Last week, Fresh Members had the opportunity to hear from Niva Leones, a passionate aesthetic nurse injector and founder of Bulverde Med Spa.
With over 20 years of experience in the industry, Niva brought her signature warmth, depth of knowledge, and practical strategies to a packed session focused on skin assessments, product integration, and patient outcomes.
‘’Aesthetics - I love it with all my heart," Niva shared. "I've been blessed to work alongside great cosmetic surgeons, and I want to pass on what’s helped me build a loyal, thriving patient base."
And if there’s one thing Niva made clear from the very beginning, it’s that: "Cosmetic medicine isn’t just about treatments. It’s about trust. It’s about connection. That’s how you build a long-term career."
Start with the skin
It’s tempting to focus on injectable plans or treatment menus, but as Niva reminded us, real results come from taking the time to understand the canvas you’re working with - the skin.
"They don’t teach skincare in nursing school," she said. "If you want to offer comprehensive care, you need to really understand the skin, and not be afraid to touch the face, assess the tissue, and ask the right questions."
Niva spoke passionately about using tools like the Fitzpatrick Scale* - not in a textbook sense, but with a human-first mindset. She encouraged open, respectful conversations about a patient’s background, skin structure, sensitivity, hormonal balance, heritage, and lifestyle.
"It’s not intrusive to ask about a patient’s background; it’s critical for giving them the right care," she explained. "That’s how you deliver results that patients trust you for."
*The Fitzpatrick Scale is a system used to classify skin types based on their response to ultraviolet (UV) radiation exposure. It categorizes skin into six types, with Type I being the most sensitive to the sun and Type VI being the least sensitive.
This scale helps in determining appropriate sun protection measures and understanding a person's risk of skin damage.
Why microneedling and peels matter (more than you think)
Niva encouraged our members to master the fundamentals first. Start with:
"You don’t need to invest $300,000 in fancy equipment straight away," Niva said. "You need technique. You need trust. And you need a strong understanding of the skin’s needs."
Build your product range the smart way
Selling skincare products can sometimes feel awkward - unless you follow Niva’s golden rule: Only recommend what you genuinely believe in and use yourself.
"Patients can tell if you’re pushing something," she said. "Start small. Stock the products you love. Trust builds from there."
She also encouraged practitioners to leverage programs like Alle and Aspire to create loyalty incentives without extra cost, adding value to the patient experience while strengthening retention.
Above all, Niva encouraged nurses and PAs to be confident in recommending treatments and products as part of their professional duty of care.
"As nurses, recommending the right treatments isn’t about sales, it’s about helping your patients feel their best. Stick to what you know. Stick to science. Trust will follow."
Ready to take the next step?
Whether you're just starting out or looking to expand your med spa, Fresh Clinics is here to support your growth. Reach out to our team today, call us, or schedule a time to chat below.