The Aesthetics Conversation We’ve All Been Waiting to Have

What the aesthetics industry isn't telling you - and how to find someone who will.

How many of you have googled “botox near me” at 11 p.m. and immediately closed the tab? Not out of lack of interest - but out of not knowing who to trust.

That’s not a personal failing. That’s a feature of an industry that runs almost entirely on marketing.

The education available to practitioners in aesthetics comes largely from the companies selling the products. Which means the information filtering down to us as consumers - through social media, med spas, and beautifully lit before-and-after photos - is built on a foundation with serious conflicts of interest. Most of us walking into an appointment have no idea how to vet the person holding the syringe. And most practices have no incentive to tell us what we don’t need.

This week’s episode exists to change that.

Meet Adriana Culling

Adriana is the founder of Maeva Aesthetics in Austin. She’s a nurse with a near-complete second degree in chemistry who spent years training under physicians, reading clinical studies, and building an approach grounded in anatomy rather than trends. She built her own practice for one specific reason: so she would never feel pressure to upsell a patient or inject something that wasn’t genuinely in their best interest.

I found her on TikTok years ago, watching her break down celebrity faces - not to gossip, but to explain what had gone wrong and why. I eventually realized she was in Austin, booked an appointment, and sat across from someone who looked at my face and told me what I didn’t need. That was the first time I’d heard that from anyone in this industry.

This conversation is everything I wished I’d had access to years ago.

The Topics We Discussed

How to find someone you can trust. Adriana’s framework isn’t complicated, but it’s specific. Look at the staff. If they don’t look the way you hope to look, walk out — they’re practicing on each other. Be skeptical of heavy discounting and high-volume practices. And find someone who asks you questions before they pick up a syringe.

The difference between what you think you need and what you actually need, or don’t need. Most of us walk in with a list we’ve assembled from social media. Most of that list is wrong for our specific face. A great injector reads your bone structure, your tissue quality, your muscle movement — and builds a plan from there. What works beautifully on one face can look completely wrong on another.

What’s worth spending money on and what’s overhyped. Adriana’s honest answer: true innovation in aesthetics is rare. Most “new” treatments are existing science repackaged with a new name and a marketing budget. She’s a strong believer in the fundamentals — SPF, Vitamin C, a retinol or tretinoin, micro needling, and consistent Botox for those with expression lines. Red light masks. The boring stuff that actually works over time.

The treatments she won’t offer. CoolSculpting. Morpheus8. There are things Adriana has looked at, assessed, and decided are not worth what they put a patient through. She says so directly. That alone tells you everything about how she operates.

What this does to your relationship with your own face. Adriana is her own billboard. She posts photos of herself. She’s surrounded by the work every day. And she was honest that it messes with her — that she can find herself fixating on things no one else is seeing. Her solution is the same one she offers her patients: back up. Get a second opinion from someone who knows you. Don’t chase perfection in bad lighting.

Running a practice while raising kids. She started Magnet Esthetics when her children were babies. She doesn’t cook. Her house is, by her own description, a mess. She is lit up by her work and intentional with the time she has with her family. Something’s always going to give — the point is to decide what it is, not let it be decided for you.

The Long Game

Late in the conversation, I said something that’s important for everyone to realize: this is a long game. Three years with Adriana. A slow, considered build. No single appointment transformed anything. The results compound over time, and they only work if the person guiding them is someone who’s genuinely thinking about your face, not their revenue.

That’s true of most things worth doing.

Find the right person. Build the relationship. Trust the process. And stop letting marketing make decisions your actual face should be making.

The episode is live now. Listen wherever you get your podcasts.

— Alexis

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