This Is Sabotaging Your Skin: Theresa Pinson, Virtual Skin Spa Founder

Aesthetics Unscripted: Theresa Pinson on Safe Injectables, Filler Rheology, TikTok Trends & ‘Ozempic Face’ Solutions

Host Kim interviews Theresa Pinson, founder and CEO of Virtual Skin Spa, which operates two New York med spa locations (Jericho and Upper East Side). Theresa shares her path from early work at a Fifth Avenue clinic focused on Botox and fillers, to running a statewide wellness program centered on metabolic syndrome, to becoming an independent nurse practitioner injector after New York laws loosened. They discuss the “Wild West” of injecting, emphasizing education, filler rheology, facial continuity, and safety topics like cannula technique, injection planes, and the risks of vascular occlusion and blindness. Theresa addresses misinformation and TikTok trends, highlights services including trapezius slimming and “Ozempic face” treatment using tightening-first approaches and biostimulators like Sculptra and hyperdilute Radiesse, and shares views on neuromodulators including Daxxify and dilution. They also cover devices, ethics and uses of AlloClae cadaver fat, clinic philosophy, team training, and a new partnership with Well Labs Plus.

Transcript

SPEAKER_00 0:03

Welcome to Aesthetics Unscripted. I'm your host, Kim, your regenerative aesthetic expert. I'm here in Manhattan live, and I'm so happy to introduce you to Teresa Pinson, like me, a founder and CEO. She operates not one but two New York Med spas. Thank you for coming today, Teresa.

SPEAKER_01 0:22

Thank you for having me, Kim.

SPEAKER_00 0:23

Please brag up on yourself and let our viewers know all about your journey to get to Virtual Skin Spa and what's your passion behind it?

SPEAKER_01 0:33

Sure. So I first came to New York in 2002, and I worked for a company on Fifth Avenue called Skin Clinic, and it was the first time a business and a medical model had blended, and we focused on Botox and fillers. I ended up staying only about a year. I went back to Alabama, my home state, to work for the state government, and I ran a large wellness program. So I've always been passionate about health, wellness, health promotion, education. So basically, I took all of those principles and sort of parlayed that into aesthetics.

SPEAKER_00 1:06

That's amazing because I know the hot thing and should have been a hot thing from a long time ago is longevity. So how do we age, not just anti-aging, right, to make our faces look younger, but we realize now, especially here in the United States, we're catching up to the rest of the world, that you can't have a beautiful face and age beautifully without taking care of the inside and your whole body. So to see you be ahead of the game and be passionate about and focus on wellness to bring that forward now to virtual skin spa is fantastic.

SPEAKER_01 1:39

Well, it's interesting because I built my entire wellness program around metabolic syndrome, which fast forward now we have GLP1s because all the high cost drivers for the uh health plan were complications from diabetes, mostly type two.

SPEAKER_00 1:58

Right. That's that's amazing to put that together, like I said, and move that forward.

SPEAKER_01 2:02

That was many years ago.

SPEAKER_00 2:04

So um let our viewers know what is what is your professional background?

SPEAKER_01 2:07

Sure. So I'm boarded uh by the ANCC in family health, and um prior to becoming a nurse practitioner, I worked in open heart cardiovascular care. So that's my background, and I did work in plastics for quite a while before I started Virtual Skin Spa, and I got really uh great um education working with surgeons in the OR, running their med spas, um, doing a lot of Botox and fillers under their direction. So that's sort of where I started. And then uh fast forward, some of the laws loosened in New York, and as an NP who practiced more than 3,600 hours in her specialty, I was able to obtain my own accounts with Allergan and other companies, and so I made the leap into being an independent practitioner.

SPEAKER_00 3:03

Well, I think that is so admirable and honorable, and wow, to me also that you were running a statewide program. How did that come about? That's really something I feel that you should be able to share.

SPEAKER_01 3:14

Sure. When I was in graduate school, I worked on a wellness program as part of my um thesis, if you will, and the uh local government said when we're when you're once you graduate, we would like you to come on board and create a real program or a a statewide program. And true to their word, a year after I graduated, they came back. Again, I was already working in New York, but I felt like I needed to revisit that opportunity because they made a spot for me.

SPEAKER_00 3:48

Absolutely, and that's just such a huge, beautiful hit on your resume. And to have that kind of responsibility really shows the grit and your organizational skills. I mean, definitely pat yourself on the back for that.

SPEAKER_01 4:01

And I think the program still goes on today.

SPEAKER_00 4:03

Yeah. That's awesome. So you have, as we said, two locations here in New York. Um, just let everybody know where do they find you and how do they follow you on social and your website.

SPEAKER_01 4:13

So you can find us at Virtual Skin Spa, and you can find my personal at Teresa Pinson, and we have um locations in Jericho in the Atrium Building, and then we are on the Upper East Side, at this time only one day a week on Wednesdays, at Joseph Battisti Salon.

SPEAKER_00 4:32

So let's talk about the art behind injection because I feel like with every year that's gone by in the last five years, every big city in America has turned into the Wild West. We've got 10,000, it seems like, new injectors popping out of the woodwork every time I turn around. And unfortunately, it seems like a theme to not worry about continuing education or practice. So we've got a lot of people throwing needles at patients. They don't know what they're doing, they're buying off-label, really inexpensive injectables, they're having all kinds of crazy health issues with it, uh, allergic reactions, wild asymmetry, migration, uh, these are not approved products by companies that we know like Galderma, Juviderm with Jroviderm, etc., Allergan with Botox. It's insane. So being such a long-term professional that understands art and education and the need to really give respect to not just the patient, but the product that you're putting into the patient. Can you please let's let's just unpack that whole thing?

SPEAKER_01 5:37

I think rheology of filler is important, and I don't think we talk enough about that amongst ourselves. I've had the uh I've been very fortunate in my career. I have been with some of the top uh companies, they're actual scientists, so I have had the opportunity to learn a lot about rheology. Um not every filler is meant to be injected in certain areas of the face. You've got to have respect for, I don't want to get too scientific, but you you've got to have respect for how much the filler provides lift, how much it provides you want a filler in mobile, very mobile areas like your lap lines, your lips, to be able to be very elastic. Um some fillers are meant to be injected very superficially for crepey fine lines. And I think that as a new beginner injector or maybe not a seasoned injector, they're just chasing lines and filling folds, and they're not giving respect to the full continuity of the face.

SPEAKER_00 6:46

Right, and then also um the different bore sizes of your needles. Are you using a cannula? Are you not using a cannula, right? I mean, these are all things that you need to come up under a mentor. And if you don't have a mentor, keep continuing with your education, right? Get every class that you can afford and get in there before you start treating the general public. I mean, it's about practice.

SPEAKER_01 7:05

I've been using a cannula pretty much exclusively for the past 10, 12 years. And when I brought my RN on board, she's been with me about six years now. She went straight to cannula. So she's had a lot of opportunity as well, and I have mentored her to make sure that and cannula is important to make sure you're in the right plane at the right depth for safety, um, to minimize, reduce the risk of occlusion, which is a catastroph could be catastrophic.

SPEAKER_00 7:37

So can you explain that a little further to our viewers?

SPEAKER_01 7:40

The facial artery uh supplies your entire face um throughout with blood supply. And if a needle isn't inadvertently injected into one of those branches of the facial artery, it can result in blindness, it can result in tissue compromise. So safety always first, and the uh size of the cannula is important as well. You want a larger bore cannula, um so it acts less like a needle. And um, unfortunately, not everyone is trained on cannula technique, but I think that it's uh a gold standard when it comes to injecting patients.

SPEAKER_00 8:26

Right. So that's why it's so important, I think, to be able to share the journey and the understanding of someone such as yourself.

SPEAKER_01 8:34

When I first started aesthetics, we leaned more into surgical anatomy. And it wasn't until about I would say eight years ago that uh true injection anatomy came to uh was actually came to fruition. And then we discussed more about the depth of the vessels, where they lie in the tissue, in the dermis, and that's just as important as knowing surgical anatomy.

SPEAKER_00 9:04

And where the nerves are, right? Because I'm seeing like a lot of these crash courses, these two-hour online courses, or these one or two hour in-person courses where they're like, ooh, pay us a couple thousand dollars, we'll give you this little ultrasound handheld so you can see where all the nerves are, forgetting about the different layers of the face, forgetting about angles, and like you said, what are you using to inject injectable-wise? And then what are you using to inject needle versus cannula? And then what about the blood supply? I mean, there's just to me on my side of it, I'm always shocked and dismayed to see how few of these new injectors, and if you're a new injector and you do your continuing education, don't throw the hate, because I love you. But I'm talking about the ones that don't. And it it's just like to me, it's crazy to think that you know, I can touch your body and I can put things into your body, and I don't know anything about what I'm doing. Like, where does that mentality come from? Lack of ethics, maybe. Absolutely, and chasing the dollar? I chase patient outcomes. So while we're talking about injectables, let me know how do you feel about all the potential new patients that come into either one of your clinics with a picture or some such raving about the latest TikTok trends. God help us.

SPEAKER_01 10:21

There's a lot of uh misinformation out there. In fact, one of the things that my office staff, uh, Alexis, we've started our own sort of TikTok channel, Regenerative Delusions.

SPEAKER_00 10:34

Oh, nice. And we love that.

SPEAKER_01 10:36

We're dropping episodes twice a week.

SPEAKER_00 10:38

Excellent. Oh, I'm definitely going to be a follower. I think that's fantastic. That sounds like a whole new session that we can sit in on together. While we're on the subject of injectables, I saw on your website menu of services something that was like, ooh, what is this? Trapezius swimming.

SPEAKER_01 10:54

Tell me about that. So we all know as women we hold our shoulders like this, especially when we're working. So um we actually take neuromodulator and you can inject it along the trapezius muscle and it sort of releases some of that tension, allowing your shoulders to look a little leaner, less bulk, more refined, more like a ballerina.

SPEAKER_00 11:16

Well, that's very cool. But then that also, when you say ballerina to me, that means you could actually help assist a patient with better posture. Exactly. This is really cool because I honestly have never seen trapezius slimming on someone's uh menu of services.

SPEAKER_01 11:30

Talking about lymphatics, going back to fillers, we all know that the hyaluronic acids are made of sugar. Right. Okay. And some are more hydrophilic. And one thing I've noticed in my career, which spans a while now, that as women age and they start going through perimenopause, they get a lot more inflammation and their lymphatics become sluggish. And that's when I notice bottom heaviness of the face, maybe opening up or waking up in the morning with um puffy eyes, maybe heavy eyelids, and it's not necessarily the filler, it could just be the sluggish lymphatic. So we educate them on how to do lymphatic drainage. And also it's made me more aware of which filler to choose for perhaps the lower face. Um, I've only ever used Bellatero under the eye because that's the one this FDA approved and it has the less uh propensity to hold water.

SPEAKER_00 12:29

Exactly. And again, this is driving forth the reason why you need extreme education, because there are a lot of different products out there for providers to use. Between fillers and neurotoxins, it's a whole new world. And as you mentioned, everyone is geared toward a different part of the face, different part of the body, different uses. So sculpture is not your juviderm, is not your juviderm kiss, etc. We could go on about this for an hour just on the different fillers and neurotoxins. So uh Daxify, Juvet, Botox, the the first, and we still call it Botox, even when we mean Daxify or something else, the majority of us. So um, let's speak a little bit about all of that and educate our viewers on what it what's the difference. Because I know Dax is the most recent one, that's Daxify, and uh super fast acting, but I also find for new injectors super scary because it's super fast acting and very easy to have a lot of asymmetry with inexperience and Daxify. So, what's your opinion?

SPEAKER_01 13:32

I always tell my patients they all have the same active ingredient, which is a five 150 kilodalton molecule. Now, how they're made, manufactured, processed, that's the key. But they all basically are created equal because the the kilodalton molecule is what goes into the synapse and blocks acetylcholine. And after that is just about the carrier proteins. When you talk about zeomen being the naked Botox, that's because it removes the carrier proteins when it's uh processed. In my experience, Daxify, they promised us it was gonna last longer, it's three times as as expensive. I did a trial in my office.

SPEAKER_00 14:18

We're not seeing the longevity, right?

SPEAKER_01 14:20

So why do I want to suggest that to my patient? They're paying three times the price and they're not getting the longevity. So that's just my personal experience. I find in my practice they all pretty much work the same. Um it is also about dilution. You know, patients are shocked when they realize that all the neuromodulators become freeze-dried. And we actually take them through the process because I've patients have overheard me say to the staff, could you go mix a Xeomin or a Java? And they're like, Oh, you're you're watering it down, and I'm like, no, you know, and I will open a box and show them. It's a film or a powder in a tiny vial. So some people or some some providers over uh or they they don't mix their neurotoxin according to the PI or what's in the product information guide. They may add more water, they may add less, or and sometimes you want a more concentrated dilution. Rarely do I want an over-concentrated dilution unless I'm working like doing a hyperhydrosis, which is underarm sweating. Um, I think where you can get into trouble is in the lower face, and that's where uh we get a lot of great results for jawlines, you know, for snatching the jawline without filler, for relaxing the platisma, allowing the cheeks to elevate. And when I'm working in that area, you want to make sure that you're using a very concentrated solution because the muscles on the lower face sometimes are just a millimeter apart.

SPEAKER_00 15:59

Right, and very strong, built up from chewing and talking and expressions throughout your entire life. So it's like major voided out biceps, right? So all of this is strong. Like with TMJ, I think, isn't that how we as an industry discovered um jawline slimming through TMJ treatments? Yes. But that is also, from my understanding, a lot more a neurotoxin that's gonna be more costly than, say, doing your glabella and your forehead because you need a lot of units to be able to help relax this area. Typically 20 to 40 on each side. Okay, amazing. I could sit here and listen to you talk all day long because I just love how specific you are about it, and it's very natural. You obviously know what you're talking about, and this is what I'm talking about. Don't just jump on your latest coupon and be like, oh my god, this is only like I can get Botox for $40 in three areas. What? I would just run. I wouldn't even walk away from a place like that. I would be so scared. So another really interesting menu item of service that I noticed on your website is a Ozempic face treatment. So I jumped on right away because as a founder and CEO, not just of a clinic, but also of SomaCell non-surgical facelifting treatment, I thought it was going to be another device. And I'm like, ooh, I want to see what device you're using. And then I saw it's not. So tell me all about that.

SPEAKER_01 17:19

When I'm dealing with a patient that's have significant weight loss, we always discuss tightening first. So that's our philosophies are very similar. Regardless of the modality, it you you want to tighten the skin envelope first. Then I prefer to use products like Radius, Hyperdilute, or Sculptra, which are both biostimulators, different but similar, and that they stimulate your body's own collagen and elastin production, which is going to be number one, more natural, more volumizing, and that more I mean, think about it, a syringe of voluma, if you're going to use it in the cheat because it has a high G prime, is one CC, which is less than a teaspoon. I can mix a vial of sculpture and have 12 of those CCs to then inject the phase, depending on the the dilution, anywhere from eight to twelve. With radius, uh some new indications have come out uh with hyperdilute radius. So basically we take a syringe of radius, we mix it with a CC of sterile uh saline, and now we've got two CCs or two syringes to uh help replace some of the structure support of the face.

SPEAKER_00 18:34

That's fantastic. So I know you have a host like me, you have a host of different devices there. And I'm just gonna put in a quick plug. I am gonna send you some information and see. I want to get your feedback. This is not a sales pitch. I would love to get your feedback on SomaCell because this is the first truly non-invasive facelifting and body sculpting device that we have here in the US. That is not heat. It's not dermal wounding, it's not heat. That means it's truly pain-free. And what we've been seeing in clinic over the last almost five years now is uh neurotoxin and filler longevity is being extended naturally because we're not fighting the body, we're not doing controlled wounding through a heat-based device. So we're not lasering your face, we're not using ultrasounds, we're not damaging you, we're working with the body through regenerative processes, uh, repair and regeneration. Uh, FDA approved goes back to the year 1997 in the beginning, and then um really hardcore worldwide use in medical indications since the year 2000. So that's all I'm gonna say because I think it's exciting that we could still say love your fillers, or if you're afraid of your fillers and you love your neurotoxins or whatever it is, you could actually use a device that is an FDA approved that can help you to lift and tighten your skin with no sun withdrawal time, with no pain, and you can come in and inject immediately after a treatment. So you can combine it in one appointment.

SPEAKER_01 20:05

I would love to look more into soma technology. Um I recognized probably five years ago that people, my patients were coming in saying, you know, they've heard so much negative and on social media, even in the news about how fillers were migrating. Um, people are moving toward more natural. I purchased uh Morpheus 8 and 21. I was one of the the initial um adapters of that. Went on to buy MFACE in 23, and we recently last year uh purchased BBL Moxie. So we really are positioning ourselves as more of a of a uh clinic that offers tightening first and then fillers secondly.

SPEAKER_00 20:51

Right, and these again from an expert, you can combine these treatments, and it's not just throwing things at the wall to see what sticks. There's a rhyme and a reason behind your heat-based devices, your non-heat-based devices. Um, when are you gonna throw in a hydrofacial as well with your neurotoxins, with your fillers? Bring it all together, and I love that. And when you said Morpheus 8, I knew you had an M8, and I was going to ask you about that because we've had this like filler fear. We've had backlash now to RF microneedling, um, especially with the FDA uh blanketed warning. And I don't feel that the general public has had enough education and understanding that there is a difference between every device, but with a high-powered device like Morpheus 8, it's really provider dependent on your education.

SPEAKER_01 21:42

You need to know your settings.

SPEAKER_00 21:43

Absolutely depth, absolutely, because the intensity and you can get a fantastic result. You don't have to run scared. Planics like Virtual Skin Spa are not just going to use one setting on every single patient that walks in the door, correct?

SPEAKER_01 21:56

Correct. In some areas like back fat. Brawl line fat, we want to destroy fat. We want to tighten and destroy fat at the same time. With the face, we use very tried and true settings for facial tightening. No fat destruction.

SPEAKER_00 22:13

See, and that's fantastic also, because even though it's non-invasive and even though it's not heat, it's not uh destruction, uh, working over the lung tissue in specific with soma cell is like the one, there's only two no-fly zones. The esophagus itself, you can work the sides of the neck and over the lungs. So if you have bra fat and you have back fat, then you know we could work, say, love handles and waste, but then what are you gonna do about something higher? And that's when you can combine with an expert such as yourself, and you can safely use something like Morpheus 8 and get a beautiful result. So when it comes to enhancement and doing things naturally, especially with the advent of getting healthier, focusing more on longevity, and then including GLP1s, there's not a lot of natural fat to go around with a lot of patients across the country to be able to do conventional liposuction and then use that fat to transfer it to do things like correcting hip dips or correcting dimples in your buttocks. So a company's come out, Tiger Matical, with a product called L Clay, and it's extremely sterilized cadaver fat. But you're a provider, and there are not a lot of providers across the country yet because it's new, but it's a very reputable company with a wildly scientific processing of this fat. So can you tell me about that?

SPEAKER_01 23:40

I actually had the opportunity to meet the CEO, she's very smart, and originally uh Tiger Aesthetics is a wound care company, so they have a lot of experience with cadaver fat. And I was also impressed, they harvest the fat very ethically, and you can actually go on their website and become a donor. So most of the fat is uh taken from women, their abdomen, and um it is purified, and we use it to inject into the buttock, hip dips, uh, providing volumization, lift. Um, prior to aloe clay, we use radius and sculptors, sometimes a combination, but it takes a lot of product. And um so with the advent of aloe clay, it's going to give us more, I believe, natural, more of a bounce, if you will. That's what I noticed. Um, and more longevity and more higher patient satisfaction. And it's very safe.

SPEAKER_00 24:45

And you could use it for corrections in other areas of the body as well, right? For people that have dimples or traumatic squaring that attribute.

SPEAKER_01 24:52

Traumatic sparring and also after bad liposuction, patients that are left with uh, you know, irregularities.

SPEAKER_00 25:00

The first thing I thought when you said ethically sourced um is that, hey, listen, viewers, they're not out there digging up graves in midnight in Potter's Field. So excellent point though, because I think that's very much in our industry as we're talking about Alloclay. Um honestly is the first time I've heard anybody except Aliclay bring that up. So again, I applaud you with that.

SPEAKER_01 25:19

Thank you.

SPEAKER_00 25:20

You're welcome. And let's talk about your virtual skin spa philosophy because again, I want to just remind the viewers that we're saying that who and what you are, you've built that into the fiber of your clinics. So this was chasing patient outcomes, not chasing the almighty dollar. Um, I know that means that we'll turn you away sometimes, especially if you were like raving about some trend on social media that's bad for you. So just just share the challenges of that and um and how your passion and your beliefs are embedded into your clinics.

SPEAKER_01 25:53

We sort of use VSS as an acronym, and we are committed to treating every patient like they're a very special someone, and that's our tagline, and we live and die by that. Um and also I'm gonna go back to what you said about the ethics about the alloclay. That was really important to me. I was sitting in the class getting ready to go and inject aloe clay for the first time, and I was like, where did this fat come from? I really want to know. Like, are they, you know, finding, we know how are the sources, you know, where where is it coming from? And they have an entire website dedicated to um uh their cadaver program, and I I highly respect that. So I think it my success, um, uh I've I've had a great team uh through the years, um, and more importantly, we've really focused on science. I mean trends come and go, science stays, and evolution is important. Every year I meet with uh Tom, who manages my website among other things, and we discuss the ASPS data, like where as an industry is this going? What are patients dropping off of? And that does give you good information because they're the ones out there getting the treatment. Yes. And I think also listening to your patient. Like if someone tells me that they had bad filler, I want to know every detail. Not exact, not who did it, I want to know where was it put in your face? Do you know what product you have? Many times they don't even know. And that shocks me. And so transparency, I think, is key. Um, we always tell patients, you know, which filler we're using and why, um, and explain to them how we're gonna inject it, uh, review the risk-benefit. So it's just a trust that you develop over the years.

SPEAKER_00 27:45

And that's so important.

SPEAKER_01 27:46

And then the word of mouth. So once you have one, you have their, I like to say birds of a feather fly together. Once you get one in the flop, typically they all come, and typically they all stay.

SPEAKER_00 27:59

Yes, the patients for life, because uh it is that relationship that you can rely on. Also, when patients are coming, um, I myself in my career, and I'm sure you do too, experience this where we're busy, we're wearing many different hats, and as much as we love you, we cannot take all the new patients ourselves. We don't have enough time of the day. So, how do you handle that? Because I know it's like a constant mantra where everyone in the clinic is highly educated for each thing in their lane. Do not be afraid to come in. You're gonna get like the most fantastic treatment from the most educated person available on that day and at that time, correct? Correct.

SPEAKER_01 28:39

As I said, I handpicked Sage, my my RN, and spent several years grooming her. And so she does take a little bit of my overflow. If it's a if it's a skin-related uh question or consult, I will allow them to meet with my medical esthetician. Again, we all have similar philosophies. Um we've we've been together for 10 years, so we've we have a lot of uh continuity in the care.

SPEAKER_00 29:08

So, Teresa, tell us anything new, exciting on deck. Not that your day-to-day is not exciting. Um, every patient coming in, I'm sure, is just like chomping at the bit. But anything new?

SPEAKER_01 29:17

Yes, uh, three months ago we partnered with Well Labs Plus, and I think it's they're going to help us uh continue to grow the practice. And um, their goal is to expand throughout the US and our philosophies aligned, and that's very exciting. It takes a little pressure off me.

SPEAKER_00 29:36

Well, it's been fantastic. I definitely want to circle back and have you back here to hear about your ongoing evolution and growth and to see what you feel and how you feel about Soma Cell. And you could follow us. Please like, comment, and share. Aesthetics unscripted on YouTube, and you could go to at SomaCellSkin.com or any social at Soma Cell. And please don't forget to follow Teresa on Tuesdays and Thursdays. But remind us of all your happenings and your tags.

SPEAKER_01 30:05

Yes, so I have my personal Instagram, Teresa underscore Pinson, and we've just started our TikTok, which is regenerative delusions. That's Alexis and I. And those drop on Tuesdays and Thursdays. We deal with some of these um delusions of social media.