 I forget that I do it and my neighbor, like I just like, I forget that I have followers, I guess is what I'm saying. I do it like it's just me and my friends. My neighbor the one day was talking about how my dog rolled in poop in the backyard and I'm like, "How did you know that?"

[01:41:14:15 - 01:41:14:16]
 (Laughing)

[01:41:14:16 - 01:41:21:12]
Speaker 2
 And she's like, "It was on your-- Because you just told me. She's like, "It was on your Instagram story." I'm like, "Oh, oh, oh my god, I didn't realize you followed me."

[01:41:21:12 - 01:41:31:19]
Speaker 3
 That's so funny, it's so true. I was with all my girlfriends yesterday for a baby shower and they're like, "Cristin, we don't need any updates for me." Yeah, like we know everything about you. Because we know what's going on. And I was like, "Oh."

[01:41:33:01 - 01:41:33:22]
Speaker 4
 Oh, you do, okay.

[01:41:34:22 - 01:41:37:20]
Speaker 2
 No, literally, I just-- Good, you should be following what I'm doing. It's like second nature at this point.

[01:41:37:20 - 01:41:39:05]
 (Laughing)

[01:41:40:07 - 01:41:54:23]
Speaker 1
 Yeah, it's like a full-time job. It is, it really is. And there's times I love it. There's times I'm like, "I need a break." And you guys probably can see when I need a break because I don't post as much, but I always try to make sure that I post on my stories a lot if I'm not doing a reel.

[01:41:56:09 - 01:42:04:10]
Speaker 1
 But I try to keep it before and after, then a funny reel, and then an educational one, and I try to keep that mojo. I don't know, it's tough.

[01:42:04:10 - 01:42:06:13]
Speaker 2
 No, I think it's good that people see personality.

[01:42:06:13 - 01:42:08:06]
Speaker 1
 Yeah, they need to see personality.

[01:42:08:06 - 01:42:15:17]
Speaker 3
 And that you're a real person. Yeah. I know, that's also one of the biggest things is, I am ugly on there.

[01:42:16:18 - 01:42:24:21]
Speaker 3
 That's me too, that's me too. I don't care. Yep. Like I have a reel. My husband literally looked at me and he goes, "You need to pluck your eyebrows before you go on this." And I was like, "No."

[01:42:26:12 - 01:42:32:00]
Speaker 2
 No, I'm not. But it makes you relatable. People wanna see that, I'm sorry. Yeah.

[01:42:32:00 - 01:42:33:18]
Speaker 1
 I said, "You're so funny."

[01:42:33:18 - 01:42:39:06]
Speaker 2
 No, you seriously. In a world of filters and face tune, we have to be the ones to reel it back in.

[01:42:39:06 - 01:42:48:11]
Speaker 3
 Yeah, and I've always been that way. You'll find that it's just, I mean, yeah. I'm not gonna have makeup on 24 seven. Yep, yep. No, I love that.

[01:42:48:11 - 01:42:54:20]
Speaker 1
 I love that. But people wanna see that unfiltered look. That's how we should appear on social media, I think.

[01:42:54:20 - 01:42:59:07]
Speaker 3
 And I think people have completely gotten away from what real skin looks like. Yeah, absolutely.

[01:42:59:07 - 01:43:21:01]
Speaker 1
 They have. And I think also, to the point of your reel that you posted, just that transparency too. Like that's why I just, we loved it so much and Nicole mentioned it to me and then she's like, "Oh my God, Kristen, come on this Sunday." I'm like, "Oh my God, I saw that reel. That's so amazing." And so thank you again to the bottom of our hearts for coming on today, especially on your birthday. Yes, happy birthday.

[01:43:21:01 - 01:43:24:09]
Speaker 2
 Oh, thank you. I said, I'm like, if I knew I would have gotten a cake.

[01:43:24:09 - 01:43:26:18]
Speaker 1
 No, I, oh, we would have sent you a cake.

[01:43:26:18 - 01:43:31:23]
Speaker 2
 No. I'm adding that to Joey's, I'm adding that to Joey's list of questions he asks in the email. Is it actually your birthday?

[01:43:31:23 - 01:43:34:04]
Speaker 1
 When's their birthday? What's their sign?

[01:43:35:23 - 01:43:39:20]
Speaker 1
 Yeah. Oh my God. Oh my God. And thank you for sharing your story.

[01:43:39:20 - 01:43:42:16]
Speaker 2
 Yes, no, thank you. Yeah, and hopefully we see you soon.

[01:43:44:04 - 01:43:47:06]
Speaker 1
 Thanks guys for tuning into this week's episode. Till next time.

[01:43:47:06 - 01:43:51:14]
 (Upbeat Music)