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Success in aesthetic medicine takes strategy, resilience, and a little bit of moxie.
Aesthetic Visionaries is where bold entrepreneurs come together to share real, actionable insights on building and growing a thriving aesthetic practice.
You already have the talent, the intelligence, and the clinical expertise. This series is your guide to navigating the challenges of entrepreneurship with confidence and clarity so you can reach—and stay at—the top of your game.
Think of it as your business coach, industry insider, and hype squad all in one. Minus the jargon and bad advice.
Ultimately, we’re here to help you stand out and sculpt a business that’s as polished and bold as your work.
Show ID (00:01):
Welcome to Aesthetic Visionaries, the show where we hear from bold entrepreneurs building and growing a thriving aesthetic practice. Let's get into it.
Mikyla Race (00:13):
Alright, welcome everyone, and thank you for joining our Aesthetic Visionaries Fireside Chat. We are excited you're here. By way of introduction, I'm Mikyla and I'm a Practice Success Lead here at Moxie. Let me introduce our speakers. Dr. G, also known as @GFaceMD is a triple board-certified dermapathologist and expert injector. She's one of the leading educators on ultrasound and aesthetic medicine, respected for her commitment to safety, precision, and advancing the industry through education. Brittany Bureski @BrittanyBAesthetics is the founder of The B and a powerhouse aesthetics business advisor. She's built a brand rooted and intentional growth, confidence and mentorship, and also serves as a VIP practice consultant here at Moxie.
(00:57):
And while today's webinar is not about Moxie, I'd love to share a quick intro for those of you meeting us for the first time. Moxie is the growth and operating engine behind 500 of the fastest growing aesthetics practices in the US. We help medspa entrepreneurs reach multimillion-dollar growth with marketing, compliance coaching, software, and VIP pricing all in one place. So if you'd like to learn more or book a free medspa strategy session or customized P&L review, visit www.joinmoxie.com. Alright, enough about us. Let's get to the good stuff. When we created our Aesthetic Visionaries series, our goal was simple: to give influential injectors and entrepreneurs the spotlight and space to have meaningful conversations that educate and inspire. And with that, I could not be happier to hand it over to Dr. G and Brittany.
Brittany Bureski (01:42):
Hi.
Dr. Gretchen Frieling (01:42):
Hi everyone.
Brittany Bureski (01:44):
This is so rare that the person interviewing the real aesthetic visionary here gets to be in person. So I feel extra lucky because she is one of my favorite people. As Mikyla said, Dr. G is, I'm sure most of you know her. Her Instagram presence is incredible, but her work is even more incredible. So thank you so much for giving me the time today to interview you.
Dr. Gretchen Frieling (02:11):
Thank you so much. I'm so happy to be here. We're going to get right into it with all the tea. The tea.
Brittany Bureski (02:19):
Yeah. We're going to get the tea.
Dr. Gretchen Frieling (02:21):
True authentic information that may be something you haven't heard before. Hopefully it is. And a little bit about my story.
Brittany Bureski (02:27):
Yeah, so tell us a little bit about that story, your journey into the aesthetic space. Obviously Dermpath, you're highly educated, we heard the triple board certified. Tell us a little bit what pushed you into the aesthetic side though.
Dr. Gretchen Frieling (02:41):
My story is long and convoluted as I like to say, but that makes it interesting and unique. And I am a triple board certified, but I'm a pathologist, not a dermatologist. And so I'm an anatomic pathologist, so I know how to diagnose disease under a microscope of every organ of the body. And I'm a clinical pathologist, which is blood banking, microbiology, blood disorders like lymphoma, leukemia and clinical chemistry. And dermatopathology is obviously more specific where it's the diagnosis of skin disease under the microscope. So everything from cancers to rashes to any other skin condition. And I loved and was drawn to that field because it is extremely challenging, it's extremely competitive and it requires clinical pathologic correlation, meaning you can look at something under the microscope and it can look like four different clinical diseases and you have to know what makes it different and it's typically the clinical correlation that makes it different.
(03:40):
So I'm obviously a very visual person. I'm very creative, I like to know the answers to things and I like to have a nice lifestyle. So pathology was a lifestyle in medicine that I was like, I could do this versus surgery, which I was on a surgical path as well. So fast forward, I finished my dermatopathology fellowship and take my boards and start working in three different labs. And I've always been entrepreneurial and I said to myself after I had my first baby and then my second baby, I was like, I think I need something different. And it was between opening a pathology lab, which at that time it was looking to be more challenging than I thought it would be. Labs were being acquired, a lot of dermatologists were having pathologists specifically in their offices at the time. So a lab to me wasn't as exciting.
(04:27):
And when I was in my fellowship, it's one of the only programs where the dermatopathologist is in the dermatology department. It was unique where I had a ton of experience in the dermatology department with injectables and general derm and aesthetics was always on my radar. And I said, I think now's the time. And it was 2017 and I dreamed of the name GFaceMD, not even kidding. And I dreamed of the logo and the next week I had it all created, something that I always kept in mind and I've always had to this day, now it's getting a little harder as we scale, but those types of things are always changeable for a better word. You can always change your name, you can always change your logo, but if you take too long to actually implement, then it's just, it's your rate limiting step.
(05:11):
So I was getting my nails done one day and there was a little room in the back of the nail salon and I said to them, who's renting that room? And they said, no one, they said, would you like it? And I said Yes. And they said it's $300 a month and you can have that little room. And there we go. I put a paper sign on the door, there was my name, and I started the next week and within a couple months the line was out the door. Within a year I'd already outgrown the space obviously, and at the time of opening GFaceMD in the nail salon, I was also working at three different pathology labs. So I'm running around to all these different locations and at the year mark I said, it's time to expand and grill. So that's the short of it. That was still long.
Brittany Bureski (05:51):
But actually I think that's incredible because what we've seen in the aesthetic space is this huge boom. Recently, especially after COVID, you had a lot of practitioners who might've been entrepreneurial or had that artistic edge and a passion for making people feel good and they might have a similar story to what you have had where it's this clinical piece they want that they want to be challenged, but it doesn't necessarily look like that traditional path that we think of for a lot of people who are in this space. So I love that. I think that's a great, great story. You mentioned the rate limiting step of taking action. Yes, there was a line out the door, but was there anything else that you felt like made you take action to start expanding? For those of you that don't know, Dr. G here just opened her third location. Congratulations in a very short period of time, and these are all very successful locations. So I'm just curious what your thought process has been for, okay, this is my next step, this is my next step. What has that been like?
Dr. Gretchen Frieling (07:03):
It's very hard to put that into words. I'm currently writing a book as well, and so it's easier for me just to write and write and write and write and write.
Brittany Bureski (07:10):
Is there anything you don't do?
Dr. Gretchen Frieling (07:13):
Yes, more things I could do. So for me, first of all, I love to learn and I think there's several things that I realize are unique about myself and my journey. One of those is that I'm a dermatopathologist, which I hid from the world in aesthetics for a long time because I'm a unicorn. There are no other pathology trained dermatopathologists that own multi-location, multimillion dollar aesthetic practices. To my knowledge, if anyone knows, let me know and I'd love to meet them. So once I actually truly embraced my uniqueness with the way I think completely unreasonably, I want to know the answer and I think anything's possible. So my goal was always I wanted to look at the end goal and work backwards. I always wanted to expand. I always wanted to grow and to create an enormous company with amazing people. And people talk about, oh, you have this amazing brand.
(08:11):
And I'm like, yes, but it's the people. The people create the brand. And the brand is just a series of systems that I've created over time. So it's hard for me to say that I consciously told myself it's time to grow because that was always in the cards, but I knew that I couldn't keep slaving away at three different pathology labs and do this on my own. And so once I created such a big patient base, I knew, okay, I needed to get some help. And what's the first thing people do when they need immediate help? The first wrong decision, and that's hire someone part-time, that's a friend, a mom friend or a patient. So patient, friend, some acquaintance. That's the first mistake, but you have to do it in order to learn that it's a mistake because you're desperate. So I was desperate. I hired a patient who was adorable, but she was clueless.
(09:01):
I mean she had no idea what to do or how to do, and she relied on me to dictate to her what to do. So that's fueling another problem. I didn't realize I was getting into these problems that was fueling another problem, which was my OCD control freak perfectionist. So I'm fueling that fire because I've hired someone that it's not her fault, she just doesn't know what she's doing. So I have to be a perfectionist. So as I grew, I've hired her and then I've learned the most from the people I've hired. And then I hired my first injector mostly because I wanted to teach her, I wanted to grow. And when I did that, obviously learned a lot of things. The systems we have now are totally different. It was like a handwritten offer letter. I don't even know if I gave her an offer letter. It was just like, what are you doing? There was no inventory system. I wasn't able to track what she was doing. I mean it was just totally shooting from the hip. But my ultimate goal was to say to myself, I want to be the business owner and injector and educator, but I want to grow people. So that's when I knew, I knew I wanted to grow that way.
Brittany Bureski (10:11):
I think that's actually a perfect answer to the question of knowing when you want to scale, you recognized, I love to teach and I am really passionate and I do want the answer to all these things. And you're a big dreamer, so obviously always having that vision. But it sounds like recognizing that people were the most important thing to success was probably a big driver to that.
Dr. Gretchen Frieling (10:34):
And for me, everyone would say hire slowly, fire quickly. And also hiring a bad team member is worse than being alone. But I didn't want to do that because I was really desperate for help because I wanted to grow. That was what I wanted. I'm like, well, no, I need to hire them to grow. That's how I do it. I cannot do this on my own. But you do realize that one of the questions I get the most with my business mentees is how do you find good people? How do you do this? And I still do not have an answer to this other than you hire the person, not the skill. You can always train the skill. And now I've blended that a little bit more. We used to not hire experienced injectors. Now we do. There's multiple different reasons for that. But my secret, which I think I've said on some podcasts in the past, my secret kind of goldmine I found is babysitters.
Brittany Bureski (11:32):
Yeah, that makes sense.
Dr. Gretchen Frieling (11:34):
So the other thing is when you're a solo entrepreneur and you're hiring your first or second employee, you have to trust. And that's the biggest thing. And I trust very quickly, I'm very different now than I was then, but I trusted very quickly. And babysitters, if you trust 'em to watch your kids and you trust them in your home, there you go.
Brittany Bureski (11:52):
You probably trust them with your other baby.
Dr. Gretchen Frieling (11:54):
Yeah, that makes sense. Yeah. So my babysitter, that big sat for my kids four or five years ago is now my director of operations. She runs the entire company and another babysitter is our producer, videography, photography, and all that. And then our chief growth officer has babysat my children. So if anybody is looking for people, I think that's a great place to start. That's a great place. And I'm also always, anytime I talk to anyone, I want to know their story. It's something I've always loved learning people's stories because you can learn from everyone. And I always have in my mind, would they ever be a good fit at GFace?
(12:33):
That's when you know you're obsessed with what you've done when you're obsessed with your company, like how could this person fit into my company?
Brittany Bureski (12:39):
It sounds like you also go with a lot of gut instinct. In terms of the flip side of that coin, you talked about getting advice that was hire slowly, fire quickly. Is there anything you learned in terms of when to move on from someone or how to identify that someone's really not a fit?
Dr. Gretchen Frieling (12:59):
It's never easy and it's harder to do in the early stages when you rely on these people so much, you put so much energy into them to grow them. It is your time and energy that you've dedicated to them. And if they're an injector, it takes time to grow, especially if they don't have any experience, they're not bringing any revenue to the company and then they leave.
(13:21):
So I went through a phase where I had three injectors, I believe all brand new, and people would just leave at a year and I'm like, what is happening? What is wrong with my system? Why are they leaving at a year? And it wasn't even a problem of me having to fire people. People were leaving and I was like, what am I doing? I now know exactly what I was doing and it's all about culture and being seen and appreciated and hiring the right person. That's when it goes to not the skill but the person because they obviously didn't have skills, but when to actually fire someone, I put up with zero tolerance for distrust and dishonesty. If there are any hints that someone is dishonest, they're out.
(14:11):
We also now have a two week trial period for everyone that joins our company and you spend two weeks with us. That's both for them and for us to figure out are you the right fit? Will you enjoy it here? And people that are dishonest, you'll know. The more you're in business, the more you learn and grow as a leader, you'll know things people do that are red flags and you don't have to make any immediate decision, but over those two weeks they will show you. So that's helped with decreasing us having to fire people.
Brittany Bureski (14:43):
That makes sense.
Dr. Gretchen Frieling (14:44):
Stealing and trust are huge.
Brittany Bureski (14:45):
Yeah, that makes sense. So staying on that topic of learning and swinging back to clinical, which is really where we started out talking about your story, obviously I know you are very well known for ultrasound. I personally have received a procedure with ultrasound in your practice. It was a game changer, especially for someone who feels like they've done pretty much everything in this space. So how did that really take off and what advice do you have for people who are looking to differentiate with something very clinical like ultrasound?
Dr. Gretchen Frieling (15:18):
To me, it was a no brainer. The first thing though is that you have to believe in it and you have to believe it's essential. You can't just bring an ultrasound into your practice to say, I have it sitting over here to manage complications. It doesn't work that way. So you have to believe in it. Why is it useful? It's not just useful for complication management. It's useful for becoming a better injector overall and understanding your anatomy every single day because you're visualizing the anatomy, you understand where the product's placed, you understand how the product changes over time and you understand why your results are they are and how to dissolve.
(15:55):
So you have to enjoy it. You have to spend the time learning it. I don't understand why injectors in our space who spend all of this time and energy at conferences learning from the same people saying the same things on stage, but they still say that they learned something why they're hesitant to learn ultrasound. Yeah, that's a good point. It makes no sense. And you know why? It's because they are not smart enough to say, oh, it's going to bring me money. It's all about money. It's expensive. That makes sense and it's not going to bring me money. Okay, it's expensive. Don't you put in huge orders of injectable products every month? What other money are you wasting? Probably a lot. All the outfits you wear at the conferences. So...
Brittany Bureski (16:39):
That's a plug for Rent the Runway.
Dr. Gretchen Frieling (16:41):
In my mind, it is completely irresponsible for people to still say that ultrasound is useless if you don't spend the time. Which by the way, learning ultrasound is not that hard. It's not that hard and it's shades of gray. It's exciting. And yes, is it time consuming? Yes, it will take you a little bit of time to learn it, but if you learn it at 1% better every single day and you use it on your employees or you use it on a couple patients, your patients are going to love it. They're like, this is so cool. Oh my gosh, you can see my blood vessels and all of this. Patients love it.
(17:26):
And at Face It Live, which is the conference that we put on every single year. It's October this year, we have a whole business of ultrasound series where we help you think bigger picture. How do you incorporate ultrasound in your practice? How do you charge for it? Maybe you don't charge for it at the beginning. How do you package it? What injectables and areas for injection do you always use it and what areas is it confirmatory? Is it anatomy knowledge to learn? I don't always use ultrasound, but I always use it for certain injections. And I've developed this all from scratch. No one has developed these things on how to price it, and that's what being a business owner is. You create systems and you change them.
(18:17):
So to me, it was a no-brainer. I knew it would amplify my own anatomy knowledge. I knew it would amplify my injectors. I knew my patients would feel safer, which I am very clear to them. This does not enhance safety. It is a tool to increase results, overall results and to help manage any potential complications so you don't feel left in the dark if something were to happen, which happens all the time. I get patients from practices all over that have no idea how to manage complications. I think it's unethical for you to inject blindly if you don't know how to treat it. So it was a no-brainer for me. I wanted to create the best experience for my patients, not have to send them elsewhere for management of a complication and to enhance our overall knowledge. There aren't any other fields of medicine that don't use imaging.
Brittany Bureski (19:11):
Yeah, yeah. That's such a good point. I was going to ask you the question as we wrap up here about if you had to have a chapter written in a biography about your life, what would it be about? And I was thinking about all the things I know about you, and I think I would name one, don't be scared to have clinical aspects to a specialty that feels very skin deep. Because so much of what you've talked about today is about consistency with education, continuing that, and not just your original clinical training, but how do new things and new systems like bringing in ultrasound or other things, how do those continue to help you differentiate as a business owner, but deliver better experiences to patients?
Dr. Gretchen Frieling (20:02):
And I think I am so hungry for business knowledge, and that's also very unique as an MD because most physicians have no clue. And I just inundate my mind with business concepts and principles. How can we create an experience here because our team is so incredibly solid right now. I never want to lose them. Well, how do I keep 'em forever? And what do I do here to make them believe and bleed GFaceMD?
(20:28):
And another chapter, which is going to be a chapter in my book is about systems. Because if you don't have systems in structure, things will fall apart. And so what I've done over time is just create an empire that's composed of systems. So now it's not me training my new injectors, which is great. It's a system online that is reproducible, measurable, and just kind of like the SoulCycle brand where when you walk in there, it's going to look the same way. You're going to get the same experience, the same kind of routines on the bike.
(21:01):
Any GFaceMD location you go to, you will get the same exact experience with a twist of another incredible personality because all of our injectors are so unique and so beautifully different, but they provide the same result. And so how do you systematize something to make it scalable? And I had a question the other day from someone. They're like, are you so stressed about the new location you opened? Are you always thinking about it? Is always on your mind? And I didn't even think about it. I was like, I never even think about that location because I trust the people there. I go there twice a week. I know it works because of our systems. And I was like, wow.
Brittany Bureski (21:42):
That's how you know made it. Yeah. So unfortunately, I think a lot of our time is coming to an end. So I'm going to kick it back to Mikyla to head us off with the Q and A section.
Mikyla Race (21:57):
Alright, well, thank you so much Dr. G and Brittany, that was such a great conversation. So a couple of questions from the audience did come up as you were presenting. Okay. So what are the first steps for someone wanting to add sonography to their skillset?
Dr. Gretchen Frieling (22:13):
So shameless plug, obviously I started my own conference because I really believe in, it's so wholeheartedly. It's called Face It Live. It's in October this year in Boston in the Seaport. It's beautiful. It's the 24th through the 26th. And what I created was something that still doesn't exist. There are smaller conferences with ultrasound that are great that incorporate cadaver anatomy, which we were the first to ever do that. But this time we're not trying to be a cadaver lab. We have live cadaver anatomy. You as an attendee don't have your own cadaver, which is great because the focus is ultrasound. We have multiple different ultrasound technologies. We have everything from starting with how to turn the machine on all the way to all of the anatomy, all of the vasculature panels that talk about business panels, that talk about complication management, interesting cases, live injections on stage, including thread placement and fat transfer, neurotoxin injection, muscle mapping. It is completely all encompassing. It is beyond incredible. And you will leave there with the tools to immediately implement ultrasound and actually know what you're doing. Because the other problem I have is injectors that get their ultrasound machine and they kind of falsify, especially on social media, that they know where they're doing and try to get patients in saying they use ultrasound, but they're really not fully educated. So come to the conference. It's so good.
Brittany Bureski (23:32):
Yes, come become a master. Yes.
Mikyla Race (23:34):
I love that. So kind of on that same note, what types of treatments or scenarios do you find sonography most essential for?
Dr. Gretchen Frieling (23:41):
There's three main areas. I use ultrasound all the time. That is the chin, the temples, the piriform. We also always use it for dissolving because the number of times I see patients that have been unsuccessfully dissolved with copious amounts of Hylenex, it's wasteful, it's costly. There's a ton of tissue trauma. It doesn't come without clinical risk. So dissolving temples are a must. I do not understand. I actually just posted something on my Instagram. I do not understand with all the layers of the temple how you are sure blindly. You're in layer two for or on bone, please tell me how it doesn't make sense. And the piriform, there's variability in the angular artery and the number of branches, the location and the depth. And so aspiration is fine when you inject, but it's just not good enough. The chin is also a very compartmentalized small area with numerous vessels and is directly connected to the mouth. So you can get tongue ischemia from improper injections and it's important to use.
Mikyla Race (24:41):
Awesome. Okay. What advice would you give to a single location owner who's scared to grow?
Dr. Gretchen Frieling (24:47):
You have to take risks. You want to list out what if I fail, I've always told myself I will not fail because I will do anything possible to not fail. However, failure is always a risk. And you have to be willing to take the risk. You have to have excitement and fear and they have to make sense to you and hate to say it. But the bigger you grow, the more risk you take. The larger the decisions are, the more money is involved, the more people are involved. But I guess you could say I'm a risk sticker. I find it very exciting because I know I'm doing something that I've never done before. I know I'm going to learn and have people around you. You can be vulnerable and ask questions to. I didn't open up to people because I wanted to draw my own and then just pop out of a box and be like, here, it's done. But ask questions, find mentors. That's why I started my mentorship program because I want to give back. But I would just say, take that risk. Go get that physical location. You know what? Because that physical location will force you. You're like, oh, I got a space one foot in front of the other.
Brittany Bureski (25:53):
Yeah. Yeah. I would add on to that. She talked a lot about systems, having the right things in place before you do that and understanding how important that is. So if you're scared, ask yourself why. Is it because you feel like you're lacking certain things or that you haven't developed certain things yet that might create that bigger risk for failure once you do scale up. But that's why it's really important to consistently be looking back at your business, asking those questions. And yes, having a good mentor or a good business coach, selfless plug for you too Mikyla. But yes, have a coach, someone that can walk you through that 30,000 foot view and make sure you're also staying on track with where you want to be when you do want to push yourself.
Dr. Gretchen Frieling (26:39):
And at the end of the day, it really is money. I mean, money is the biggest thing. You have to have money to stay in business. And a lot of people understand this concept now, but your hands are free. Okay, a machine, a laser, don't go out and purchase this huge laser. Use your hands, build your patient base, figure out what makes you unique, push it out on social media and start to bring in the revenue, which is going to help you grow. It's about money at the beginning and keep track of your money.
Brittany Bureski (27:04):
Totally. It's okay to start small. Yeah, just remember her story, that nail salon, $300 a month and now look at her now. Three locations. So.
Dr. Gretchen Frieling (27:13):
We're working on the fourth.
Mikyla Race (27:14):
Alright, well, final question, Dr. G, if our audience would like to keep learning from you, what is the best place to find you?
Dr. Gretchen Frieling (27:22):
You can find me on Instagram, obviously for free education. We've transferred a lot of it over to Patreon. So I have three different Patreon channels that include a business, one ultrasound, and then Clinical Pearls. So that one's really great. It's GFaceMD, is the handle for that. And then obviously Face It Live and we do in-person trainings. We actually have Lee Walker coming in October. So that's really, really great. And Face It, Live.
Brittany Bureski (27:46):
In her podcast.
Dr. Gretchen Frieling (27:47):
Oh, and my podcast. Yes. Yes. Face It with Dr. G.
Mikyla Race (27:50):
Amazing. Alright, well to everyone who joined us today, thank you so much for tuning in. Keep an eye out for an email with the recording of today's session. In that email, you'll also find a link to share your feedback on the session, just like we're constantly evolving our software and services based on your feedback. We do the same with this series, so your feedback really matters to us. Please don't be shy. I would also love to invite you to attend our next Aesthetic Visionaries live session. You can find it at www.joinmoxie.com/events. And as a quick reminder, today's event was brought to you by Moxie, so if you'd like to learn more, feel free to check out our website at joinmoxie.com. Thanks again for joining. Huge thank you to Dr. G and Brittany Bureski, thank you so much. Thank you.
Show ID (28:34):
Thank you for listening to Aesthetic Visionaries. For more resources on building and growing your medspa, visit joinmoxie.com/learn.