How to Run a (Remote-friendly) Healthcare Practice

How Nicci Levy Built a Botox Empire on Customer Experience


In 2009, Nicci Levy took a job as a business development manager at Allergan, the pharmaceutical giant behind Botox. Working her regular beat between Los Angeles dental offices, doctor’s surgeries, and beauty spas, she noticed a disconnect between how she thought about beauty and the way medical experts delivered facial aesthetics treatments. 

It was a realization that would inspire Levy’s future business empire.

Levy was a beauty industry vet. She’d worked at the Benefit Cosmetics counter at Macy’s during college and landed a steady stream of gigs in the industry after she graduated. So she understood the intimate relationship people have with cosmetic services.

“Our faces are so unique to our beings,” she explained in an interview with Spotlyte. “Because of this, it’s vital to make people feel truly cared for, and creating a memorable and elevated experience for someone is key.”

But from what she saw on her rounds, the experience of receiving a Botox treatment was as far from that as it was possible to be. Botox was delivered like a flu shot in sterile doctor’s offices and dental surgeries. “[Y]ou’re sitting in a medical office,” she told The Cut, “next to sick people, next to acne patients, next to surgical patients—and you’re there to look pretty, you know?”

Levy spied an opportunity.

By transforming Botox from an unglamorous and functional service into an enjoyable experience, Levy could create a new business category—and own a large chunk of the market.

The Drybar of facial aesthetics

While Levy’s plan was bubbling away in the back of her head, someone was testing out her idea, albeit in a different industry. Fellow Los Angeles resident, Alli Webb, had just launched Drybar, a chain of hairdressing salons. But Webb’s salons weren’t like all the others that dotted LA’s streets. 

Instead, they offered only blowouts, taking what was once a functional part of a haircut and turning it into its own luxurious experience:

Alchemy 43’s treatment room

“I thought it was so amazing how they took something that was part of a larger hair styling experience and they kind of extrapolated that out and they made it its own category,” Levy told Girl Boss

“So, I thought, why can’t we do this with injectables? Why can’t we literally extrapolate it out of the larger medical or dermatology or plastic surgery experience and really focus on it and make ourselves experts at it?”

Levy began planning her own version of Drybar: a clinic that focused solely on facial aesthetics, turning a dentist’s side gig into an experience people would actually enjoy. She drew on all her industry expertise and even called in a favor from her brother, who was at a business school in France, to consult on her business strategy. 

Eventually, with her plan perfected and figures double-checked, Levy went on the hunt for investors—a search that didn’t take too long.

At a women’s entrepreneur event in LA, Levy spotted Toni Ko, the founder of NYX Cosmetics, who had recently sold her business to L’Oreal for $500 million. Levy immediately jumped on LinkedIn, found Ko, and tapped out a quick introductory message: “Hi, you don’t know me, but you will, and I’d like to talk to you about this idea I have.”

Ko agreed to meet for breakfast the next morning, and by the end of the meal, she was sold on the plan. “I’m in,” Ko said, according to Levy. “How much money do you need?”


A Guide to Evolving Your Clinical Operations

A wrinkle-free patient experience

With a little investment, Levy began building her first clinic, Alchemy 43—and it was unlike anything the industry had seen before. The typical strip lights and utilitarian waiting areas were replaced by bright colors, comfy furniture, and neon—lots of it. “BRB… Taking Care of Me,” read one bright looping sign. “No Lines Here,” read another:

Even the treatment names were non-medical. Ask for a “Smooth Talker” and Levy would iron out your laugh lines with Juvéderm. Request “Hello, Bright Eyes” and she’d freshen up your face with a couple of units of Botox.

Avery Stone, a journalist at The Cut, recalled visiting Alchemy 43 for the first time. 

“This is my first-ever cosmetic treatment, though the room feels designed to make me forget I’m having a medical procedure at all,” she wrote. “I’m sitting in an ENT chair, but there’s a gold chandelier on the ceiling, a gold accent chair in the corner, and succulents hanging on the wall.”

Technology played a huge role in Alchemy 43’s experience, too. Levy scans her patients’ faces using cutting-edge 3D imaging tech and then digitally treats the photos to show patients what they would look like after certain treatments. 

“The day I visit, after having three photos taken of my face from different angles, I ask to have myself edited to mimic the results of various treatments, including lip enhancement and a jawline contour,” Stone said. “The sensation is one of having a selfie FaceTuned by a stranger.”

Everything about Alchemy 43 is designed to normalize facial aesthetics, to align it with a blowout from Drybar rather than a root canal from the dentist. Levy believes Alchemy 43’s improved patient experience is having a much wider effect, nudging the service out of its niche and into social acceptance—a route already traversed by waxing.

“[Waxing was a] fringe thing to do, but things go through this evolution and then pretty soon everybody does it and you’re crazy if you don’t,” she told Vox. “I feel like Botox and injectables are at that peak now. No longer is it this shameful thing. Now it’s like, ‘Who does your Botox?’”

Keep on refining your client service experience

It’s easy to read praise-filled reports from journalists and first-hand reviews from patients on social media and assume Levy got everything right—but she didn’t. Alchemy 43’s customer experience has evolved and much of the progress was guided by its patients.

To attract younger patients, Levy experimented with a membership model, trying to align her business with other subscription products, such as Netflix and Blue Apron. But initially, she charged a hefty monthly fee, including one ill-fated offering with a $1,200 upfront fee. 

Maybe understandably, her customers didn’t bite. “Millennials are scared of credit in a smart way,” explained Levy, in an interview with The Cut. “If they don’t have it, they don’t spend it.”

Using feedback from her patients, Levy refined her subscription offer. She nudged the monthly fee by $50, listened for a reaction, and then nudged the price again. Slowly, she homed in on an optimal fee of $99 per month. 

It was affordable enough that patients were prepared to pay and high enough to make commercial sense. But, perhaps most importantly, it created the experience her patients desired.

Infographic: The Cloud’s Impact

Ideal Patient Experience™

“More salon than spa”

Since Levy opened her first Los Angeles flagship clinic in 2016, Alchemy 43 has grown quickly. Within her first two years, she’d opened up three new clinics in LA—one in Beverly Hills, one in Santa Monica, and the last in West Hollywood. Just last year, she doubled down on expansion, opening her first clinic on the east coast in New York’s Flatiron district.

All of Alchemy 43’s success is driven by Levy’s unwavering commitment to her patients, elevating a sterile medical treatment to an enjoyable beauty experience.

“We like to say that we are more salon than spa,” she told RealSelf. “We specialize in one thing and one thing only—cosmetic injectables. We’ve crafted an entire experience around this one thing and offer a really unique experience, from a 3D consultation to the makeup touch-up post-service.”

Of course, not every healthcare business would benefit from the retail elements Levy brought to facial aesthetics—but all of them can learn something. Sure, leave the bright neon signs to Levy, but borrow her dedication to customers. 

Think about how you can make your clinics, offices, and spas more inviting. Consider how you can tweak your services to make them less austere and a little more comfortable––a little less “hospital-corners” and a little more “bedside manner.” Talk to your patients and ask what they want your business to be. While relinquishing control to your customers may feel scary, you’ll soon reap the rewards—just like Levy did.

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