Clinical Practice Development Director 

We sat down with Lee Middleton, BSN, RN, Clinical Practice Development Director at Cosmetic Skin & Laser Center, to talk about what she’s learned from nearly two decades in aesthetic medicine, why education and trust matter just as much as treatment, and how regenerative aesthetics are shaping the future of patient care. From helping patients rediscover their confidence during life’s biggest transitions to training the next generation of providers, Lee shares the philosophy that has guided her career: the best aesthetic results are the ones no one can detect.

Tell us a little about yourself. Where do you live and what do you enjoy outside of work?
That’s always a funny question because my answer depends on the week. One week I’m in Petoskey, the next I’m in Suttons Bay, and then I’m back in Florida. My home base is South Africa, so I joke that I’m a bit of a squatter between Michigan and Florida these days, and it’s working out just fine.

Outside of work, my perfect day starts with a slow morning, a great cup of coffee, and a hike in nature with my husband. I also love planning travel whenever I can. That’s definitely my happy place.

What inspired you to pursue a career in aesthetics?
Interestingly, I kind of fell into it. I originally came to see Courtney as a patient because I was interested in Botox in my mid-to-late thirties. Around that same time, an opportunity opened up at CSLC, and I learned everything from the ground up under Courtney’s mentorship.

The job came first, and the passion followed. Looking back, it was one of the best unexpected career paths I could have imagined.

What was your background before joining CSLC?
I spent 15 years working in labor and delivery and women’s health. That experience gave me a strong clinical foundation and reinforced how important patient education, trust, and long-term relationships are. Those same principles continue to guide me in aesthetic medicine today.

Have you personally tried any treatments CSLC offers? Which are your favorites?
I’ve tried every treatment we offer.

If I had to choose one favorite, it would be Total FX laser resurfacing. I’ve done it eight times over the 17 years I’ve worked here, and nothing compares when it comes to giving your skin a true reset.

That said, I believe the best outcomes come from combination treatments. Healthy skin paired with thoughtfully placed injectables creates results that look natural, refreshed, and long lasting.

What’s your philosophy when it comes to aesthetic treatments?
The best aesthetic results are undetectable.

I want patients to feel like their investment was worthwhile every time they look in the mirror, but I never want someone else to immediately think they’ve “had work done.”

As I’ve gotten older, I’ve become even more passionate about skin health and skin radiance. Structural support absolutely matters, but healthy, glowing skin is the foundation of beautiful aging.

What concerns do patients most commonly come to you with?
Many patients tell me they woke up one day and suddenly felt like they had aged overnight.

That often happens during late perimenopause or early menopause, when hormonal changes can dramatically accelerate visible aging. It creates an opportunity to talk not only about aesthetics, but also about hormone optimization and regenerative medicine because both play an important role in helping patients look and feel their best.

What’s your favorite treatment combination for natural-looking results?
I like building treatment plans around a strong foundation.

If someone already has beautiful skin quality, we may focus on treatments like Ultherapy to strengthen deeper structural support. If skin quality is the primary concern, then microneedling or laser resurfacing becomes the priority.

From there, we thoughtfully layer injectables to restore balance. That combination creates the most natural, long-lasting outcomes.

One of your favorite patient success stories?
Rather than one specific patient, it’s really a category of patients.

I love working with women who are navigating a major life transition, whether that’s becoming an empty nester, going through a divorce, or experiencing a significant personal loss. They’re often ready to prioritize themselves again.

Watching them regain confidence, feel healthier, and reconnect with themselves is incredibly rewarding. It’s never just about looking better. It’s about helping someone feel like themselves again.

Many patients worry about looking overdone. What do you tell them?
Education changes everything.

I often pull out before-and-after photos of our own patients and walk them through what natural results actually look like. We also spend time explaining facial balance and why supporting the outer framework of the face is often more important than simply adding volume to the center.

That’s what prevents the overfilled look people are afraid of. Once patients understand the “why,” they feel much more comfortable.

Is there a treatment that has surprised you most with its results?
Microneedling with PRF continues to impress me.

The science makes sense. You’re creating a controlled injury that stimulates your body to repair and regenerate itself. Whether someone is in their twenties or their nineties, it consistently improves skin quality in a meaningful way.

What’s one thing you want every new patient to know?
Walking into an aesthetic consultation can feel vulnerable.

You’re meeting someone new and talking about the things that make you feel self-conscious. My goal is to make patients feel heard, comfortable, and confident that they’re in the right place before we ever talk about treatment recommendations.

Trust always comes first.

How has aesthetic medicine changed over the last 5 years?
Social media has changed everything.

Patients have access to more information than ever before, which can be both helpful and overwhelming. My job is to help separate trends from science.

One thing I’ve always appreciated about CSLC is that we’ve never chased trends simply because they’re popular. Courtney and Dr. Lo have always emphasized evidence-based treatments that are proven to deliver safe, consistent outcomes.

Where do you see aesthetic medicine heading in the next 5-10 years?
I think regenerative aesthetics, metabolic health, peptide therapies, and biostimulatory treatments will become even more integrated over the next decade.

We’re already seeing that shift happen, and I believe we’re only at the beginning. I also think we’ll discover even more ways to use our own biology, beyond PRF, to naturally support healthier aging.

What do you enjoy most about being part of CSLC?
The culture.

From the very beginning, we’ve focused on education instead of trends, quality instead of discounts, and long-term patient relationships instead of memberships.

CSLC invests heavily in provider education because knowledge directly impacts patient outcomes. That’s something I’m incredibly proud to be part of.

What does confidence mean to you?
Confidence comes from feeling healthy, feeling comfortable in your own skin, and knowing you’re taking care of yourself.

When your physical health, emotional well-being, and appearance begin working together, confidence naturally follows.

A skincare myth you love busting?
You don’t need an elaborate routine to have healthy skin. If I could recommend one product to almost anyone, it would be prescription tretinoin. Pair that with a little Botox or Dysport a few times a year, and you’ve built an incredibly effective foundation.

Your dream place to recharge?
South Africa will always be where I go to reconnect with myself. It’s home, it’s peaceful, and it’s where I feel most grounded.