Fill Me In: An Aesthetics Podcast
On Fill Me In: An Aesthetics Podcast, Jon LeSuer NP-C and Nicole Bauer FNP-BC dive deep in the world of aesthetics. As aesthetic nurse practitioners with their own medical practices, Jon and Nicole fill you in on everything in their field.
Fill Me In: An Aesthetics Podcast
The PDGF Debate: Pressing Play on Growth Factors & Off-Label Innovation w/ Leslie Fletcher, NP-BC
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Welcome back to another special live episode of the Fill Me In Podcast, recorded straight from the floor at Modern Beauty Con! In this episode, hosts Jon and Nicole sit down with 26-year aesthetics industry pioneer Leslie Fletcher, NP-BC—founder of the InjectAbility Clinic and the InjectAbility Institute.
Leslie pulls back the curtain on the most disruptive, trending, and controversial topics facing aesthetic injectors today. We dive deep into the legalities and clinical techniques surrounding Platelet-Derived Growth Factor (PDGF), discussing how to transition therapeutic data into cosmetic results safely via cannula, mitigate adverse events, and navigate the "politics" of regenerative aesthetics.
Leslie also shares her clinical breakthroughs with advanced neurotoxins, including her signature Microtox® technique for skin tightening and melasma improvement. Plus, we explore the crucial business systems that keep a high-volume medical spa thriving—from leveraging Medical Assistants to boost hourly revenue by thousands, to implementing a flawless "Image Review Session" protocol using 3D clinical photography.
Whether you are a new injector looking to build an authentic internal brand on social media or a seasoned practice owner getting your medical protocols in order, this episode is packed with clinical gold and practice management secrets you cannot afford to miss.
Connect with Leslie Fletcher:
Instagram | https://www.instagram.com/lesliefletcher_np/
Instagram | https://www.instagram.com/injectabilitybeauty/
InjectAbility Clinic | https://www.injectabilityclinic.com/
InjectAbility Institute | https://www.injectabilityinstitute.com/
Patreon | https://www.patreon.com/cw/injectability?utm_source=ig&utm_medium=social&utm_content=link_in_bio
🚨**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/
Producer of Fill Me In: Joey Ginexi
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[00:00:00] Jon: Welcome back to another episode at Modern Beauty Con of the Fill Me In [00:00:10] podcast. We have a special guest, Leslie Fletcher. Yes. Thank you for coming today.
[00:00:13] Leslie Fletcher: Oh my gosh, thank you for having me, you guys.
[00:00:16] Jon: And she just got out of a fascinating lecture.
[00:00:18] Leslie Fletcher: Mm-hmm.
[00:00:19] Jon: It was amazing. I
[00:00:19] Leslie Fletcher: [00:00:20] thought it was good.
[00:00:20] Jon: It was so
[00:00:21] Leslie Fletcher: good.
It was incredible.
[00:00:22] Jon: It was amazing. And what was it about? So
[00:00:25] Leslie Fletcher: the topic was decoding neurotoxins. Um, I wanted to kind of like [00:00:30] dispel some myths. Mm-hmm. Uh, and but also, like, maybe corroborate some myths- Mm-hmm ... that maybe you have heard or haven't heard as far as, like, post-treatment instructions, [00:00:40] pre-treatment instruction, um, how to make it more effective.
Mm-hmm. Um, and then just, like, mechanism of action. I don't think we know this drug very well. We think we do. We think we're [00:00:50] so, like, hip and cool. Like, "Oh, I've been doing this 25 years." Yeah. "I know this like the back of my- I could do it with my eyes closed." But like- Right ... I really don't think we've discovered the- the potential for this drug [00:01:00] in so many different ways.
[00:01:01] Jon: I thought your before and after highlighting the melasma improvement-
[00:01:04] Leslie Fletcher: Yeah ...
[00:01:05] Jon: just with mi- microtox, your signature microtox- Right. Yeah ... injection was amazing.
[00:01:08] Leslie Fletcher: Yeah.
[00:01:08] Jon: Yeah.
[00:01:09] Leslie Fletcher: And she's [00:01:10] tried other things for melasma, and this worked- Yeah ... the best for her. So, um, and you know, just working on the anti-inflammatory- Yeah
benefits of it, and then we did that live model on [00:01:20] stage.
[00:01:20] Jon: Who happened to be your husband.
[00:01:21] Leslie Fletcher: Happened to be my husband. Remarried. Super handsome before- ... and super handsome now. He
[00:01:26] Nicole: got perfectly
[00:01:26] Leslie Fletcher: smooth. He did. Yes. He did pre-treat with Ajour NAVID, so I don't [00:01:30] know if you heard that. Yes. Yeah.
[00:01:31] Jon: And he said it works so well.
[00:01:32] Leslie Fletcher: It works so w- He just texted me. He's like, "That... I- I didn't- I didn't even know you were in my skin." We need it for our office. It's amazing. So, so that's a really cool new drug. But [00:01:40] anyway, we did inject him live on stage, and I was just hoping it was gonna work like it had- Yeah ... in the clinic, 'cause it was, like, promising that he was gonna look like he lost 30 pounds in [00:01:50] five minutes, and he did.
It worked, so. It
[00:01:52] Jon: was so amazing. So that
[00:01:53] Leslie Fletcher: was really great. Yeah.
[00:01:54] Jon: For those of you guys that don't know Leslie, you're out in California.
[00:01:58] Leslie Fletcher: I am in California.
[00:01:59] Jon: She owns [00:02:00] Injectability- Mm-hmm ... Clinic, right?
[00:02:01] Leslie Fletcher: Mm-hmm.
[00:02:01] Jon: How long have you been an injector for? I'm
[00:02:03] Leslie Fletcher: in my 26th year.
[00:02:05] Jon: So yesterday. Yesterday.
[00:02:06] Leslie Fletcher: That's
[00:02:06] Jon: great.
[00:02:06] Leslie Fletcher: Mm-hmm.
[00:02:07] Jon: You've seen a lot evolve over the years.
[00:02:08] Leslie Fletcher: I have.
[00:02:09] Jon: [00:02:10] Yeah. Do you love being a business owner?
[00:02:12] Leslie Fletcher: I do. Yeah. I mean, it is exhausting. Yeah. And, and it's just trying to make everyone happy- Mm ... which is, like, our life anyway. Yeah. Like, we wanna make our [00:02:20] patients happy. We wanna make our trainees happy. Mm-hmm. I wanna make my employees happy.
Um, and then we got the patient, and it's just, it's a lot- It's a lot ... to try to make everyone happy and make them- Mm-hmm ... all feel, like, very, you [00:02:30] know, valued and-
[00:02:31] Jon: Mm-hmm.
[00:02:31] Leslie Fletcher: It's... That's... But I love it because I think I wouldn't want it either way because I have a certain level of expectation for- Mm ... excellence.
Mm-hmm. [00:02:40] And working somewhere else, if that didn't match up- Right ...
[00:02:43] Jon: mm-hmm ...
[00:02:43] Leslie Fletcher: I think it would be really hard for me. It was hard for me. That's why
[00:02:47] Jon: I had to start my own. Right, that's why you're here. The minute I start complaining- Mm ... I [00:02:50] think of you-
[00:02:51] Leslie Fletcher: Oh ...
[00:02:51] Jon: because- And
[00:02:52] Nicole: all she
[00:02:52] Jon: does- Truly- Yep ... and I think of you, seriously, because you make it seem so easy.
[00:02:57] Leslie Fletcher: Mm.
[00:02:57] Jon: Like, you seem... Like, you balance it. And I know that [00:03:00] you have help and-
[00:03:01] Leslie Fletcher: A lot of help ...
[00:03:01] Jon: I'm sure you d- you've learned to delegate over the years, but- Yeah ... what would you s- what would you... What advice do you give for people that are struggling? I
[00:03:07] Leslie Fletcher: mean, I think it is definitely... We've, we've gotten, like, [00:03:10] our family involved, so my husband is a personal assistant- Yeah
as you guys know.
[00:03:13] Jon: Mm-hmm.
[00:03:13] Leslie Fletcher: Um, my daughter is essentially, too, and we have a lot of, um, ancillary staff at the clinic, and-
[00:03:19] Jon: Amazing ...
[00:03:19] Leslie Fletcher: [00:03:20] when I look at, you know, we have three injectors, and we have basically 10 ancillary staff to support those injector- Wow ... which is, like, a ratio that's not normally healthy for [00:03:30] business- Yeah
standards, but- That's how
[00:03:31] Jon: important-
[00:03:32] Leslie Fletcher: But I- ...
[00:03:32] Jon: ancillary staff is.
[00:03:33] Leslie Fletcher: Yeah, exactly. They're behind the scenes. They are. Mm-hmm. And, and it helps us deliver that type of patient experience- Yes ... we want. But [00:03:40] also, a, a side note, I mean, they're all sort of like personal assistants for me, like, one's sending me photos I need for- Right
these types of presentations. Another one's, you know, doing this. Mm-hmm. I'm like, "Can you do this really..." I mean, I'm just kinda-
[00:03:49] Jon: [00:03:50] Yeah ...
[00:03:50] Leslie Fletcher: little... So I, I think definitely they're all justified. Don't worry. No one's going anywhere. But, like, I use them- I take it personally ... in different ways. Yeah. Mm-hmm. [00:04:00] Yeah, and they're great.
So I, I definitely think just lean in to help. Yeah. There's certain things you can't delegate- Yeah ... obviously, but there are a lot of things that you can. Mm-hmm.
[00:04:07] Jon: Mm-hmm. Um, you've been [00:04:10] certainly a pioneer with platelet-derived growth factor over the past two to three years since its inception- Mm-hmm ... kind of into the aesthetic space.
Uh, it's been an interesting year.
[00:04:18] Leslie Fletcher: Mm-hmm.
[00:04:19] Jon: Yeah. [00:04:20]
[00:04:20] Leslie Fletcher: Yeah, 18 months. Yes. It's been very interesting. And
[00:04:22] Jon: I think, um, and I'm also in my practice, I inject it. Yeah. Um, PDGF as well, under eyes, forehead, scalp. [00:04:30]
[00:04:30] Leslie Fletcher: Mm-hmm.
[00:04:30] Jon: Anywhere, obviously. Mm-hmm. Um, but obviously we practice good standard of care. Yep. We have good protocols.
Yeah. We have a good consent form. Patients are our number one priority. Mm-hmm. We would never offer [00:04:40] treatment that's not safe for our patients. Mm-hmm. But I think the biggest concern with, um, other injectors in the industry are, you know, is, is it a, is it legal- [00:04:50] Mm-hmm ... or illegal to inject? Yeah. So how would you answer that?
[00:04:53] Leslie Fletcher: I mean, I think the word legal or illegal is a little bit... It's... You have... It's more than that. Yeah. I mean, is it within [00:05:00] your scope? Yeah. Have you- Mm-hmm ... created the proper protocols and channels to do this? safely for your patients, and can you create a rationale [00:05:10] for why you would choose this particular product over another product that maybe is FDA approved?
Mm-hmm. Um, and why are you... What, what would make that patient be a good [00:05:20] candidate for this? Mm-hmm. Um, you have to be able to explain that with every single patient. Yeah. And you have to go through certain channels, and I do believe in complementary alternative medicine guidelines that the National Institute of Health put [00:05:30] together.
I think this fits in perfectly for that.
[00:05:32] Nicole: Mm-hmm.
[00:05:32] Leslie Fletcher: California, thankfully, is very progressive in their treatment. Um, a- and a lot of states are. Mm-hmm. We just have to look for that, [00:05:40] you know, that specific code that kind of helps us- Yeah ... do this for our patients. Mm-hmm. Because it will be FDA approved, and they've already- Mm-hmm
you know, put together their- Mm-hmm ... their protocol to get this [00:05:50] approved. Um, but it already is FDA approved for human use. Mm-hmm. Four times over. So the research is already there. You just have to look for it. Mm-hmm. And you [00:06:00] have to extrapolate therapeutic to cosmetic.
[00:06:02] Jon: How, um... Have you seen any complications with it?
[00:06:05] Leslie Fletcher: I have not seen any complications. I- Mm-hmm. That's very technique specific.
[00:06:09] Jon: Yeah.
[00:06:09] Leslie Fletcher: Um, [00:06:10] I've heard complica- I've been helping with complications, for sure, but every time I talk to someone about a complication, when I ask what their technique was, it makes sense. Mm-hmm. So it is a growth [00:06:20] factor. If you put too much- Mm-hmm
in one location, it will grow- Especially too superficial ... too much in one location. Yeah.
[00:06:25] Jon: Too, too-
[00:06:26] Leslie Fletcher: Yeah ... superficial. Well, it will f- it'll happen either deep or superficial. It'll just [00:06:30] show more superficially, right? Mm-hmm. But, uh, yeah, I do think it's very technique specific, which I think is what's propelled me to be so passionate about the education.
Mm-hmm. Because it could [00:06:40] be, you could, you could have some pretty- You know, not great results Yes Just like any other filler- Of course ... if you don't know
[00:06:46] Nicole: how to put it in safely.
[00:06:47] Jon: And what did you say last night? That's
[00:06:48] Nicole: exactly what I said last night. There's [00:06:50] adverse events with anything. For sure. And it's definitely, a lot of it is technique.
[00:06:53] Leslie Fletcher: Yeah.
[00:06:53] Nicole: And making sure that you're trained and always evolving and- Type of patient.
[00:06:56] Leslie Fletcher: Right.
[00:06:56] Nicole: Yes. Yeah.
[00:06:57] Leslie Fletcher: And we experience adverse events in our practice. [00:07:00] I mean, we do. Mm-hmm. We do so many. You're gonna get your, your lid whatever, your heaviness, and your, you know, little bump and maybe a nodule here and there.
Mm-hmm. And, and we know how to handle it. The more patients you see. But I [00:07:10] have to say, this probably has our lowest side effect. It i- I mean, I haven't- Same here ... had one person with a l- highest satisfaction- Mm-hmm ... of anything we do.
[00:07:17] Jon: Mm-hmm.
[00:07:17] Leslie Fletcher: Um, and very low- Mm ... side [00:07:20] effect profile.
[00:07:21] Jon: I always tell, uh, my patients that my regenerative patients are my happiest patients- Yeah ... to be honest.
[00:07:25] Leslie Fletcher: Yeah.
[00:07:26] Jon: Yeah.
[00:07:26] Nicole: I was gonna ask, like, how many patients would you say a week you're treating with [00:07:30] PDGF?
[00:07:30] Leslie Fletcher: I went through, um, about 80 vials last month.
[00:07:35] Nicole: Wow.
[00:07:35] Leslie Fletcher: So I don't know what that translates to.
[00:07:38] Nicole: But a good amount. And
[00:07:39] Leslie Fletcher: then you're not seeing- And I'm only [00:07:40] there 50% of the time 'cause I teach. Right. Right. So it's, it's been-
[00:07:44] Nicole: A popular treatment ...
[00:07:44] Leslie Fletcher: very popular.
[00:07:45] Nicole: Yeah. And you haven't been seeing a ton of-
[00:07:48] Leslie Fletcher: I
haven't ...
[00:07:49] Leslie Fletcher: you haven't seen any. Yeah. No, I [00:07:50] have not.
[00:07:50] Nicole: Wow.
[00:07:50] Leslie Fletcher: No. I've had to, like, you know, blend a few areas, but just like filler, you can do that.
Right. But that's only happened twice. Mm-hmm. Myself, on myself. Mm-hmm. Which was, you know, patient one, [00:08:00] so.
[00:08:00] Jon: Yeah.
[00:08:00] Nicole: Best case scenario.
[00:08:01] Leslie Fletcher: Yeah. But other than that, no.
[00:08:03] Jon: If you guys have not completed a training with Leslie, highly consider it. She is absolutely amazing. Where can they find you? Did you do [00:08:10] trainings?
Like, where can they register for your trainings?
[00:08:12] Leslie Fletcher: Yeah. Probably the easiest place is through Instagram. Yeah. We have a Linktree, and, um, you can get to either our training [00:08:20] website, which is injectabilityinstitute.com, or we have a Shopify too. Mm-hmm. Which is kind of a whole separate website, but all of them are listed.
I'm trying really hard to get everywhere. This is definitely our most [00:08:30] popular class from the history- PDGF? ... of all classes. Yeah. Is it really? I mean, they're sold out everywhere. That's
[00:08:34] Jon: amazing.
[00:08:35] Leslie Fletcher: So, um, there's a lot of demand. Mm-hmm. Nobody else is training it. Mm-hmm. And I, I feel [00:08:40] like it's a really thorough training.
Mm-hmm. We spend about two hours on the legalities of it. Yeah. Um, the pathways of working it and the mechanism- Mm ... of action, mitigation of side effects- Mm ... treatments of [00:08:50] side effects. You know, all the myths, and then we're like, "All right. Now it's time for the technique." But, um, it's funny, I wanna change the name of the class.
There's really kinda no name. It's just PDGF. What do you wanna change
[00:08:59] Jon: it [00:09:00] to?
[00:09:00] Leslie Fletcher: I wanna change it to, like, press play- Ooh ... 'cause everyone, when we do an interview, like with, like in the beginning- Yeah ... they're like, "Well, we were doing it, but we just pressed pause." Oh. Oh. And for a while- Press [00:09:10] play ... we pressed pause.
Be like, "Play PDGF." That's creative. Because- Press play.
[00:09:13] Nicole: Oh my God, I love that.
[00:09:14] Leslie Fletcher: Yeah. I, I mean, it... So for me, we look at, like, the standards, the [00:09:20] ethical standards as a clinician. You have non-malfeasance, which is not doing any harm, right? Mm-hmm. Just making sure that you're- Not doing harm. I did my due [00:09:30] diligence.
This product is safe. It's been researched for 30 years. Like, there is no harm that can be done. The other one is beneficence, though, like doing good. Mm-hmm. So if you have a [00:09:40] procedure that you know can do good for a patient, and you don't do it, you're not practicing ethically, in my opinion. I mean, I know- Well, that's
[00:09:47] Jon: what was so sad about this.
[00:09:48] Leslie Fletcher: Yeah. And so- You know?
[00:09:49] Jon: It's
[00:09:49] Leslie Fletcher: like- Right ... it
[00:09:49] Jon: was [00:09:50] doing so much good for them.
[00:09:51] Leslie Fletcher: Right. It really was doing so many wonderful things. And it is. It still is. If, if you're Confident enough to go forward. Right. And I, I do think you have to do it [00:10:00] responsibly. I don't think you should just jump into this stuff without training.
I mean, the calls that I've gotten from people-
[00:10:05] Jon: Well, that's the
[00:10:05] Leslie Fletcher: issue ... who have had issues, they- It
[00:10:07] Jon: was trendy. People just wanted to jump on it.
[00:10:09] Leslie Fletcher: Yeah.
[00:10:09] Jon: They'd go, "Oh, I'll take-" They
[00:10:09] Leslie Fletcher: [00:10:10] don't
[00:10:10] Jon: know the mix it "... the uncrossed linked HA with it-" They're, yeah ... "and then I'll inject it." And like, "No, no, no." You know?
[00:10:14] Leslie Fletcher: Yeah.
[00:10:14] Jon: Yeah.
[00:10:15] Leslie Fletcher: Yeah. So be- Mm-hmm ... be responsible. Do your due diligence.
[00:10:18] Jon: Mm-hmm.
[00:10:18] Leslie Fletcher: Start responsibly with the right [00:10:20] patient, staff, family member. Slow. Track the side effects. Mm-hmm. Track the effects. Film the procedures. I mean, there's a way to do things right. Mm-hmm. So, um, and then take a course, [00:10:30] for heaven's sake. Yes. Yep.
[00:10:31] Jon: 100%.
[00:10:31] Leslie Fletcher: Yeah. Yep. Yeah. Yeah. So, and then innovation obviously with, um, with toxins is another really popular course. Yes. Yeah. So.
[00:10:39] Nicole: I wanted to ask you about [00:10:40] your clinical, um, photography- Yeah ... because I feel like that's something you bring up in a lot of your lectures too. Like, how important it is to document things, like you just said, filming- Essential
and all that too. Mm-hmm. Um, what do you guys use for photos? Do you [00:10:50] have, like, a specific room?
[00:10:50] Leslie Fletcher: Yeah. We do. We actually have a photo room. We have two of them- Mm-hmm ... because if there's some backup, I'm like- Right ... "We gotta get going." Right. So we have two of the exact same room with the exact [00:11:00] same equipment.
Mm-hmm. Um, we use Photo Finder. Okay. F-O-T-O Finder. It's kind of similar to the Canfield, but a little more affordable.
[00:11:09] Jon: Mm-hmm.
[00:11:09] Leslie Fletcher: It's [00:11:10] still, I mean, I think it's like 17,000, but- Yeah. Yeah ... honestly, like, I ha- I bought it before I opened up my business. Mm-hmm. It sat in my garage for like three months. I'm like, "I don't need anything.
Like, I can [00:11:20] inject in this chair." Yeah. I need a camera system. Yeah. That was the most important thing to me. Mm-hmm. Um, we also have, um, QuantificAir or LifeViz. Yep. And [00:11:30] that's a 3D system- Okay ... and it does a lot of measurements, which has been really great for the- Mm-hmm ... PDGF 'cause you can show, like, those shadows and concavities- Mm-hmm
versus convexities and, [00:11:40] uh, and it has volumetric changes and things like that. Yeah.
[00:11:42] Jon: Have you heard of AURA?
[00:11:44] Leslie Fletcher: Yeah.
[00:11:44] Jon: Have you-
[00:11:45] Leslie Fletcher: Yeah, they're here actually. Um-
[00:11:46] Jon: Yeah? Have you looked into that one?
[00:11:47] Leslie Fletcher: I, I haven't. Okay. Um, [00:11:50] I think it's gonna be similar though.
[00:11:51] Jon: Right.
[00:11:52] Leslie Fletcher: D- is there, like, a, a chin plate for that one? No. No chin plate.
There's not actually. Okay. Yeah. Yeah, I don't love the chin plates. Right, 'cause
[00:11:58] Nicole: we have the Vizia, and that's like the one- Yeah, the, yeah ... restricting [00:12:00] factor. It covers some of the forehead and then the chin.
[00:12:02] Leslie Fletcher: Yeah.
[00:12:02] Nicole: Um, and too, like, you can't really do dynamic photos in it. Mm-mm. So it, you're kinda limited.
[00:12:07] Leslie Fletcher: Yeah.
[00:12:08] Nicole: But the- Yeah ... the AURA did have the measurements [00:12:10] and all that. Mm-hmm. 'Cause that is very good to have too, I feel like. It
[00:12:11] Leslie Fletcher: is. Yeah. I mean, that's definitely... It's so sad that, you know, 26 years into this or however long this field's been around, that we're just now going, "Oh my [00:12:20] gosh, look at this. We could actually document these results."
I'm like, "Wait a minute. Like, this is what we sell." Right. Mm-hmm. Mm-hmm. "We have one product." Yes. "It's outcome." Yes. Why are we just now thinking this is important? Right. Right. Yeah. [00:12:30] You know, and not prioritizing it using- Mm-hmm ... you know, iPads and iPhones in rooms with, without, you know, proper backgrounds. I mean, we have everything like laser, there's a laser [00:12:40] measurement.
Everything's ghost imaged. Everything is millimeters. Mil- Mm-hmm ... that everything matches up, which is- Yeah ... the only way you can truly say- I did [00:12:50] this, this is what happened, and, like- Right ... let me make the trajectory of the outcome came from that. Like, if, if anything changes, you, you kind of have to throw out your theories right away.
Right. Right?
[00:12:59] Nicole: Mm-hmm. And [00:13:00] if you think you're too busy to take pictures like this, you're not. Because if you guys can do it-
[00:13:03] Leslie Fletcher: Uh-huh ... anyone can do it. Yeah. It's a seven-minute process. Mm-hmm. We've timed it. We have 25, uh, baselines that [00:13:10] we will repeat, uh, for follow-ups. Mm-hmm. And then maybe we don't do 25 every time, but- Mm
whatever that specific follow-up, it's gonna be at least 12.
[00:13:17] Nicole: Yeah.
[00:13:18] Leslie Fletcher: Um, so yeah, but that's [00:13:20] where the ancillary staff comes in handy- Exactly ... 'cause we have a image specialist- Yes ... who does it all.
[00:13:23] Nicole: So that's what I was gonna say. So when, when you have someone come in for a follow-up, they're not seeing you.
[00:13:27] Leslie Fletcher: Well, they'll get their images.
Okay. And we don't even call it a [00:13:30] follow-up, it's an image review session. Love that. So it's very, like-
[00:13:32] Nicole: Love
[00:13:32] Leslie Fletcher: that ... positive. Yes. We're not following up- Right ... 'cause there's a problem.
[00:13:35] Nicole: Mm-hmm.
[00:13:36] Leslie Fletcher: We're, we're reviewing your images- Yes ... 'cause this is an investment. Yes. [00:13:40] Mm-hmm. Yeah, so come in for your image review session.
Are you kidding me? So, yeah. That's
[00:13:42] Nicole: a great, yeah. It just changes their mindset, for sure.
[00:13:44] Leslie Fletcher: It does. Yeah. Like, we're just gonna... I mean, it's showing them the value. Mm-hmm. I, I keep looking at this, like, Louis [00:13:50] Vuitton purse. Yeah. What if you bought that, but then shoved it in a closet and never got to look at it again?
Right. Mm-hmm. And, like, you're like, "I don't know. Was it worth it? Like, I, I never even used that." That's so true. But when you look at the [00:14:00] image review and you're, like, celebrating the wins- Mm-hmm ... look at your brows, look at your skin texture, look at... And you look at every little thing, that value is then increased- Yes, absolutely
so easily [00:14:10] with the patient. And they're gonna be like, "Well, I'm never living without this again." Right. "Look what it did for me." Yep,
[00:14:14] Nicole: yep. And that is true, 'cause sometimes I'll have a Botox patient come back, like, six months later and I'm like, "So how'd you like it?" Yeah. And they're like, "I don't really remember."
[00:14:19] Leslie Fletcher: [00:14:20] Yeah.
[00:14:20] Nicole: Like, you know,
[00:14:20] Leslie Fletcher: and like- I guess it was okay. Yeah. I mean. Like, "
[00:14:21] Nicole: Oh, I'm not really sure." So that is a, that's a great idea.
[00:14:24] Leslie Fletcher: Mm-hmm. Yeah. So then you pull them up and you're like, "Here's what it was. Do you wanna do that again?" Yeah. Mm-hmm. "Did you like the way it did your neck? Did you like..." You know, so they get to [00:14:30] see that purchase again.
Yeah.
[00:14:31] Nicole: And you guys, do you feel like you're typically on everybody doing full face tox?
[00:14:34] Leslie Fletcher: Oh, yeah.
[00:14:35] Nicole: Yeah. Yeah.
[00:14:35] Leslie Fletcher: Yeah. There's no more
[00:14:36] Nicole: just
[00:14:37] Leslie Fletcher: upper- Our, our-
[00:14:37] Nicole: Yeah ...
[00:14:38] Leslie Fletcher: our average is, like, 96 [00:14:40] units- Yeah ... in our practice. Okay.
[00:14:41] Nicole: That's
[00:14:41] Jon: great.
[00:14:42] Leslie Fletcher: Yeah.
[00:14:42] Jon: Yeah. Yeah. Well, you said it on stage. You said, "That's typically my problem. I'm ran out of tox.
I need
[00:14:46] Leslie Fletcher: more." I did. I hadn't even started. I was like, "Oh my gosh, I'm out." I had [00:14:50] 100 and I'm like, "Where, where's the rest of it?" Where'd it go? I could've used easily 150, but- Yeah. Yeah ... it did well. Yeah.
[00:14:56] Jon: I love it.
[00:14:57] Leslie Fletcher: Yeah.
[00:14:57] Jon: I love it. Um, what is your, [00:15:00] um... Off topic, but what is your favorite place to vacation?
[00:15:03] Leslie Fletcher: Oh my gosh.
Um, I am a cold weather gal. Oh, okay. I don't like sun, I don't like heat, and I really don't like [00:15:10] the beach. How terrible am I? No. I live at the beach. That's
[00:15:12] Jon: why you look the way you do.
[00:15:13] Leslie Fletcher: Oh. Um, so we're actually going to Ireland in a month. You are? And I've been before. That's amazing. And I think just, like, [00:15:20] mountains, fog- Yeah
you know, greenery. Like, just cozy weather- Mm-hmm, mm-hmm Want to relax and, you know- I love that ... a comfortable bed kind of place. Yeah. But yeah. Yeah. [00:15:30] I l- and I love old buildings and old, you know, design, and so anything European- Yeah ... is gonna be-
[00:15:37] Jon: Now, please tell me you're seeing The Devil Wears Prada 2.
[00:15:39] Leslie Fletcher: Oh [00:15:40] my gosh.
I- we're having, like, a whole work thing. I- Oh. Oh, I love that. I'm like, "Everyone's wearing blue." Okay, tell me about it. Like, it's a whole thing. Yeah,
[00:15:46] Jon: cerulean. Yeah. Cerulean.
[00:15:47] Leslie Fletcher: I'm all cerulean. Mm-hmm. Exactly, yes. Mm-hmm. Yes, the s- the [00:15:50] different ... Oh, I love that movie so
[00:15:52] Jon: much. That's the best. That's the best.
[00:15:52] Leslie Fletcher: And you know why I wanna take my staff?
Here's a secret. Hopefully they don't watch this.
[00:15:57] Jon: It'll be after.
[00:15:57] Leslie Fletcher: I feel like I need to be a [00:16:00] little more like Miranda. Like, I, I, I know she's- I do, too ... she's the villain. But, like, I f- any support you can give me helps me be a better [00:16:10] person. Mm-hmm. So- Yeah ... if you see me walking in the door and I've got 18 bags- Mm-hmm
and they're falling all over the place- Okay ... like, do me a favor and open the door. Yeah. Right. 100%. Just open the door for me. Yeah. Don't make me ask- Yeah ... 'cause then [00:16:20] I feel bad. Yep. But, like, help me help you. Mm-hmm. You know?
[00:16:24] Nicole: So true.
[00:16:24] Leslie Fletcher: Yeah. 'Cause we're busy, as you mentioned. Mm-hmm. And busy owners and training and, and anything [00:16:30] I can do- Mm-hmm
to, like, take anything off my plate. Yeah. And, and Miranda does that so well. Yeah. She doesn't-
[00:16:35] Jon: Oh ...
[00:16:35] Leslie Fletcher: she doesn't do any of that stuff. Queen of delegation. I mean, she's, you know, her execution is not the [00:16:40] best. Yeah. And I won't be like that, but, you know? Her,
[00:16:43] Jon: the
[00:16:43] Leslie Fletcher: smart-
[00:16:44] Jon: Support ... fat girl.
[00:16:44] Leslie Fletcher: Exactly. Yeah. I
[00:16:47] Jon: just-
[00:16:47] Leslie Fletcher: Yes.
I'm so excited to see
[00:16:49] Jon: it. Oh, [00:16:50] God. Yeah. It's gonna be great.
[00:16:50] Leslie Fletcher: And, of course, the fashion. No,
[00:16:51] Jon: that's so true. I know. I, my, my employees, I, I, I wanna make it so good that they don't wanna leave.
[00:16:57] Leslie Fletcher: Same.
[00:16:58] Jon: You know? Same. And I l- and it ... I [00:17:00] don't even mean that, like, in that way. I just- Yeah ... I genuinely love and care for them.
I agree. And they honestly do provide the best care for our patients. They treat them a lot like I do- Mm-hmm ... which is important.
[00:17:09] Leslie Fletcher: Mm-hmm.
[00:17:09] Jon: [00:17:10] Um, but like you said, I, I, if they're ever bored I'm like, "Oh, no, there's things that we could do."
[00:17:14] Leslie Fletcher: Yeah.
[00:17:15] Jon: Let me find you something. There's always something to do. Yeah,
[00:17:16] Leslie Fletcher: yeah.
[00:17:17] Jon: Um, yeah.
[00:17:18] Leslie Fletcher: Yeah. Mm-hmm. But my [00:17:20] mistake is not asking. Yeah. Like, I just need to be a little bit ... Instead of expecting them to read my mind- Yeah ... and be like, "Why wouldn't you get me my coffee?" Like, "It's 2:00. I'm dying." What's
[00:17:29] Jon: [00:17:30] your sign?
[00:17:30] Leslie Fletcher: I don't even know. I don't- What's your birthday? I'm on the cusp. I'm, like, between the Libra and the, the
I don't know. It's October 23rd, so I'm, like, both Scorpion and- Oh ... [00:17:40] Libra or Leo. Oh. I don't know.
[00:17:41] Jon: Interesting.
[00:17:42] Leslie Fletcher: But I, I definitely expect people to read my mind. Yes.
[00:17:45] Jon: Yeah. That's how I am. And I get
[00:17:46] Leslie Fletcher: mad when they don't. Yeah. Yes.
[00:17:47] Jon: Like, I
[00:17:47] Leslie Fletcher: don't know what's wrong with that. Yeah.
[00:17:48] Jon: Yes. My husband says that all the [00:17:50] time.
He goes, "Use your words." I was just telling him- Use your
[00:17:51] Leslie Fletcher: words, that's
[00:17:52] Nicole: a toddler phrase,
[00:17:53] Leslie Fletcher: you
[00:17:53] Nicole: know,
[00:17:53] Leslie Fletcher: right?
[00:17:53] Jon: I know, but I'm like, you can't think? Yeah. Like, see ahead? Yeah. Yeah, I do the same thing,
[00:17:58] Nicole: and my husband will be like, "You never said that out loud." [00:18:00] Yeah. And he's like, "You might've said that in your head-" No.
but that never came out of your mouth." That's a great
[00:18:03] Leslie Fletcher: phrase. Yeah. Like, sure. Well, he
[00:18:04] Nicole: should be
[00:18:04] Leslie Fletcher: in there, is the problem. Yeah.
[00:18:06] Nicole: Yeah. Exactly, he should be reading it.
[00:18:07] Leslie Fletcher: The problem is he's not in there. It's [00:18:10] not you not saying it.
[00:18:11] Nicole: Thank you. Thank you.
[00:18:12] Leslie Fletcher: I'm with you. I'm on your side.
[00:18:13] Jon: Oh, my God. Oh, my gosh.
[00:18:16] Leslie Fletcher: Um. Yeah.
[00:18:17] Jon: What other questions? I have a question. Yeah, go ahead.
[00:18:19] Nicole: Um, [00:18:20] what's one thing that you wish, like, every patient knew before they walked in your door?
[00:18:25] Leslie Fletcher: I guess, okay, so Guy, this is like deep dive stuff into my psyche. [00:18:30] And, and I hate saying this, but I wish they knew how skilled I was. Yes. Is that terrible? No, abso- no, not at all.
And again, it's my own fault. Like, I am not a good promoter of me.
[00:18:39] Jon: [00:18:40] Mm-hmm.
[00:18:40] Leslie Fletcher: My assistant's really good. She'll be like, "Do you even know?" But, like, sometimes they're a little bit bossy, and they're- Mm ... like, kinda condescending, and I wanna be like, "I [00:18:50] teach this stuff." Right,
[00:18:51] Nicole: right.
[00:18:51] Leslie Fletcher: Like, I kinda know- Research it
what I'm doing. Yep. Yeah. You know, don't question me. I mean, it's okay to question. Mm-hmm. But, like, yeah, I, I don't think a [00:19:00] lot of them know-
[00:19:00] Nicole: Yeah. Mm ...
[00:19:01] Leslie Fletcher: what they have. I really hate to say that, though.
[00:19:05] Nicole: Yeah, but it- I feel like it is hard to promote yourself sometimes.
[00:19:07] Leslie Fletcher: It's very hard.
[00:19:07] Nicole: Yeah, and it doesn't always feel genuine.
[00:19:09] Leslie Fletcher: It,
[00:19:09] Nicole: it, it-
[00:19:09] Jon: Especially if [00:19:10] you're- It
[00:19:10] Leslie Fletcher: doesn't feel right ...
[00:19:11] Jon: authentically humble. Yeah. Yeah. Like, you know what I mean? Exactly. Like, innately humble. Mm-hmm. Yeah.
[00:19:14] Leslie Fletcher: Yeah.
[00:19:15] Nicole: Yeah.
[00:19:15] Jon: Mm-hmm. What do you think, who, who is the most, would you say, the most important [00:19:20] role in the office? Who do you think has it? She does. Yes. Besides the injector and like maybe the owner.
[00:19:27] Leslie Fletcher: I mean, I, I gotta say, the medical [00:19:30] assistants are such an integral part in our success. Not only in, like, making us more productive- Mm-hmm ... because she went out of town one time [00:19:40] and I was behind every day by two hours. Yeah. Oh. So that's how much more prod- I'm seeing two hours worth of patients every day more because of her.
That's amazing. So definitely increasing our, [00:19:50] you know, procedure value per hour. But also just that relationship. Yeah. They have a little bit more of a less... It's more of a friendship- Mm-hmm ... versus a professional. Mm-hmm. And so they are able to kind [00:20:00] of pull out a little more of that relational side, which endears the patient to your practice forever.
Mm-hmm. 'Cause we're now friends, not necessarily- Right ... [00:20:10] clinician-patient relationship.
[00:20:11] Jon: How many more patients do you see having a medical assistant, would you say, a day? Well,
[00:20:15] Leslie Fletcher: if two hours is the case, that could be, you know, four Botox patients. Yep. [00:20:20] Or a Botox and a filler. Mm-hmm. 'Cause I do about an hour for fillers.
Mm-hmm. Um, or two fillers. So I mean, that 1,500 an hour- [00:20:30] Yeah ... kind of average is like three grand a day- Right, yeah ... that we're seeing. So medical... I'm a huge proponent of medical assistants- Yes. Yeah, me too ... for a busy injector.
[00:20:38] Jon: What message do you [00:20:40] have for the next generation of injectors, would you say?
[00:20:45] Leslie Fletcher: So I think building your patient [00:20:50] base on who you are- Mm-hmm
not necessarily personality-wise, but who you are as a clinician- Mm-hmm ... is key. And I listened to your talk, the virtual [00:21:00] talk on the social media. Oh. I thought it was really good, by the way. Thank you. And I love, I loved your balance. Like a little bit of fun, but not too much- Yeah ... so that it, you lose that clinical [00:21:10] respect.
[00:21:10] Nicole: You do.
[00:21:10] Leslie Fletcher: I think that's the easiest trap to get into for our newer injectors in the modern aesthetic field is like, "Oh, I could quickly g- gain [00:21:20] followers- Mm-hmm ... if I do these ridiculous things." Clickbait or
[00:21:23] Jon: ridiculous
[00:21:23] Leslie Fletcher: things, yeah.
[00:21:24] Jon: Yeah.
[00:21:25] Leslie Fletcher: And the clickbait, for sure. Mm-hmm. And then, but they're not seeing, like, these aren't [00:21:30] valuable prospective patients.
[00:21:31] Jon: Mm-hmm.
[00:21:32] Leslie Fletcher: These aren't your target demographic. Like, your j- followers are- Right ... that's, it's innocuous. Mm-hmm. Like, you're j- Mm-hmm ... not even a thing that- Mm-hmm ... you know, [00:21:40] matters- Mm-hmm ... i- if they're not coming in and actually getting the injections. Right. Mm-hmm. So are they quality or quantity? Mm-hmm. So really creating your internal brand, [00:21:50] your ethos, and, like, letting that come across clear on all of your channels, and then have it be the same as it is- Mm-hmm
in real life. In
[00:21:58] Jon: person.
[00:21:58] Leslie Fletcher: You know, in person, so it's not [00:22:00] like a, you know, disingenuous type situation where it's, like, fake.
[00:22:05] Jon: I think that can be hard for people Absolutely. It, it's like- It's, yeah ... how do I come across authentic on-
[00:22:09] Leslie Fletcher: [00:22:10] Yeah ...
[00:22:10] Jon: on socials, you know? It's
[00:22:11] Leslie Fletcher: a tough one.
[00:22:12] Jon: Yeah. But you have to, you know, it's hard and not everybody's good at it, and not everybody wants to show that personal side- Mm-hmm.
Mm-hmm ... you know, a little bit, which I [00:22:20] get. But I do think, like, doing a, showing a little bit of that, it does let people in.
[00:22:25] Leslie Fletcher: Yeah.
[00:22:25] Jon: You know? And they get to know you outside of being-
[00:22:27] Leslie Fletcher: Completely ...
[00:22:28] Jon: a provider.
[00:22:28] Leslie Fletcher: I real- that really resonated [00:22:30] with me- Mm-hmm ... because they come to see you because they want to be with you- You
as almost like a friend- Mm-hmm ... but they know you're a clinician, too.
[00:22:37] Jon: My patient, I had two patients this week, two, that literally [00:22:40] said, "I don't think I need anything. I just wanted to come see you." Yeah. Yeah. "But I'll spend my budgets around this." Yeah.
[00:22:44] Leslie Fletcher: No, it's true.
[00:22:46] Jon: And I'm like, "Oh my God."
[00:22:46] Leslie Fletcher: Yeah. It's okay. And obviously you're ethical enough, if they didn't need anything- Yeah[00:22:50]
you would send them away and be like- And want to put my said no ... "Well, you know what? We have you on the schedule, let's just chat." Yes. "How are you feeling?" Like, "How's that, you know, I know you were struggling with this thing at work." Yeah. Like, "How's that going?" Mm-hmm. And that is [00:23:00] what's gonna separate you from the people who are just- Sure
in it for the money and to see, like, 40 patients a day. You're like, "I don't have time for this." Yeah. That's not gonna happen at your practice. Mm-hmm. And [00:23:10] that's gonna bring the loyalty. Mm-hmm. And in the long run, that lifetime value of the patient is so much more important than getting a bazillion patients in to spend- Oh, it's so true
$200 each [00:23:20] time.
[00:23:20] Jon: Mm-hmm.
[00:23:20] Leslie Fletcher: And that's exhausting as an injector.
[00:23:22] Jon: So exhausting.
[00:23:23] Leslie Fletcher: Yeah.
[00:23:25] Jon: Okay.
[00:23:25] Leslie Fletcher: Yeah.
[00:23:26] Jon: I love it.
[00:23:26] Nicole: Yeah.
[00:23:27] Jon: Um, do you have any advice for us, Leslie?
[00:23:29] Leslie Fletcher: [00:23:30] You guys are really good, um, journalists. Very amazing. Oh, really? Yeah. Thank you. Yeah. Oh. Absolutely good. Um, [00:23:40] I, I don't know, I love the way you repurpose things.
You have little clips- Okay ... and you don't just do the whole, like, two-hour interview. Mm-hmm. Mm-hmm. You pull out some important things. Um, just make sure the whole story is told. Yeah. Yes. [00:23:50] Sometimes when you just pull a little piece, it's like, is that really the intent of the whole thing? Right. Mm-hmm. Um, which is hard in editing.
I don't know if you do all your post-edit stuff, but... Oh, there's the guy right there. [00:24:00] Well, so this is, I mean, this is a struggle- Yeah ... 'cause I do all my own video edits- Sure ... for work too, which is, you know, no small feat, by the way. Mm-hmm. Oh. I keep telling my team, it's one hour per [00:24:10] minute. Whatever minute you see- Oh my gosh
on Instagram, that's one hour of edits. Mm-hmm. But I tried, I tried delegating that out, and it was really hard because, like, [00:24:20] they don't know what my goal is with this. Mm-hmm. Mm-hmm. Like, there's always a, like, a strong rationale for why I want this particular cut or this particular thing because it's, it's a [00:24:30] message that I wanna get across, and that's hard for someone who's- Very hard
you know, a great video editor, which I don't think I'm great, but at least I know what I want. Right. You know? So-
[00:24:39] Nicole: You know the message, [00:24:40] yeah. Yeah.
[00:24:40] Leslie Fletcher: So that's hard. It is hard. Um, I don't know if you give direction for that. Like, "Hey, we, we're looking for this type of message." Yeah.
[00:24:46] Nicole: We do. And he'll- And he'll usually send us a nice long clip, and then we give him, [00:24:50] like- Chop.
Yeah ... yeah, exactly, what we can pull from it- Yeah ... and what we can take away from it.
[00:24:53] Jon: He'll like-
[00:24:53] Leslie Fletcher: Yeah ...
[00:24:53] Jon: give us, like, four options. It's very laborious. "Is this good? What are you looking for?" Yeah. That kind of thing.
[00:24:57] Nicole: And we did, we ran into that in the beginning. People were, like, [00:25:00] commenting stuff on our reels.
Yeah. And then we'd be like, "Oh, well, if you listen to the whole episode-" Yes ... you know, you would... And like, you don't realize, like, the, especially the people that follow you on Instagram, really some of them aren't listening. Yeah. So they're not getting that full picture. [00:25:10] Oh, no. And then they're like- Yeah
"Wait, so what are you..." You know? So we kind of- Mm ... found that out in the beginning. You gotta definitely close that-
[00:25:15] Leslie Fletcher: Right ...
[00:25:15] Nicole: thought when you're in the reel, you know?
[00:25:17] Leslie Fletcher: Or at least in the copy somehow. Yeah. Like, give the overall [00:25:20] theme of it. Yeah. Right. But I mean, balancing, you've got this whole other business too.
So- Mm-hmm ... um, what, what are your goals for this particular business? What is it, what [00:25:30] is it, what are you hoping to achieve with the, the podcast?
[00:25:33] Jon: I think-
[00:25:33] Nicole: Like, right, just like giving everyone exposure and like also giving education without having to pay for [00:25:40] it or- Mm-hmm ... you know, and like getting a ton of different minds- Mm-hmm
and being able to share that with everyone-
[00:25:44] Leslie Fletcher: Yeah ...
[00:25:45] Nicole: without, you know, a fee or a,
[00:25:47] Jon: you know- I wanted to build a community. Mm-hmm. And I, [00:25:50] um, we wanna get more involved with the conferences- Mm-hmm ... and actually have like a booth maybe- Mm-hmm ... you know, at, whether it's AES or- Yeah ... AMSPA next year. Even this, maybe next year we'll actually [00:26:00] get in early enough to get a booth.
But I think we wanna bring in just people that ha- are like-minded- Mm-hmm ... and wanna share their experiences and be transparent, authentic, don't gatekeep- [00:26:10] Mm-hmm ... you know, and give their secrets of what they do. Yeah. You know, everyone has their own story.
[00:26:14] Leslie Fletcher: Right.
[00:26:14] Jon: Um, and I think it's just, uh, even more now, just so important to [00:26:20] have that community.
Mm-hmm.
[00:26:20] Leslie Fletcher: Mm-hmm.
[00:26:21] Jon: And so that we can reach out to someone and not be alone on an island somewhere. Right. You know what I mean? Right. Especially with this whole PDGF-
[00:26:27] Leslie Fletcher: Yeah ...
[00:26:27] Jon: d- debacle this past year, which was really sad. Mm-hmm. And [00:26:30] that's what saddened me. Mm-hmm. You know? Um, 'cause it just makes our profession-
[00:26:33] Nicole: Yeah, and it divided a lot of people.
[00:26:34] Jon: It divided a lot
[00:26:35] Leslie Fletcher: of people. It really did. It got, like, very political. It was like- Oh ... "Are you thi- are you [00:26:40] pro-PDGF- Wait ... or are you..." I mean, like.
[00:26:41] Jon: It was so political.
[00:26:42] Leslie Fletcher: Yeah. Mm-hmm. It was like- It was like, "Let's not talk about this at the dinner table." Yeah. "Let's just have friends." Yeah. Yeah. Guys, don't
[00:26:47] Jon: bring up
[00:26:47] Leslie Fletcher: PDGF with me.
Which is really sad. Exactly, [00:26:50] yeah. It's like, you know, we're clinicians and we see things differently. Yeah. And I, I respect both sides. Sure. I really do. I just, I think dogma is, is [00:27:00] very divisive. Mm-hmm. And you can't, you can't be black and white about things. You've just gotta say, "Hey, for me, I'm not comfortable with-
[00:27:07] Nicole: Mm-hmm
[00:27:08] Leslie Fletcher: X, Y, and Z- Mm-hmm ... because of X, Y, and [00:27:10] Z." Or, "Hey, for me, I'm completely comfortable with it because I- Right ... did the research, I did whatever." A- instead of like making someone feel that they are, um- [00:27:20]
[00:27:20] Jon: Incompetent ...
[00:27:21] Leslie Fletcher: in- unsafe or untrustworthy or, uh, I don't know, maybe even like money hungry. Like I think I, I said, [00:27:30] I said this in the class, like-
[00:27:31] Jon: Yes
[00:27:31] Leslie Fletcher: it's not my favorite procedure to do. Mm-hmm. It's very hard.
[00:27:34] Jon: It is.
[00:27:35] Leslie Fletcher: Time consuming. The, the ROI is not like amazing on it for the amount of time it takes [00:27:40] to put in. My shoulder is killing me afterwards 'cause the- Yeah ... the, you know, the execution has to be- Right ... so like m- you know, rhythmic and all this stuff.
Mm-hmm. And it, it's [00:27:50] not. A- and it lasts like we're looking at 18 months right now. I know. So it's not the best revenue maker.
[00:27:57] Jon: Right. Right.
[00:27:58] Leslie Fletcher: But in the end, it's [00:28:00] what's the best for the patient. For the patient. So I feel like the whole thing has been spun to been like, "You're money hungry." I'm like, "Well, actually, no."
Like, if I really was money hungry, I'd be doing toxin all day, and- Right ... [00:28:10] fillers that, you know, I would do short-acting fillers- Right ... at that. I would grab, like, the ones that last six months, not- Mm-hmm ... I'm going for the ones that last two years- Right ... because it's the best for the patient. Mm-hmm. [00:28:20] And the same for this.
It's like I'm picking the longest lasting procedure that is gonna give them the best value- Mm-hmm ... which is in a, in turn, actually- Mm-hmm ... I'm probably [00:28:30] gonna be losing money.
[00:28:31] Jon: Well, I feel like this drug, like, filled a void-
[00:28:34] Leslie Fletcher: It definitely filled a void ...
[00:28:35] Jon: in our profession, really.
[00:28:37] Leslie Fletcher: Yes. And that's how I've tried to launch it, [00:28:40] is as an alternative to fillers in areas I wouldn't do fillers.
Forehead, superficial temple, noses, um, some of the lateral A [00:28:50] frame, you know, all of the eyebrow shaping, and the lid rejuvenation. Some of the areas that just fillers either are completely unsafe. Mm-hmm. I [00:29:00] mean, we know almost 30% of all cases of blindness come from the forehead. Mm-hmm. So I'm never gonna put filler there, ever.
I don't care if it's FDA approved. Sure. It's not happening. So there was no alternative, [00:29:10] uh, or the product's FDA approved, but the technique would be off-label. Um, but it's not happening. So then there were a lot of patients who needed, you know, volumization- [00:29:20] Mm-hmm ... in the forehead, especially with all the GLP-1s.
Oh. And then the resistant toxin patients. Mm-hmm. And there was just, there's a gap, and this product filled it. It filled it. And-
[00:29:29] Jon: [00:29:30] Mm-hmm ...
[00:29:30] Leslie Fletcher: you know, it's just- Mm ... we've made a way to make it work.
[00:29:33] Jon: Especially
[00:29:34] Leslie Fletcher: the under-eye. Legally... Yeah, I mean, under-eye sometimes- It's amazing ... patients that aren't good candidates for an [00:29:40] FDA-approved product under there, you make the case that this is actually better for them.
Right. Whether they have, you know, malar edema. They've got allergies. Mm-hmm. They wake up puffy in the [00:29:50] morning- I've actually seen it- ... bags ...
[00:29:51] Jon: help malar edema.
[00:29:52] Leslie Fletcher: It helps with malar edema. It helps with under-eye bags. '
[00:29:55] Jon: Cause I'm thinking it
[00:29:56] Leslie Fletcher: strengthens- Discoloration ... the
[00:29:57] Jon: muscle.
[00:29:58] Leslie Fletcher: It, it strengthens the skin on top [00:30:00] of it to kind of compress all that stuff back in.
It thickens the dermis.
[00:30:03] Jon: Okay.
[00:30:04] Leslie Fletcher: Well, the way I do it, but yes. I- It thickens the dermis ... I do it your way. Yeah.
[00:30:07] Jon: With a cannula.
[00:30:08] Leslie Fletcher: Yeah. So-
[00:30:08] Jon: I've always done it your [00:30:10] way.
[00:30:10] Leslie Fletcher: Yeah. You don't want it in the muscle. You want
[00:30:11] Jon: it- I didn't do it needle to bone-
[00:30:13] Leslie Fletcher: Yeah ...
[00:30:13] Jon: for, at least personally. Yeah. But I've, I've always had good results with cannula.
Right. And then that was helpful. And most of the fibroblast activity anyway [00:30:20] is more superficial.
[00:30:20] Leslie Fletcher: It's, it's very superficial. Yes. So all that skin textural strength, strengthening is happening up in that dermal layer.
[00:30:26] Jon: You should host, um, her-
[00:30:28] Nicole: I know, we should do
[00:30:28] Jon: one ... at your new facility. Yeah, [00:30:30] yeah. She's getting a new practice.
Yeah. Yeah.
[00:30:31] Nicole: Two rooms. Oh, okay. So yeah, we're gonna have a bigger training area, so yeah,
[00:30:34] Leslie Fletcher: we should. Very good. Yeah. Yeah. Yes. I think there's, the need is there- Yeah ... for sure. For sure. Yeah. The need [00:30:40] is there for all training, advanced training, innovation, you know, kind of changing the way people think about things because I don't think it's as simple as- Mm-hmm
some of the rudimentary trainings [00:30:50] that are out there now kind of make it. And I mean, I was a victim of that too, and I was even a creator of... I do have a fundamental class, and we teach kind of the basics, but it's like, you guys, this is [00:31:00] like, you're just scratching the surface. Right. The innovation- Mm ... in this field is
[00:31:04] Jon: so progressive.
Well, your obscure, 75 obscure use course- Yeah ... for Botox, incredible. Yeah. I mean, I did it twice, [00:31:10] but even after the first time, my unit dosage went up.
[00:31:13] Leslie Fletcher: Mm-hmm. Right.
[00:31:13] Jon: And I was just more comfortable doing other things. Yeah. And, uh, Alicia, my injector, who took your course- Mm-hmm ... I think when you came to Syracuse, she was, she to this [00:31:20] day told my newest injector, she's like, "That changed everything for me."
[00:31:23] Leslie Fletcher: Oh, wow. Yeah. That's great.
[00:31:24] Jon: So,
[00:31:25] Leslie Fletcher: thank you very thankful. And it, you know, it's not about increasing units, right? No, no, no. It's about making the patient happier. More comfortability, confidence. So I'm sure [00:31:30] they were... Your patients', your satisfaction went up as well. It
[00:31:33] Jon: did. Yeah. '
[00:31:34] Leslie Fletcher: Cause you're now able to treat things that they've been concerned with.
[00:31:37] Jon: Yes.
[00:31:38] Leslie Fletcher: And you didn't have a way to do it [00:31:40] before.
[00:31:40] Jon: It increased their confidence. Yep. For sure.
[00:31:42] Leslie Fletcher: For sure.
[00:31:43] Jon: Yeah.
[00:31:43] Leslie Fletcher: Yeah. Mm-hmm. And that's a gift. It is. So every training that you take as a newer injector, as an, uh, seasoned [00:31:50] injector, it's a gift for your patients. I mean, it is essentially- It's so true ... benefiting them.
Yep.
[00:31:55] Jon: Mm-hmm.
[00:31:55] Leslie Fletcher: Yeah.
[00:31:56] Jon: And patients see that. They do. They see us going to conferences and- Well, they [00:32:00] should. Yeah. And, well, I know, and I'm sure you get it, too, and I'm sure you get it, too. They appreciate it. They're like, "I come to you because I just feel-" Yeah ... "like you're so innovative." Yeah. And you question things and, you know, you learn.
[00:32:10] You're constantly learning. Yeah. You're not just settling.
[00:32:11] Leslie Fletcher: Yeah.
[00:32:11] Jon: You know? Just-
[00:32:12] Leslie Fletcher: Yeah. I have, I have some patients say that, too. But some of them are like-
[00:32:15] Jon: I don't know ... "
[00:32:16] Leslie Fletcher: Why are you always gone?" Yeah. Like, "Why?" Join in. And I'm like, "But you don't understand, like, I'm doing [00:32:20] this for you." Yeah. This is, this is for you.
I'm getting to be... Every time I go to this, like, I get better. I'll just be
[00:32:23] Jon: in the corner, and I'll just say, "She's a really big deal."
[00:32:25] Leslie Fletcher: Yeah. I'm sorry if that interferes
[00:32:29] Jon: with your schedule. That's why. [00:32:30] We depend on her to be on stage-
[00:32:31] Leslie Fletcher: Yeah. We need her ...
[00:32:32] Jon: and to do her job.
[00:32:34] Leslie Fletcher: We need her. Yeah. Oh
[00:32:36] Jon: my gosh.
[00:32:37] Leslie Fletcher: But-
[00:32:37] Jon: I love it
[00:32:37] Leslie Fletcher: we're changing, changing the [00:32:40] industry, the field-
[00:32:40] Jon: Um, yes ...
[00:32:41] Leslie Fletcher: one person at a time, one technique at a time, one training at a time. Mm-hmm. And then that impacts the patients.
[00:32:47] Jon: Yeah. Are you, is your name in a [00:32:50] textbook yet?
[00:32:51] Leslie Fletcher: No.
[00:32:51] Jon: It needs to be. It will be.
[00:32:54] Leslie Fletcher: I doubt that.
[00:32:55] Jon: Yeah, you know, like, social studies textbooks- Uh-huh
it'll be in there.
[00:32:58] Leslie Fletcher: Well, I am a grandma. So I [00:33:00] guess I am old enough to be in a textbook at this point in time. She's a
[00:33:03] Jon: grandma but doesn't look like one. No, no,
[00:33:04] Leslie Fletcher: no. I hope not. I hope not. Our little ones are the same age. Oh, no. I think you're, like, maybe a couple weeks [00:33:10] apart. Yeah. So I always-
[00:33:10] Nicole: He's 11 months today.
Yeah.
[00:33:11] Leslie Fletcher: I will send my daughter your thing. Yeah. I'm like, "She's feeding him solids."
[00:33:14] Nicole: Yeah. "
[00:33:15] Leslie Fletcher: Let's get going."
[00:33:16] Nicole: Oh, he's throwing them up, so.
[00:33:17] Leslie Fletcher: Yeah. Oh, is he? He's like- I'm like, "He's [00:33:20] in a highchair. Why don't you put Tate
[00:33:22] Nicole: in the high..." Yeah. I'll get him in a highchair.
[00:33:22] Leslie Fletcher: Yeah.
[00:33:23] Nicole: Oh, yeah, he can do, like, the soft stuff. Uh-huh.
But anything that's still, you have to chew, he struggles with.
[00:33:28] Leslie Fletcher: Yeah. Yeah,
[00:33:28] Nicole: yeah.
[00:33:29] Leslie Fletcher: So you're not into the [00:33:30] whole, like, hand him a stick and let him gnaw situation? Mm-mm.
[00:33:32] Nicole: No.
[00:33:32] Leslie Fletcher: They did that. Oh my gosh. He had, like, a filet,
[00:33:33] Nicole: and he was like- Oh my gosh ...
[00:33:36] Leslie Fletcher: and he didn't know what to do with it. Oh,
[00:33:37] Nicole: it gives me so much anxiety.
[00:33:38] Leslie Fletcher: I know. She was stressing, [00:33:40] too,
[00:33:40] Nicole: but- Yeah, yeah. He'll, like, cough, and I'm like, "What happened? What's wrong?"
[00:33:42] Leslie Fletcher: Oh, geez. Yeah.
[00:33:44] Nicole: It's so much fun. Yeah. Oh, it's, like, the best age, too, right now. They're,
[00:33:47] Leslie Fletcher: yeah, they're
[00:33:47] Nicole: great. Just, just smiling and learning [00:33:50] everything. Yeah. And you can
[00:33:51] Leslie Fletcher: see
[00:33:51] Nicole: his little
[00:33:52] Jon: personality. Just little
[00:33:52] Nicole: themselves.
Awesome grandma. Yep.
[00:33:53] Jon: Aw, thanks. Yeah. Is that your
[00:33:55] Leslie Fletcher: first one? Yeah. Oh, okay. Yeah. That is fun. Yeah, it's- And nerve-wracking.
[00:33:58] Nicole: Keeping us busy, yeah. Oh, yeah. Yeah.
[00:33:59] Leslie Fletcher: [00:34:00] Yeah,
[00:34:00] Jon: they're, um... I mean, you've been an, an injector for 20? 26.
[00:34:04] Leslie Fletcher: Mm-hmm. 26. 26
[00:34:06] Jon: years.[00:34:10]
[00:34:13] Leslie Fletcher: Right. So I had my, I had, she was roughly two- Yeah ... I think a little younger than two, and then- Mm-hmm ... the other [00:34:20] one was born right around then.
[00:34:21] Jon: So I think you should ask her. 20. Yeah. I mean, she is a practice owner- Uh-huh ... doctor, you know.
[00:34:26] Leslie Fletcher: But I wasn't at that age.
[00:34:28] Jon: Okay,
[00:34:28] Leslie Fletcher: okay. Yeah, true. I, I worked for [00:34:30] someone when they were little like that.
[00:34:32] Jon: Did you? Yeah. And I, yeah. But even when they were older, like- Yeah ... owning a practice and growing and making sure you're a mom and doing all of that. Oh,
[00:34:37] Leslie Fletcher: totally. What- Oh, I said this at one of my last [00:34:40] conferences I did on, like managing practice and home. Mm-hmm. In all of my ancillary staff's job description was like, "May run personal errands for Leslie."
[00:34:50] And those personal errands were picking up the kids from school. Yes. And like, so we would set a timer and I'd be like, "Oh my gosh, it's 2:45. You gotta go get Ashley. You got..." You gotta go get Ashley. You know, and then [00:35:00] like everyone ha- and then the front person would leave, and she'd put out a little sign like, "We'll be right back."
Aw, yeah. And she'd go pick up my youngest from school and, you know, everybody just kind of helped out. Yeah. Pitches in, right? But it was in the job [00:35:10] description to be- Yep ... you know,
[00:35:11] Nicole: helping
[00:35:11] Leslie Fletcher: out.
[00:35:12] Nicole: This is gonna be happening. Yeah. When he was probably up until like seven or eight months when he's a little quieter- Yeah
we would, we would bring him to the office, like my manager would have him in the back. Oh, yeah. Yeah. And like, just for like things that I had to [00:35:20] be there and- Oh, sure ... and I didn't have anyone.
[00:35:21] Leslie Fletcher: Yeah.
[00:35:22] Nicole: Um, but now he's like-
[00:35:23] Leslie Fletcher: He's
[00:35:23] Nicole: a little too boisterous ... he just wants to be everywhere. Yeah. And he is like yelling and, which is fine, but you don't really want your patients hearing that.
[00:35:29] Leslie Fletcher: [00:35:30] Yeah. It depends
[00:35:30] Nicole: on how
[00:35:30] Leslie Fletcher: big your facility is- But so... Yeah, exactly, yeah ... and the person you have watching them. Yeah. But we had three babies at our practice the same month- Oh my gosh ... a year ago. Yep. [00:35:40] They all got a little nanny- Mm-hmm ... and had the sitter on-
[00:35:42] Nicole: I love
[00:35:43] Leslie Fletcher: that ... at the practice. Yep. Yeah, so they shared one.
'Cause you just have to, you have to do
[00:35:45] Nicole: what you gotta do.
[00:35:46] Leslie Fletcher: Yeah. Yep. They shared one.
[00:35:47] Jon: I've thought about doing that. You thought about it?
[00:35:49] Leslie Fletcher: Yeah.
[00:35:49] Jon: My [00:35:50] new office, because they're all having kids, and-
[00:35:51] Leslie Fletcher: Yeah. Yeah. So if you have a s- so ours is 7,000 square feet, so we do have like the institute size. Ours
[00:35:56] Jon: is 6,500.
[00:35:57] Leslie Fletcher: And we had enough room, and so I said, [00:36:00] "Until they start, like, toddling around- Like...
Yes, yep ... and pulling down the, you know, skeletons- Yeah ... that are around here- That's, that's a relief ... um, you can bring the babies." I mean, how
[00:36:08] Jon: great is that?
[00:36:08] Leslie Fletcher: Oh, the breastfeeding [00:36:10] alone. It's, oh. It was just, it made it easier for them and easier for us. Yeah. That pumping break is-
[00:36:14] Jon: Actually, we shouldn't talk about this 'cause now they're gonna expect it.
[00:36:16] Leslie Fletcher: I know. Sorry, guys. They're gonna- Yes. Yeah. They're all gonna be like- Get a nursery Well, I [00:36:20] heard.
[00:36:20] Nicole: Yeah. I can, I can just pop in there. Yeah. Redo here. Yeah.
[00:36:22] Leslie Fletcher: Yeah. It's too funny.
[00:36:23] Nicole: Yeah.
[00:36:24] Leslie Fletcher: Well, you said you wanna keep them there. You don't wanna them leave. I do. Yeah. And that's a huge value added- Yeah ... to be able [00:36:30] to bring their baby to work.
Yeah. Mm-hmm.
[00:36:32] Jon: Huge. Yeah. Do you guys offer 401and- We
[00:36:34] Leslie Fletcher: do ...
[00:36:34] Jon: benefits?
[00:36:35] Leslie Fletcher: Yep.
[00:36:35] Jon: Yep. Same.
[00:36:36] Leslie Fletcher: Yep.
[00:36:36] Jon: Yep.
[00:36:37] Leslie Fletcher: Same.
[00:36:37] Jon: Yep.
[00:36:38] Leslie Fletcher: Yeah. That's great. Yeah. We, we, [00:36:40] we want it for the long haul. Yeah. When we interview it's like, "So, what are you doing in the next- Want lifers ... like 20 years?" Yeah. 'Cause you're not leaving.
[00:36:46] Nicole: We all joke, we're all like, "We're, we're being buried under this building."
Yeah. We
[00:36:49] Leslie Fletcher: all [00:36:50] have
[00:36:50] Nicole: lots next to each
[00:36:50] Leslie Fletcher: other. Yeah. We- Exactly.
[00:36:52] Nicole: Ah, no one's leaving.
[00:36:53] Leslie Fletcher: Yeah. Yeah. We hope that. 'Cause it just, it's just so just- disruptive and just- I know ... it just breaks the [00:37:00] whole family, you know? It does. It's a family. Like, and so when anyone leaves, it's like, ugh, all the dynamics are different- It is
and all that. You
[00:37:07] Jon: have to adjust. So-
[00:37:08] Leslie Fletcher: Yeah, you have to adjust ... we like 'em to stay.
[00:37:09] Jon: Yeah. Yeah. [00:37:10] Um, thank you so much for coming today. Yeah, thanks for having me. And being our guest.
[00:37:14] Leslie Fletcher: We covered a lot. Yeah.
[00:37:15] Jon: This was amazing. We had a different angle. Yeah, a lot of different angles. Oh, yeah.
[00:37:17] Leslie Fletcher: From playpens to, you know, innovations.
[00:37:20] Innovations. Yes. Yeah. Yeah. I
[00:37:22] Jon: love it.
[00:37:22] Leslie Fletcher: Yeah.
[00:37:23] Jon: And then we'll have to have you on again, 'cause we have- Yeah ... I mean, we could talk for hours. We
[00:37:26] Leslie Fletcher: could talk for hours. Yeah. I could talk for hours. I'm talking, it's
[00:37:29] Nicole: good. And, um, just [00:37:30] remind everyone where they can follow you and-
[00:37:31] Leslie Fletcher: Yeah, so I actually have two pages.
Our, our business... Well, four. Uh, five. I don't even know, but- Two more to count ... Injectability Beauty is kind of the main hub. [00:37:40] Um, Leslie Fletcher, NP is my personal but also professional. Um, and then we have Injectability Institute, and then we have, uh, Microtox, we have EtheraTox. We have Regenability, which is all the PDGF stuff.
And then I have Patreon,[00:37:50]
which I think- Mm-hmm ... is a, I, I'm bad at, I'm a really bad promoter, actually. I'm terrible. But-
[00:37:59] Jon: I am, too ...
[00:37:59] Leslie Fletcher: [00:38:00] um-
[00:38:00] Jon: She's really good.
[00:38:01] Leslie Fletcher: Do you guys have Patreons?
[00:38:02] Jon: She
[00:38:02] Nicole: does. We
[00:38:02] Leslie Fletcher: do, yes. I don't even know that. Yeah, yeah, yeah. Like, how terrible is that? I don't even know that. She's
[00:38:05] Nicole: great.
[00:38:06] Leslie Fletcher: Okay. Well, I promise four videos a month.
Mm-hmm. Sometimes [00:38:10] they come out in one day. Okay. 'Cause I'm like, "Ah." They come all out at
[00:38:13] Nicole: one time,
[00:38:14] Leslie Fletcher: yeah. Exactly. But, um, but I try to make it innovative- Mm-hmm ... and try to m- 'cause people are always, like, wanting to learn, you know, [00:38:20] and they don't- Absolutely ... live close by. Mm-hmm. And so, yeah, just put together a little video- Yeah
and kinda give the rationale and the technique and yeah. And then
[00:38:26] Nicole: you also have, which I think we both purchased, was your protocols
[00:38:29] Leslie Fletcher: [00:38:30] and- Oh, the protocols ...
[00:38:30] Nicole: yeah, all that. Yeah. The binder, yep. The protocols. The consents, everything,
[00:38:34] Leslie Fletcher: so. It's like 120 documents. Mm-hmm. Each one's, like, 12 to 15 pages of protocols all [00:38:40] written, you know, by a medical provider- Mm-hmm
over the course of 10 years. And it, they're changing, constantly changing, and then the consents as well to go with that. Yeah. So I try to make it [00:38:50] turnkey because I was just actually talking to the attorney at Lynnea Law yesterday. We did a, I did, I was pretending I was you. I did an interview with her.
[00:38:57] Nicole: I love it.
[00:38:58] Leslie Fletcher: I was like, "Ah, I look so [00:39:00] cool. I'm the interviewee."
[00:39:01] Nicole: Yeah.
[00:39:03] Leslie Fletcher: Or interviewer, I guess. Yeah.
[00:39:04] Nicole: That's great.
[00:39:05] Leslie Fletcher: Um, but she, I was asking her, like, "What's the biggest thing- Mm-hmm ... that you could recommend to people?" And she's [00:39:10] like, "Get your paperwork in order." Yeah. She's like, "That is the first thing they look for-" The first thing they look for.
Mm-hmm ... "is your protocols." And personally, having gone through, uh, gone through that- Mm-hmm ... like, six years ago, [00:39:20] um, a competitor called, and you know, the first thing the nursing board asked for was, "Well, let me just see your protocols." Mm-hmm. And I come out with this binder. It's, like, a D-ring. It's this thick.
It's all signed and [00:39:30] dog-eared and everything, and he's like, "You're gonna be fine." Like, literally closed the case. Yep. Yeah. Yeah. And that just felt really good. Yeah. And I think if you don't have that feeling of- [00:39:40] Confidence and just knowing that you- Can't sleep at night ... you can't. Yeah, I mean, it's- You have to be prepared.
Yeah. Yeah. The liability's too big. Right. We've worked too hard. Yeah. So do it right.
[00:39:48] Nicole: Absolutely.
[00:39:49] Leslie Fletcher: Yeah. [00:39:50]
[00:39:50] Nicole: Well, thank you so much.
[00:39:51] Leslie Fletcher: Thanks for having me. Yeah. Appreciate it.
[00:39:52] Jon: We love you.
[00:39:53] Leslie Fletcher: We love you.
[00:39:54] Jon: And- Bye, guys ... till next time, guys, thanks for tuning [00:40:00] in.