In this month’s “Meet the Aesthetic Expert” column, Will Kirby, DO, FAOCD, talks with Emily Kaye Perbellini, MSN, FNP-Ca, board-certified family nurse practitioner specializing in aesthetic dermatology. They discuss how to avoid burnout, challenging patient populations, and the role allied healthcare professionals in aesthetics.
Welcome to “Meet the Aesthetic Expert,” where, each month, dermatologist Will Kirby, DO, FAOCD, of LaserAway, will connect with select industry leaders to get their expert opinion on the aesthetic specialty. With an emphasis on straightforward, candid questions, Kirby will focus on the best in aesthetics and get the experts’ frank thoughts on where the field is headed.
Emily Kaye Perbellini, MSN, FNP-C, is a board-certified family nurse practitioner (NP) specializing in aesthetic dermatology.She has an unparalleled history of telehealth expertise as well as specialization in clinician hiring, aesthetic training, and continuing medical education. Holding many titles over the year including director of operations, vice president of clinical operations, regional director of standardization, and national director of telehealth, she currently serves as the vice president of telehealth for the nation’s leader in aesthetic dermatology, LaserAway. Extensive personal treatment implementation experience coupled with a long history of managing teams of clinicians both in-person and remotely makes Perbellini a unique force in the aesthetic industry.
Kirby: Can you please tell our readers a little about your backstory?
Perbellini: Born and raised in Pearland, Texas, I was the middle child, only girl, and grew up trying to prove myself better than the boys. As a natural born feminist, I found myself defying the odds of winning male dominated competitions at a young age including the All-Texas State Drum Competition at age 14, 15 and 17 and the Presidential Award for Athleticism at ages 10, 12, and 13!
This fierce ambition to win in my youth matured into drive to make a positive difference in my career. I completed my undergraduate degree at University of Texas Medical Branch, Galveston, Texas, in 2004 and delivered babies for 4 years before moving to California. There I entered the world of aesthetic dermatology in 2008 and attended Azusa Pacific University, Azusa, California, to become a NP. I have my NP license in 12 states and counting while currently coaching my team through obtaining multi state licensure—a task not for the faint of heart!
K: What initially led you to an aesthetic career path?
P: Well, when I met you in 2008, Dr. Kirby, I was fascinated by your drive for success, business mindset, and perpetual growth quest. Moreover, you had the unique ability to make work fun, which was a new concept for me, and that I was lucky to learn at a young age. Your positive encouragement and mentorship inspired me—forced me?—to obtain my master’s degree and NP license, which has truly given me wings in the medical field and in this industry. I now manage a team of 40 incredibly talented registered nurses (RNs), NPs, and physician assistants (PAs) while serving as the vice president of telehealth for LaserAway Medical Group!
K: Thanks for your kind words, it makes me happy to hear this! Now then, what is the best piece of career advice you have received?
P: When considering a career in aesthetics, seek out a reputable company with strong medical and business leadership that will help foster your success in the industry. Do not “settle” and work for a mediocre company just to get a foot in the door. Make sure to do plenty of research to ensure you join a group that is growing financially with a strong business team with seasoned medical leadership. Furthermore, personal success cannot be rushed in the field of aesthetic dermatology and the learning never stops; it takes years to master bedside presence and technique with patients seeking aesthetic procedures. So be patient and enjoy the journey.
K: What resources do you believe aesthetic providers should invest in right now?
P: No matter the advancements in technology, if you’re not investing in your staff, co-workers, and colleagues, then your business will never meet its full potential. There is great pride and honor in paying well and offering great benefits. Patients absolutely pick up on staff energy and an unhappy clinical team undermines patient confidence—even ruining the patient experience. So, take any measure you can to decrease clinician turnover and keep them engaged and, above all, let them know they are appreciated always! Additionally, recognizing the unique skillset in each clinician and fostering that specific talent is an imperative investment as well. For example, if you have a clinician who is passionate about education, then lead them to educate within your company!
K: I wholeheartedly agree. What aesthetic patient population is the most challenging to deal with and why?
P: Social media influencers have led patients to seek out aesthetic procedures striving to achieve an unrealistic, superhuman look. Many young Generation Z patients are already seeking out excessive filler trying to alter their appearance. This presents such a challenge for aesthetic clinicians in setting realistic expectations. Our job is to enhance a patient’s existing beauty and improve overall cosmesis in a natural way, not to fully alter someone’s look. Convincing a patient that they are already beautiful is sometimes one of the most difficult parts of the job.
K: What is the biggest myth in the aesthetic industry?
P: One of the biggest patient myths in the aesthetic industry is that a patient is too young to “need” a product or procedure, or that perhaps it is too late for them to begin their aesthetic journey. Aesthetics is more about prevention and maintenance. When speaking with people in the community about procedures, we frequently hear the comment, “oh you don’t need Botox Cosmetic” or “you’re too young for tretinoin.” Similarly, older patients believe that it might be too late for them to start aesthetic procedures saying, “It is too late for me to try to improve my appearance?” Both beliefs are untrue, as there is no perfect age to begin your personal aesthetic journey!
K: Telehealth exploded during the pandemic. Is it here to stay? What role will it have in aesthetics moving forward?
P: Since the pandemic, my telehealth team has quadrupled in size and now functions in numerous new ways. We provide good faith exams, virtual patient assessments, clinical consultations, follow up care for patient concerns, and prescription products. Our teams are comprised of experienced RNs, NPs, and PAs who are oftentimes the patient’s first encounter with an aesthetic medical professional. Any aesthetic practice not investing in telehealth is likely going to learn a hard lesson in the near term as telehealth is most definitely here to stay and will likely replace many traditional in-clinic processes.
K: This is a bit of a loaded question, but you are uniquely qualified to answer it because of your history in the field: What role do allied healthcare professionals play now in aesthetics and what role will they play five years from now?
P: Thankfully, the unfair subjugation that allied healthcare professionals have endured for many years is slowly disappearing. See, several states already allow full practice authority for the NP and as the role of the NP degree expands and gains more autonomy it is likely that NPs will eventually have even more clinical opportunities. PAs are on the same trajectory, gaining additional roles and responsibilities in states across the nation. RNs have greatly benefited from improved clinical education opportunities. On top of all of this, young physicians are more comfortable with delegation and supervision today than at any time in the past. The most successful aesthetic practices have already improved diversity and inclusion by integrating allied healthcare professionals into their teams.
To address the question, many people don’t realize, or even purposely neglect the fact, that allied healthcare professional already account for nearly 70% of aesthetic treatments implemented in the United States and it’s my contention that we will only see that number increase in time. So, allied healthcare professionals already represent the majority of clinicians in our industry and 5 years from now they will be even better positioned for success!
K: What can the aesthetic industry do to increase diversity and inclusion?
P: As far as patient treatments go, I have witnessed the aesthetic industry make vast improvements in terms of diversity and inclusion during my career. For example, laser technology has evolved to be safe and effective for all Fitzpatrick skin types, procedures have been normalized for all genders and sexual orientations, and clinicians find joy in helping patients from all walks of life achieve their aesthetic goals. In terms of clinician diversity, as the stubborn old guard willingly retires or involuntary leaves the aesthetic industry because of attrition, we’ll hear new voices and see fresh faces that better represent the patients receiving the treatments and the clinicians implementing them. We still have a lot of work to do. I’m proud of my organization because we already put a premium emphasis on workplace diversity and inclusion!
K: What advice do you have for people in the aesthetic space to avoid ‘burnout’?
P: Three things:
K: How do you define success?
P: My definition of success is to hop out of bed feeling a sense of peace and fulfillment with my at-home and work family! I’m so luck to awake each day with joy and without stress. It’s the ultimate accomplishment and allows me to live in the present. Obviously, we all have daily stressors, but how we handle that stress will determine the outcome of our overall mental health and wellness. Our families and colleagues play an immense role in our happiness. If you are an aesthetic clinician reading this right now and you aren’t happy when you walk into work, then you aren’t working with the right people. Make a change today, send your CV out, apply for new roles – life is too short to work with people you don’t love!
K: What is your favorite aesthetic treatment to personally receive?
P: I absolutely love my results from Thermage FLX device and look forward to treating more areas of my body. As a 40-year-old and just 6-months post-partum, Thermage is one of the few treatments I can receive while breastfeeding and it is such a great solution for skin tightening and maintaining a youthful appearance. Better still, we just launched “Baby Thermage,” it’s a faster treatment that better targets a specific problem area. It has not only helped tighten my postpartum belly, but also has motivated me to continue exercising and making progress to achieving the highest level of health at my age.
K: If you weren’t an aesthetic expert, what would you do for a living?
P: Prior to becoming a nurse in 2004, I studied piano performance at the University of Houston Moore’s School of Music, Houston, Texas. I quickly switched majors and decided to go into nursing. While working in labor and delivery at Memorial Hermann in Houston, I recognized that women used music to assist in natural birth. It rarely worked. So, I decided to compose music with a therapeutic goal to help this cause and am immensely proud of the fact that I have composed three records: The Arrival, Departures and Arrivals, and Passengers. These albums were brought to life during my time in California and have been utilized by many to reduce anxiety. If I were not in the aesthetic industry, I would devote all of my time to music therapy!
K: What is your favorite quote that is applicable to the aesthetic industry?
P: “Yet her features were not of that regular mold which we have been falsely taught to worship… [in fact] there is no exquisite beauty…without some strangeness in the proportion.” - Edgar Allan Poe
I love this excerpt from Poe’s Ligeia. It describes the uniqueness of us all which we should learn to embrace rather than change.
K: What advice would you give your younger self, knowing what you know now?
P: I was a worrier in my youth. I hustled hard chasing my career in my 20’s and 30’s, but paired it with a lot of worry for the future. Knowing how things worked out, I would have told my younger self to enjoy the journey because everything would work out better than I could have imagined. Every bit of hard work paid off in a big way, all in perfect timing, with all necessary lessons taught along the way.
K: Emily, thank you so much for your interview! It has truly been an unconditional pleasure working with you all these years and it’s wonderful to watch not just your family blossom, but see your career explode has been an absolute joy to witness as well. You are an absolute inspiration for our field. How can we learn more about you and follow your future accomplishments?
P: I feel like we are just getting started! Please follow LaserAway on any of our social media channels and connect with me on LinkedIn at https://www.linkedin.com/in/emily-holmes-perbellini-5683362a/. I’m also at Instagram at: @emily_perbellini_np!