Erika Barry on Sculpting a New Era of Aesthetics with Full-Facial Rejuvenation

Join us for Erika’s presentation, “The Future of Aesthetics: Full Facial Rejuvenation — Priming with Facial Sculptra,” at Modern Beauty Con, on May, 6, 2023, at the Boston Park Plaza.

 

When we caught up with Erika Barry, it was eight o’clock on a Monday night, and she still had a few hours of work left to do. Later, when asked how she maintains balance, she frankly stated, “I don’t have balance.”  

 

Throughout the conversation, it became clear that in an industry where so much attention is given to immediate results, Erika has established a successful practice and huge following by speaking candidly about the importance—for both injectors and clients—to focus on the long-term.    

 

Along with a preview of her Modern Beauty Con presentation, “The Future of Aesthetics: Full-Facial Rejuvenation — Priming with Facial Sculptra,” she shared insights on the responsibility of injectors to positively influence beauty standards, how she learned to combine treatment modalities by beta-testing and “kind of doing it wrong” at first, and why she tells her clients they have to eat their “healthy greens before eating that candy bar.”

 

This year your presentation focuses on Sculptra. What inspired you to choose that product and why are you excited about it? 

E.B.: I’m very excited by it because it’s kind of a secret in the aesthetic industry. It’s become more popular in the past few years—specifically with what I do, full-facial rejuvenation, Eight-Point Lift, which I spoke about last year. So it’s great for people who were at the conference last year and saw me do the Eight-Point Lift. I alluded to Sculptra then. I described the Eight-Point Lift as buying a house, and Sculptra as the insurance for that house. That’s the way I describe it to my patients as well, in order to convey how important it is for them. I also really love the injection technique. It’s known as an advanced injection, but it’s so simplistic that once people hear about it, they’re like, “Oh, I need to bring this to my practice.”

 

What about the technical aspect of it do you like so much?

E.B.: Sculptra is similar to a neurotoxin in that you don’t really know how the body is going to react to it. You don’t really know how much collagen it’s going to produce. So you have to think about the patient—their ethnicity, their gender, their age, their skin quality, the fat layers—and consider where to place it with a technique that’s going to give them the best result. I’ll talk about how to use a really small amount of Sculptra, which I really under-dose. I dilute it 10 to 1 instead of 9 to 1, and I really [apply] it in a facelift pattern. I was trained surgically, so I’m big into thinking about, “Well, if they perform facelifts in the temple, preauricular, neck area, then that’s where I really need to focus my Sculptra. And I get a lot of great results using a small amount—like, one or two vials, once or twice a year. It produces a facelift look versus a puffy face. When some people think of Sculptra, they think, “Oh, gosh, it’s going to be puffy and look bad.” I really don’t use it that way. I use it as a primer.

 

You connected a lot of different dots with that response—diluting it more, the influence of thinking like a plastic surgeon. For less-experienced injectors, what can get them to the stage where they start making connections and discoveries like that? 

E.B.: It’s definitely experience, because when you’re confident, you can go into a consultation with the mind-set, “Well, I’ve been doing this for X amount of years.” At first, I was kind of doing it wrong, and that’s where I speak from. I’m like, “Hey, I was putting a bunch of filler into people’s cheeks to try to lift the laxity around their mouth and their lower face, and I really couldn’t figure out how to improve the skin around their mouth, like the smile lines and nasolabial fold, other than just adding filler to their face. And it looked weird. They couldn’t smile properly.” It really took me diving into a different modality—biostimulants, hyper-diluted Radiesse, and Sculptra—to unlock the importance of combining modalities to get the best result. 

 

So it’s really going in and saying, “Listen, I know this is costing you X amount of dollars, and you’re not gonna see a lot of results, and it’s kind of frustrating because people want to see instant results. But it’s like going to the gym every day to lose weight. It’s not fun, no one wants to do it, but it’s necessary.”

 

In my presentation, I’ll go over all the modalities. I’m focusing on Sculptra, but it’s good to know the other modalities they need and the way I combine it with Morpheus and with my Eight-Point Lift. Because the hardest thing is, “OK, I saw this lecture. Now how do I incorporate it into my practice and my patient’s plan of care?”

 

You mentioned some frustration with fillers and how you didn’t feel like your patients looked the way you wanted them to. What’s that like in real time? Were they happy with the results? Is that feeling more due to perfectionism on your part? 

E.B.: It’s more me. I think the patient doesn’t know, which is really interesting. It’s how society trends and how beauty standards really shift on us. And it’s our job [as injectors] to say, “This ain’t good.” 

 

Like, “We should do better”?

E.B.: Yeah, but our patients really don’t know. They love cheeks because it makes them feel instantly better. It’s like eating a chocolate bar, right? You feel instantly good. And then six hours later, you’re like, “Oh, that candy bar hit me.” People might feel great initially, but then you keep adding and adding and you can’t smile properly and the whole harmonization of your face is really thrown off. So that’s why it’s our job to say, “I totally get you want that lift and that fun contour. I’ll get you there, but let’s do Step One first, which is a full face of neurotoxin, a full face of Sculptra, Morpheus. Then let’s add a little bit more cheek, and you’ll be way happier with that result.” 

 

But it takes a lot of confidence to put my foot down and say, “No, I’m not putting one more syringe in your face. As a provider, it’s also hard because I probably make way more from an Eight-Point Lift, and it takes me just as long as doing one vial of Sculptra. It’s ethics, too. You have to do what’s best for patients, and those patients who do Sculptra have been seeing me now for seven years, and they’re so happy because I put my foot down and essentially said, “You have to eat your healthy greens before eating that candy bar.”

 

The title of your presentation uses the word “Priming” with Sculptra. A lot of people describe it as a kind of foundational treatment. Would you say this is now a product you build treatment plans around?

E.B.: Yes, one hundred percent. I don’t take new patients, but if I were to see a brand-new patient who’s 55, 60, 65…a majority of the injectors at the conference will be in that position where it’s, like, “What should I do with a 65-year-old patient who’s never had a syringe of anything in her face? Where do I start?” That’s where I’m like, “You have to start with full-face Sculptra. Then neurotoxin. I really talk about my treatment plan and how I differentiate between starting with Eight-Point Lift versus Sculptra, and the importance of priming the skin. 

 

That’s why I tell my patients, “I could just throw filler in your face, but I’d rather prime it with Sculptra first, give it three months for that collagen to really settle in, then add the filler. Because sometimes they come back and they’re very happy. They don’t even want filler. They’re just good, which is ideal because they’re happy with you and you saved them a bunch of money.

 

Does its ability to do a particularly great job of tightening skin around the mouth suggest people within a particular demographic are the primary candidates for this treatment? Or is its use far-ranging?

E.B.: I suggest it to all of my patients who are 25 or older. But it’s specifically for two different kinds of patients. One is those who are about 60 years old and do not want a facelift, so I say, “OK, well, filler doesn’t lift; filler fills. So the only thing I can do for around your mouth is Sculptra.” The second are those patients who have really heavy smile lines, or skin laxity, and they already have the maximum amount of filler, and it helps to give more support around the area.

 

As far as I understand, there’s a fair amount of maintenance, like massaging the face every day for a certain period of time. Is that still true?

E.B.: That is true, definitely. There’s a study that says you don’t have to massage, but I do have the patient massage for five minutes, five times a day, for five days. It can help decrease the risk of nodules. Still, the best thing to reduce the risk of nodules is on my end: making sure I dilute it enough, that I inject slowly, that I inject in the correct layer of skin, which I’ll discuss at the conference as well. 

 

In regard to expectations, there’s so much information out there now, especially with social media. Do you feel like that helps, in the sense that you can fast-forward a lot of the conversation with clients, or does it actually require more effort on your part to backtrack and start at the beginning? 

E.B.: I love it. I’m a millennial. I love technology. I want my patients to be as informed as possible. It’s very good for me because they see everything that’s scary, which I touch on in my consultation anyway. It’s my job to make sure they’re giving informed consent, and I don’t want anyone who’s not 100 percent ready. So I love the internet, I love when people Google things and find out the scariest horror stories. This is elective, no one needs it, so I’d rather they get all the information they possibly can.

 

You were one of the first injectors to start a virtual-learning platform. How do you go about deciding which topics to focus on? Is it based on questions you’re getting, or is it more about the things you’re fascinated about? 

E.B.: Questions. That’s all I do. I used to be concerned about running out of things to talk about, and now there’s not enough hours in the day to create content because there’s always another question about something.

 

How do you balance that content creation with being the co-owner of multiple practices? 

E.B.: I don’t have any balance. Right now, for instance, I’m speaking with you, and I have about two hours of work left to do here on the couch.

 

That’s probably relieving to many people, acknowledging how much work all this requires. 

E.B.: Yeah, I think people are like, “I want Instagram fame, and I want this, and I want that.” I’m like, “You could have it. You just have to be willing to put in the work.” I’m not a genius. I’m just dedicated. It requires a lot of discipline because there’s many times where I could just be, like, “I’m not gonna post today. I’m not gonna respond to this question on Patreon.” But then I tell myself to put in the discipline for X amount of hours and X amount of days, and then take a breather. But it’s also important to stay in your own lane. The way I keep going is by not comparing myself to anybody else. That would drive me nuts. I’m also obsessed with aesthetics. And when you’re obsessed with something, it really helps with your drive.

 

You have a pretty extensive medical background but have also attributed your progress to years of self-teaching. What, exactly, did that self-teaching look like? 

E.B.: We didn’t have Modern Beauty Con when I was getting started. We didn’t have these amazing conferences and learning platforms. So for me—and I think a lot of injectors have a hard time with this—it was a lot of experimentation. I was very confident in my understanding of anatomy and my skills, so I felt safe…but I had to push myself and try something in a different area, try a different dilution of Sculptra, or try flipping Eight-Point Lift and Sculptra to get those best results. It took me beta-testing it—and that’s the self-teaching. It’s a personality trait as well. I’m detail-oriented, and I’m also able to look at things and say if it’s gonna look good or not. A lot of people don’t trust their aesthetic eye, and that takes time. 

 

Join us for Erika’s presentation, “The Future of Aesthetics: Full Facial Rejuvenation — Priming with Facial Sculptra,” at Modern Beauty Con, on May, 6, 2023, at the Boston Park Plaza.