Amanda Guarniere is a nurse mentor, entrepreneur, and founder of The Resume Rx. She was named one of the top “nurse influencers to follow” and runs The Nurse Becoming podcast, which provides a place to hear honest conversations about personal and professional growth through the lens of nursing, and has an archive of over 120+ episodes. Amanda reaches a diverse audience of 31K followers on Instagram on @theresumerx.

Stephanie Hwang is the co-founder of Mosaic Skin Studio, her own concierge aesthetic medical spa service focused on bringing evidence-based clinical skin care treatments to a diverse population through neighborhood pop ups and a little skin studio in Glen Park, SF. She is a Stanford graduate and UPenn nurse.

Amanda: Congrats! Are you up and running? How does it feel!

Steph: Little hiccups with my medical chair delivery, and for a while I couldn’t get syringes delivered which was stressful, but I am up and running! It’s been a crazy whirlwind of a month with toddler adventures and my infant business journey. There is so much to do, but I’m excited to start and educate about skin care!

Amanda: What are things that you wish people knew about the aesthetics industry?

Steph: There’s a whole spectrum of care when it comes to skincare treatments. On one side you have services for people like my husband, who washes his face with leftover shampoo in the shower (sorry babe, called you out). On the other hand, there’s really intense plastic surgery. In the middle, there are so many different options that people have now to take care of their skin. Things starting from medical grade skin care for those who want to take their home regimen to the next level, then moving to medical grade chemical peels when you start to physically see results...then microneedling, lasers, ablative lasers, leading to injectables like neuromodulators and dermal fillers.

There are a lot of options in medical aesthetics that are very safe, clinically based and extremely effective to treat, but also preventative. For example, using sunscreen protects from UVA as we know. I see using an antioxidant in the same way because it prevents oxidative damage to the skin (imagine preventing fruit sitting out and turning color). Another example is doing preventative botox at lower doses, which prevents strong lines of motion from coming in, and you don’t necessarily have to freeze your muscles to achieve this. Or doing light chemical peels from time to time to exfoliate effectively so your skin is exposed to more of the topicals that you’re applying.

Amanda: It’s true, I know a lot of people who prevent the strong furrow in their glabella - sorry, the furrow in between their brows - by treating moderately, rather than fully dosing the area. It makes it a lot more cost effective too, as most aesthetic providers only charge for what amount of product they use. Do you do the same to keep costs down?

Steph: Yes I do - because every face has different strength muscles and requires different doses. This makes things a lot more cost effective, too. A treatment of baby prevention botox could cost only 200-400 – which, let’s be real, is the cost of a La Mer cream. A botox or neurotoxin treatment doesn’t have to have the 600-1000 dollar price tag that most people believe it has. And real talk, no cream gets to the root problem of wrinkle formation.

I’m also excited to roll out packages of effective services like 2 microneedling sessions with 2 products and 3 botox sessions will be rolled up into a reduced price. I want patients to see me as a repetitive investment to their skin health - almost like a gym membership but without the dumbbells. For those who really allow me to curate their skincare regimens, I offer a big discount on products and services. And also I love coupons - I always send these out to my patients when I have rebates or promotions..

Amanda: I agree about the efficacy of baby botox rather than buying expensive creams with little clinical evidence. There’s a perception that Botox and other neuromodulators like Xeomin and Dysport are only for certain populations - would you say that’s changed in the last few years?

Steph: Yes totally. In the last few years, aesthetics have become much more accessible. Historically, you needed to go to a plastic surgeon’s office in order to get an aesthetic treatment like neurotoxin or dermal filler, and that was really not accessible to most people since plastic surgery offices typically have the highest costs. I mean, look at San Francisco. Almost all of the aesthetic practices are in Financial District, Union Square downtown, and Pacific Heights/Presidio area which are the more wealthy areas of SF.

Aesthetic treatments used to only be for wealthy, older women. That has changed so much with the advent of medical spas and social media surrounding injectables. They are now a much more accepted and also efficacious way to treat aging and the wrinkles and folds that pop up with time. We have tools to slow it down and still look like our true selves.

“I purposely opened up in the Glen Park/Mission areas because there were no medical-grade aesthetic services in those areas. The areas south of 16th street really are not considered ‘where the money is.’.. It’s where the REAL people live and breathe, and diversity is what I love about the area.”

I purposely opened up in the Glen Park/Mission areas of San Francisco because there were no medical grade aesthetic services in those areas. The areas south of 16th street really are considered “not where the money is.” It’s because there’s a lot more socio-economic diversity in those areas with multi-family dwellings and older residential properties. There’s also a potentially younger population in that area that probably wouldn’t utilize those services. I don’t know why there’s only one medical spa chain south of 16th street.

But now with more people working from home, it’s the perfect time for me to bring medical grade treatments to convenient residential areas like Dogpatch, Mission, Bernal, Glen Park, etc. Part of my business model is to collaborate with local salons/spas/aestheticians, so that I can bring my services to the people, rather than having people come to areas like Fidi and Union square to see an aesthetic clinician. It’s where the REAL people live and breathe, and the diversity is what I love about the area.

Amanda: Is that why you mention “faces of color” and “diverse faces” on your website? Your website has a very unique vibe, by the way! It doesn’t look so “medical.”

Steph: Thank you! That’s what I was going for. My weekly space is in collaboration with Pono Boutique and I loved it because of the earthy, Hawaiian vibes. My audience is those outside of Financial District, Union Square, Marina, or Pac Heights. I wanted to create a neighborhood-y and comfortable space for people to come learn about effective skin treatments, in a more residential space, and bring these services to the people rather than making them accessible only to the lucrative areas of SF.

I wanted to create a skincare service branded in authenticity: effective skincare options are available, the people are authentic and genuine, and it’s a different feeling than if you walked into a sterile medical facility or surgery center. My next step is to put in a library, where people can donate and take books!

Amanda: I don’t think I know of any medical spa that has a free library. I love it! Final question. To echo what you have been saying, you want your service and space to feel authentic and comfortable, accessible and relatable. What DON’T you want Mosaic to be?

Steph: Hm…. Good question…. I don’t want Mosaic to be a place where people get one service and leave, like an auto shop that you go to only when your car breaks down. I want Mosaic to be the neighborhood hair salon, where you gather with groups, chat and gossip, and form a long term relationship with your provider. I know it’s possible because my FAVORITE thing about aesthetics has been forming these long term relationships.

I have close friends now who were my patients first, and then I see them now for playdates and communicate with them all the time about so many things outside of skin. I feel like I can participate in the women empowering women movement. Women come to me and open up to me about what makes them vulnerable, and they leave a bit more confident.

My goal is to be a provider you feel comfortable delegating your skin care to. I want to be the nanny to your toddler, the consultant you hire when you don’t know what to do, or a financial advisor that takes care of your assets who you revisit every 6 months or a year or see before important life events. I am a provider focused on PREVENTION, so instead of being reactive to skin changes, I want to prevent them from happening by coming up with a 2- 4-6 month follow up plan everytime I see a patient. I want to be well-versed in diverse skin types and face structures, and elevate skincare for faces of color which have historically been forgotten.

“I am a provider focused on PREVENTION, so instead of being reactive to skin changes, I want to prevent them from happening...I want to elevate skincare for faces of color which have historically been forgotten.”

It’s so important for me to spread the confidence that comes with getting a little somethin’ somethin’ that no one else knows about but you. Sure, it’s no fun getting poked, but when you get up from my chair, you know that “pain is gain” and you have a plan on how to protect and maintain your skin.

Amanda: I love your thoughts, Stephanie. I wish you were not across the country so I could come visit and steal a book from your library! Thank you for sharing.

Steph: Thanks for having me, Amanda! Come visit me anytime in SF!

A conversation with Amanda Guarniere, founder of The Resume Rx

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