The standard picture of opening an aesthetic practice involves a lease, a build-out and a launch. Maritza Mejia FNP did none of that. She started in her own house, treating patients as a concierge injector, and grew into premises one rented room at a time.
The route is unglamorous, it is cheap, and it is repeatable. It is also funnier than the conventional version.
The Botox Garage
She began by going to patients rather than having them come to her.
“At the beginning we did the concierge injector,” she says — travelling to people's homes to treat them. Then the model inverted and they started coming to her, which is where the house came in.
“I didn't realize my garage was going to be the Botox garage,” she says. “My living room, my dining room, was a waiting area.”
The economics were, briefly, excellent: “I was paying my own mortgage. So it was perfect for me. That was money made.” No rent, no build-out, no second set of bills — every treatment went against a cost she was already paying.
Why It Could Not Last
Two pressures ended it, and both are worth anticipating if you are considering the same start.
The first was domestic. “My husband is like, okay, this is crazy, we can't even eat” — with the dining room functioning as a waiting room, the house had stopped being a house.
The second was the neighbours, and it is the detail everyone remembers: “Even my neighbour is like, too many cars. They thought I was doing drugs in that house.” As she puts it, “the wrong drug — it's like a beauty drug.”
A steady stream of unfamiliar cars arriving at a residential address at appointment intervals looks like exactly one thing to a neighbour. Beyond the comedy, there is a real point: a home-based clinical operation has zoning, privacy, insurance and licensing dimensions that a spare room does not solve, and the pressure to move is not only social.
The Suite Model: How the Maths Actually Works
“That forced me to go into a suite,” she says. And this is where the number that makes the whole model work appears.
“I got one suite, and they charge you weekly. New York, they charge around $350 per week. But if you do a toxin, one patient, you already pay for that suite.”
Read that again, because it is the entire argument for starting in a rented suite rather than a leased clinic:
- The commitment is weekly, not multi-year. A traditional lease is a large fixed cost for a term you cannot exit. A suite is a small fixed cost you can stop.
- One treatment covers the week. At that rate, a single neurotoxin patient clears the rent. Everything after that is contribution.
- The break-even is visible. You can hold the whole calculation in your head, which means you always know where you stand.
Compare that to opening with a build-out, devices on finance and staff from day one — the position covered in how to open a med spa, where fixed cost is what removes your ability to be patient.
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Growing By Adding Rooms
From there the expansion was incremental rather than a leap.
“So I was just continuing doing that. And then we opened a second suite, then a third suite.”
Each addition was justified by demand that already existed, and each could in principle be reversed. That is the opposite of the conventional path, where you commit to the space first and then try to fill it.
And the identity grew with it: “I started as Injectables by Maritza, when it was a solo person — with my own social media, my own appointments, my own everything — to Long Island Beauty Bar by Maritza.”
Worth noting that the brand changed when the business did. She did not launch a practice name and grow into it; she named the solo operation honestly and renamed it when it became something else.
What She Would Warn You About
Mejia is candid that the growth outran her preparation. “I didn't realize how the business was going to go, because I wasn't prepared for this.”
That is the standing risk in the staged model: it is so easy to add the next suite that the administrative layer never gets built deliberately. The counterpart story — a practice opened before the owner was ready for the administration — is I bought myself a job.
She also kept her hospital income during the early phase, treating on the side, which is what made a cautious start affordable at all.
The Staged Path, Step by Step
- Train first, and practise on friends and family. Build repetitions before overhead.
- Keep your existing income while the patient base is small.
- Start with a narrow menu. Mejia's opening list was neurotoxin, filler and one microneedling device.
- Know the rules before you treat anywhere. Where you may treat, and under what supervision, is a state question — and a home is not automatically a permitted setting. See who can own a medical spa.
- Move to a weekly suite when demand or the neighbours make it necessary. Check the break-even: how many treatments cover the week?
- Add the next room only when the current one is full.
- Build the administration deliberately before the third suite, not after.
Empire runs a workshop specifically on this route — starting an aesthetic practice while still working — with the business architecture in Blueprint for Success and scaling an aesthetic practice for what comes next.
Frequently Asked Questions
Can you start an aesthetic practice from home?
Some clinicians begin that way, and it removes rent entirely at the start. It also raises zoning, privacy, insurance and licensing questions that a spare room does not answer, and where you may lawfully treat is a state-level question. Confirm your position with your board before treating anywhere.
What is a med spa suite and what does it cost?
A suite is a single treatment room rented within a larger facility, usually on a weekly or monthly basis rather than a multi-year lease. The faculty member in this article cites roughly $350 a week in New York — at which a single neurotoxin patient covers the week's rent. Rates vary widely by market.
Is it better to start in a suite or lease a clinic?
A suite keeps fixed cost low and reversible, which preserves your ability to grow slowly without pricing pressure. A full lease commits you to a large fixed cost before the patient base exists. The staged approach described here adds rooms only as demand justifies them.
What is a concierge injector?
A clinician who travels to the patient rather than treating in fixed premises. It removes premises cost at the start, and carries its own considerations around supervision, emergency preparedness and what is permitted in your state.
Disclaimer
This article is educational and is not legal, financial or medical advice. Rules on where treatment may be delivered, supervision, delegation and practice ownership vary by state and change over time. Confirm your position with your state medical or nursing board and with a healthcare attorney licensed in your state before treating outside a licensed facility or opening a practice.
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