How One PA Shadowed Her Way Into Aesthetic Medicine: Simone Hopes, PA-C

Simone Hopes knew early on in life that she wanted to work in medicine. Her first unofficial patient was a dead frog she grabbed off the street at age 10. She used a science kit her mother had given her to dissect it, and she knew right then, “Yeah, this is what I want to do,” she says.

While she originally envisioned becoming a pediatric surgeon, that all changed when Simone, the third eldest of eight children growing up in Texas, saw a Physician Assistant (PA) care for her baby sister, who was born premature. It opened her eyes to a career that felt right for her. “I started to understand what a PA was and what their roles were, and the reality of them being able to do almost anything,” she says.

Fast forward a little over a decade. After earning a BS from the Tennessee State University in biochemistry and a MSHS with a PA concentration from the University of Maryland Baltimore Graduate School and Anne Arundel Community College PA program, Simone shadowed a physician assistant in Houston, solidifying her goal.

For the past three years, she has offered injectable procedures in patients’ homes, in Houston, Texas. But the journey to landing her first job out of school wasn’t easy.

Here’s how she navigated the complex process to becoming a Physician Assistant in Medical Aesthetics—and the valuable lessons she learned along the way.

1. Plan ways to get the experience your first job will require.

Most entry-level aesthetic injector jobs require two years experience, but how can you get job experience without that first job? Simone’s answer was a clinical rotation during PA school for plastics and reconstructive surgery. “That introduced me to neurotoxins and a little bit of aesthetic experience,” she explains, “so I used that as leverage when I applied at a local Med Spa.” She also called plastic surgeons all over Houston to find shadow opportunities; almost everyone turned her away, but eventually her perseverance paid off.

Her shadow opportunity came from a plastic surgeon at a practice in Houston, where she spent two to three hours a day for four months to learn and grow her craft, on top of her full-time work at a hospital and other educational courses. “You have to make sacrifices now for a greater reward later,” she says. That’s the kind of hard work that pays off in the industry. “My mentor trained me, he educated me on many of the intricacies of aesthetic medicine and when it was time, he vouched for me. He became my resume builder,” she says.

2. Find a mentor as well as a shadow opportunity.

When she was first applying to PA school, Simone found a mentor in a Black practitioner in family medicine who showed her the ropes, including neurotoxin injections, and ended up mentoring her all through PA school. “He allowed me to come in, literally get all my patient care hours,” she says. “He really helped me a lot.”

Now that she has experience, Simone finds enjoyment in being a mentor for other physician assistants just starting out. “If I’m working, I don’t mind someone coming and learning from what I’m doing and how I’m doing it,” she says, “I really enjoy giving people that extra push and helping to be that resume builder.”

3. Learn how to treat all skin tones—even if it’s not taught in school.

Simone’s aesthetic training didn’t come close to addressing the full palette of skin tones in the U.S. population today. There’s not a lot of clinical data on treatment of people of color, and even fewer products that cater to dark skin. With this knowledge gap in mind, Simone set out to learn on her own, finding a great resource in the Skin of Color Society, an organization that raises awareness of and supports research on dermatologic health issues related to skin of color. There she found books on how to treat skin and hair in people of color. For instance, she explains people with fair skin have a different focus than people with darker skin. Typically, individuals with fair skin focus on wrinkles and rosacea, which lasers can help.

Simone has also learned a lot from a new book about skincare for people of different ethnic backgrounds. It addresses things like how to treat hyperpigmentation, targeting inflammation—not just the discoloration afterward.

4. Don’t let those initial rejections stand in your way.

Simone currently has a whopping 72 direct messages from aspiring aesthetic providers who want to shadow her—and she can’t possibly accommodate them all. “People have been met with a lot of rejection, and it makes you question, 'Is this what I’m supposed to be doing? Should I continue to try this?'” she says. What is worse is that many providers keep their techniques close to the vest, lest they lose clients. But Simone sees it another way. “I think it should be community over competition, because, ultimately, we're all in this together.” Put in the legwork, search for a Medical Aesthetics provider to shadow, she urges, because there will be someone who wants to see you grow and isn’t worried about you poaching their clients.

5. Find community—even if you have to create it.

Simone would like to see more diversity in the Medical Aesthetics industry, and one way to get there, she says, is to help each other. “Like ‘hey, you're right down the street, if you have a diverse patient population, do you mind if I stop by and check out how you treat people from different backgrounds or of different ethnicities?’ Instead of seeing it as competition,” she says.

She and another woman of color she met at a conference started a group with about 25 Black injectors from all over the country. “Just to be able to have that resource with people not feeling like, ‘oh no, she’s going to take my ideas’—it’s amazing,” she says. Members bounce ideas off of each other, ask about policies and procedures. They make sure to like each other's posts on social media and just generally try to help one another. “I think that's what we need as an aesthetics field, in medicine in general, and overall, to help us progress.” Simone suggests checking out aesthetic practitioner groups on Facebook. And if you can’t find what you’re looking for, start your own.

6. Look outside your neighborhood and beyond social media to broaden your aesthetic perceptions.

Too many people compare themselves to images on Instagram. “I see these girls with these high cheekbones and a brow shaped a certain way,” she says. “I don't want to look like that,” and many of her clients don’t either. Patients often ask which treatment different influencers or actresses they have seen have done so they can achieve a similar look. “I always tell them, I want you to look like, ‘I woke up like this,’ not like, ‘Girl, what did you do?’” She adds that of course she gets aesthetic procedures—but not to the point where she’s completely changing her overall look. “I still have all my ethnic features,” she says.

Traveling around the world—immersing herself in a country’s culture and artistry—has broadened Simone’s perceptions, and she brings those insights back to her practice. “Look around you for inspiration. There is a big world out there and people outside your neighborhood or even your country can offer you a new perspective,” she says.

7. Make it a priority to learn the business side of the industry.

Medical schools and Physician Assistant programs rightly focus on training providers to achieve desired medical and aesthetic results. Some items often missing from the training curriculums are key lessons on how to build a practice. “That’s why it’s so important when you want to branch out to know the business, know the rules, know the laws, know what you can and can't do as a clinician—a physician assistant, nurse practitioner, medical doctor, whatever it may be,” Simone advises. “Because, ultimately, even if you can get great results for your patients, you won’t be able to get any results if you're not able to practice.” Simone has learned a lot from the trial and error of colleagues. “In private, people don’t mind showcasing the failures that helped them get to where they are now,” she says, which is one more reason to value community over competition. Any one failure should help build everyone’s success.

8. Look for opportunities that enhance your patients’ experience.

Simone is part of a network of aesthetic injectors who travel to private family homes. By visiting people in their homes and meeting their families she gets a better understanding of who they are and what is important to them. “I get to know my patients’ ins and outs, and I like having that connection with them,” she says.

Another perk of getting out of the office is freeing people to pursue their own take on Medical Aesthetics. Simone tells the story of how some of her patients are not comfortable in traditional aesthetic practices because there can be an unspoken pressure to conform to a certain aesthetic. “The front desk people, the manager, everybody might have a certain look,” Simone says. “I realize that we often compare ourselves, including our faces and our bodies, to the people we surround ourselves with. When patients are at home, it’s their environment, they're free,” Simone says. “So they can really tell me what they are hoping to achieve without feeling the pressure to look like somebody else.”