Medical Aesthetician, Facialist, MA

With more than 20 years in aesthetics and a decade at CSLC, Karmen Endress, LA, MA, has had a front-row seat to the evolution of aesthetic medicine. Now caring for patients in Lake Mary and Winter Park, Karmen brings decades of experience, a thoughtful approach to skin health, and a belief that the best treatment plans begin with listening. Get to know Karmen, her approach to aesthetics, and the experience that has shaped the way she cares for her patients.

Can you tell us a little about yourself. Where do you live, and what do you enjoy outside of work?
I moved from Traverse City, Michigan, to the Lake Mary area about two years ago. Before that, I worked with CSLC in Traverse City and Suttons Bay for about eight years, and when CSLC opened in Winter Park, I came down to help with the new location.

I have two kids, and outside of work, I love pretty much anything outdoors. Biking, camping, and paddleboarding are some of my favorites. I definitely miss Michigan summers and all of my friends and coworkers in Traverse City, but I do not miss the winters! I will take the Florida heat over the snow and cold any day.

How did you get started in aesthetics?
I have been in aesthetics for more than 20 years. I actually started my career in resort spa settings and gradually transitioned into medical aesthetics. Over the years, I worked in dermatology and then spent about 10 years working for a plastic surgeon before moving to Traverse City.

When I moved, I was looking for something different from the surgical environment. I happened to see a CSLC commercial, looked into the practice, and decided to check it out. That was 10 years ago!

Have you personally tried any of the treatments offered at CSLC?
I have tried a lot of CSLC treatments over the years. Most recently, I tried AcuPulse CO2 laser resurfacing when we brought it to Lake Mary, and it was amazing. I have also experienced treatments like LaserLift, BodyTite, threads, fillers, and many others. Having firsthand experience with so many treatments helps me understand what patients can expect throughout the process.

What is your philosophy when it comes to aesthetic treatments?
I focus on the patient and try to listen more than I talk. I want to understand exactly what they are trying to achieve, what results they prefer, and what budget they are working within.

Sometimes the best treatment plan means taking a little longer to reach the destination, and that is completely okay. We can still get there. It is about finding the best path for that particular patient rather than giving everyone the same plan.

What treatments do you especially enjoy performing?
I have always loved treatments like Ultherapy, IPL, microneedling, and Morpheus8. In Florida, microneedling and Morpheus8 are two treatments I especially enjoy performing.

I love treatments that stimulate the skin and work with the body’s own regenerative processes because you can create beautiful improvements while still keeping the results natural.

What are some of the most common skin concerns patients bring to you?
Texture, tone, and pigmentation are probably about 75% of what I see, especially since moving to Florida. Sun exposure and the wide variety of skin types we treat here make those concerns especially common.

One of my favorite approaches for pigmentation and texture is combining a series of microneedling treatments, VI Peels, and Hydrafacials. Those modalities work differently, and when you use them strategically together, you can create a real transformation in the skin.

Why do you believe combination treatment plans are so important?
There usually is not one single treatment that accomplishes everything a patient wants. Different modalities address different components of aging and skin health.

For example, one treatment may stimulate collagen and elastin, while another addresses pigmentation, texture, or volume loss. We can also incorporate regenerative options like PRF when appropriate. I spend a lot of time educating patients that achieving their goals may involve blending several approaches rather than relying on one treatment alone.

Do you have a favorite patient success story?
One of my favorites actually led to something much bigger at CSLC.

I had a patient who wanted Morpheus8 but could not comfortably tolerate the treatment. I started thinking about how we could pivot and still help her achieve a more intensive skin rejuvenation result. We combined traditional microneedling with PRF and fractional resurfacing, and she had such great results.

I shared what we were doing with the team, and we began using the approach more in Traverse City. That concept eventually evolved, with additional modalities added, into CSLC’s exclusive RegenGlo treatment. It is pretty exciting to look back and realize that a solution created for one patient helped inspire something we now offer across CSLC.

What do you tell patients who are afraid aesthetic treatments will make them look overdone?
I remind them that it takes quite a lot to create the exaggerated results they may have seen, and that is not what we want for them either.

CSLC takes a conservative approach. We want you to look well rested and like the best version of yourself at whatever age you are, not like you obviously had something done. It is much easier to start conservatively and build from there than to go too far. Patients should never feel like the goal is to completely change their appearance.

What do patients commonly misunderstand about Botox and fillers?
People sometimes think Botox can go anywhere or that it will erase every line. That is why education and realistic expectations are so important.

Neuromodulators like Botox and Dysport reduce muscle movement, but if a line is already present at rest, we may soften it without completely eliminating it. Improving that line may also involve skincare, microneedling, or another modality.

It is similar with filler. Patients may hear that they need several syringes and think that sounds like a huge amount of product without realizing how that product is distributed throughout the face. Once you explain what each treatment does and why you are recommending it, the treatment plan makes much more sense.

What is one piece of advice you give every new patient?
It is never too late to start using high-quality, medical-grade skincare. I always tell patients that investing in treatments without taking care of your skin at home is like going to the gym and then going home and eating donuts.

You do not need 10 different products. I would rather have someone consistently using a few products that are right for their skin, including an appropriate retinoid or exfoliating product when indicated.

I also remind patients that something is better than nothing. Not everyone has an unlimited aesthetic budget. If three microneedling treatments are not realistic right now, doing one is still better than doing none. We can build a care plan around your budget and take a little more time to reach the goal.

What makes CSLC different from other aesthetic practices?
I have been in aesthetics for more than 20 years, so I have watched this field change tremendously. We have gone from relying heavily on surgical approaches to having incredible technologies that can create impressive results with less invasive treatments.

One of the things I value most about CSLC is that the practice stays at the forefront of new techniques and technology while continually educating its providers. I believe in the vision Courtney and Dr. Lo have for CSLC and RegenCen and the emphasis they place on continuing education. This field changes quickly, and being part of a team that continues learning and evolving is incredibly important.

How have you seen aesthetics evolve throughout your career?
The technology, products, and ingredients have improved dramatically. We can accomplish things today without surgery that simply were not possible earlier in my career.

I am also excited about the direction of regenerative medicine and the increasing attention being given to areas like hormone optimization. Having personally experienced hormone therapy, I understand how impactful that conversation can be. Seeing aesthetics and regenerative care come together is something I find incredibly exciting.

What does confidence mean to you?
I think confidence comes with experience. It comes from trial and error, learning from mistakes, and eventually knowing what works and what does not.

It also comes from having confidence in the people around you. We work collaboratively at CSLC, and there are times when the best thing you can do for a patient is talk through a case with another experienced provider. Being able to draw on one another’s expertise helps us determine the best path for each individual patient.

What is a skincare myth you love busting?
That dermaplaning makes your hair grow back thicker or darker! If that were true, men’s beards would be completely out of control. Dermaplaning does not change the hair follicle, so it cannot change how the hair naturally grows.

What is your go-to skincare product?
Anything that promotes appropriate exfoliation and cellular turnover. Depending on the patient, that might be AlphaRet, a retinoid, or another exfoliating product.

You can have an entire arsenal of skincare products, but if you are not appropriately exfoliating, you are trying to treat skin cells that are ready to shed. Consistent exfoliation can make a tremendous difference in texture, tone, and how well the rest of your skincare routine works.

What is your dream destination for rest and recharge?
I would love to go to Fiji and stay in one of those overwater bungalows where you can look down and see the fish beneath you. I went to Greece recently, which was incredible, but staying in one beautiful place over the water and completely relaxing sounds pretty perfect.