My Start in Aesthetics by Rana Kennelly

I want to start by telling you this: You’re beginning from a really good place—right here with us at The Confidence Lab.

If you want this career in medical aesthetics—if you’re willing to put in the work, stay humble, and stay honest—you will be successful. I truly believe that.

I’ve been in aesthetics for over 20 years. I started before Botox Cosmetic was even FDA-approved in 2002.

I started injecting bovine collagen—a product called Zyplast made by Allergan. Every patient needed an allergy test before treatment. We’d test them, have them come back the next day, and if all was well, they’d get injected. Zyplast was a creamy substance that lived in the fridge and was originally FDA-approved for treating wrinkles—not for lips.

But that didn’t stop collagen lip injections from exploding in popularity after the movie Beaches came out in 1988. In that film, Barbara Hershey played a character ten years younger than she actually was, with noticeably pouty, collagen-filled lips—and just like that, everyone wanted “the Beaches lips.”

That moment sparked one of the first big lip enhancement trends in aesthetics—even though the product wasn’t technically meant for that area. And look where we are now—some things haven’t changed much, and yet, so much has evolved.

When Restylane, the first hyaluronic acid filler, was FDA-approved in 2003—it was the Wild West. No protocols. No structured training. No conferences.

It was the blind leading the blind.

And in a strange way, it was kind of amazing. We didn’t think anything could go wrong. I remember treating a patient who broke out in cold sores after lip filler, and we just thought, “Oh, it’s a cold sore!” Little did we know—it was vascular compromise. That realization only came years later, in hindsight. Back then, no one had heard of Hylenex for reversing hylarounica acid filler let alone been trained in emergency protocols for adverse events.

I’ll never forget when Radiesse got FDA-approved in 2006. We were taught to inject it intraorally—yes, inside the mouth. You’d stick a needle between the 4th and 5th tooth, straight into a bacteria-filled space, with no pre-cleansing, and blindly inject 1.2 ml of a non-dissolvable biostimulator directly into the cheek. Then massage it into place.

That was the protocol. And we did it—because we didn’t know any better. But honestly? My gut told me it wasn’t right. I did it anyway. Now I teach: always listen to your gut.

Years later, I found myself at my first-ever aesthetic conference, led by the fabulous (and fabulously overdone) Dr. Fredric Brandt—the “Botox Baron,” dermatologist to the stars, from Miami to Manhattan, treating celebrities like Madonna. If you don’t know him, go look him up.

He walked in, long and graceful strides, swinging a custom Louis Vuitton bag with his name on it. He asked the room: “What’s your Botox reconstitution?”

He started at 10cc. Hands went up. Then 9cc… 8cc… all the way down to 1cc.

I was one of only four people in a room of 150 plus practitioners who raised their hand at 1cc.I wanted to crawl under the table. I felt like such an outlier and wanted to hide in the herd. I was terrible at math, and I just liked the simplicity of 1cc.The most common reconstitutions at the time were 2.5cc (on label) or 4cc. But I still remember the hands going up for 10cc and thinking—Are we serious?

Imagine the golf balls of fluid and the spread of toxin into neighboring muscles at that dilution—treating the mentalis or DAO and inadvertently hitting the DLI? Ahh! But don’t worry…Back then, we weren’t even treating the lower face with Botox—we just froze the upper face and left the rest to rot.

The first thing you learned with fillers? How to dental block your patients. Because hyaluronic acid burned like hell. There was no lidocaine in it. We’d block patients so hard their faces would droop. They’d walk out looking like stroke victims—slanted mouths, frozen lips, overfilled nasolabial folds—and still thank us at checkout.

Now picture the look back then: A frozen forehead. Flat brows. Zero expression. Shiny glare bowling ball. Overfilled nasolabial folds so you resembled a monkey and puffy sausage filled lips. It was a look that people got addicted too and paid for, let’s say that.

Then in 2009, Juvederm Ultra XC and Juvederm Ultra Plus XC were FDA-approved.The boxes had two new letters on them: XC. None of us even knew what they meant. There weren’t reps in every office like there are now. Later, we learned: XC = Extra Comfort, because the fillers were pre-mixed with lidocaine.

Game changer.

And everything was done with needles. Cannulas weren’t used for dermal fillers yet—they were for fat transfers. There weren’t any thin enough for aesthetic use.

That brings me to another memory—when I wanted to learn how to use a cannula, I called everyone across the country looking for training. Eventually, I got in touch with a cannula company who told me: “If you want to train with the best, you’ll have to fly to Paris.”

So I did. Next thing I knew, I was on a flight to Paris to train with plastic surgeon Dr. Sandrine Sebban, founder of the SoftFil® cannula technique. In Europe, her original cannula was actually placed inside the Voluma box along with a needle. I believe the gauge was 18G or 20G—but don’t quote me on that.Can you imagine using something that big today?! For reference my favoured cannula is a 25g.

Fast forward to today...

I created The Confidence Lab so that you could start from a place of support, safety, and structure.

You don’t need to guess your way through this industry the way I did. You don’t need to fake it until you make it. You are not alone. And if I’m being honest? My greatest strength is in sharing my mistakes. It’s also my proudest truth.

By being open about where I’ve messed up. But I have learned how to grow from my mistakes and I’ve helped build a culture where we all get better together.

You’re entering this industry at a beautiful time.

A time where evidence-based practice leads the way. Where mentorship is real. Where patient safety is a priority. You have access to research, resources, and most importantly—people who truly want to see you thrive.

Lean on us. Ask questions. We are all human and we are all going to continue to make mistakes, just not big ones. If you stick your head out, you’ll find there’s a whole community waiting to help. I promise. And we’re here for you.