We had the good fortune of connecting with Michelle Cote and we’ve shared our conversation below.

Hi Michelle, we’d love to hear more about how you thought about starting your own business?
After 15 years in high-volume dermatology practices, seeing 38+ patients daily, I faced increasing frustrations: bureaucratic red tape from insurance companies, inability to fully help my patients, high office-staff turnover, and a shift from patient-centered care to profit-driven private equity demands. This environment led to burnout and stress, prompting me to seek change. I wanted to feel valued, not just viewed as a commodity, and realized that I could provide value to myself by starting my own aesthetic business.

Seeking better work-live balance became even more important after having a child and the COVID pandemic. I desired flexibility to enjoy more time with my family and the San Diego lifestyle. I always loved the aesthetic side of dermatology and, although I initially thought it was impossible as a Physician Assistant due to regulatory constraints, I saw colleagues in California successfully running their own practices. This realization, combined with legal guidance, gave me confidence to seek this path.

It was not long after my first meeting with attorneys that a trusted friend and colleague, working as a regional sales director for a Southern California start-up helping medical providers launch their own med spas, reached out. It felt like a sign to take the leap!

Can you give our readers an introduction to your business? Maybe you can share a bit about what you do and what sets you apart from others?
It took about a year in business to truly define our brand. Every experience, from patient visits to partnership opportunities – whether positive or negative – has been essential to our growth. At Etoile Aesthetics SD, our focus is on fostering a trusting and supportive relationship between patients and provider throughout their aesthetic journey. We offer non-surgical aesthetic treatments such as neuromodulators, biostimulatory treatments, fillers and more.

With my background in dermatology and dermatologic surgery, I bring over a decade of intricate knowledge to my clients. While anyone can create a skincare line or repeat product marketing talking points, becoming a true skin expert requires in-depth knowledge, continuous education, and practical experience. Our goal is to enhance natural beauty with a conservative, thoughtful, and artistic approach that boosts confidence without changing one’s appearance.

Many of our clients come to us from larger med spas where they felt unwelcome or pressured by sales quotas. My aim is to maintain a small, boutique practice that tailors to each client’s specific needs, providing a welcoming, safe, and comfortable environment. Safety is our top priority. With my extensive training as a Physician Assistant, clinical experience, ongoing education, and a competent team, we strive to offer our clients a trusted expert experience. We want the public to see value in the treatments they are seeking, not just the price per unit or the price per syringe.

Any places to eat or things to do that you can share with our readers? If they have a friend visiting town, what are some spots they could take them to?
I’m fortunate to have my best friend locally, but when newcomers visit, we tailor our recommendations to their desired experiences San Diego is a fantastic family-friendly city, and I’m grateful to raise my son here. Attractions like Sea World, the Zoo, the USS Midway Museum, and Legoland are always a hit. For awe-inspiring hikes, Annie’s Canyon in Solana Beach, as well as Torrey Pines Reserve, are great options. Beach days are my favorite leisure activity with La Jolla Shores, Coronado, and Cardiff being my top choices.

When I’m solo, I enjoy hanging out at Pacific Beach, riding a beach cruiser on the boardwalk, grabbing a cocktail at JRDN, and savoring fish tacos at PB Fish Shop or Oscar’s. Stand-up paddle boarding at La Jolla Shores offers both a good workout and a calming experience, with mesmerizing marine life including, sharks, sea lions, fish, and stingrays. Unwinding with a glass of wine or happy hour anywhere in Little Italy with girlfriends is always satisfying.

Who else deserves some credit and recognition?
My family and husband have always been super supportive of my career choices. Wanting to start my own business was no different. My husband has a Master’s degree in Finance and an MBA so he has been a great advisor throughout the whole process. My patients that have followed me through the years and trusted me enough to refer their friends and family certainly have contributed to my confidence and success. Their loyalty means the world to me! I must also recognize Portrait and Brittany Bureski, Owner of The B Means Business, for their immense effort and dedication in helping me launch my business. Their support has enabled me to no be able achieve a level of independence and control, I also owe tremendous acknowledgment to my referral partnerships, Elevate Training and Altha Align, both women-owned small businesses that are aligned in business philosophies. They have gone out of their way to be a huge part of my success and have been incredible to work with. I don’t take it lightly when a small business recommends me to their clients. It’s an honor and it drives me to be at my best every day.

Website: https://etoileaestheticssandiego.com

Instagram: etoileaesthetics_SD

Image Credits
1st photo (outdoors) – Sandra Tenuto
2nd photo headshot, last 3 photos- Izabela Sekowska
Patient Before and Afters – Michelle Cote

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