Not sure why I was flagged for inappropriate behavior for posting the above. The point I was trying to make is that if you become licensed in another specialty, there are plenty of derm offices that would be happy to hire you to see general derm patients. You'll find this in every major city and in derm practices with multiple locations staffed with NPs and PAs. If aesthetics is your thing, you can open your own medspa or partner up with a medspa seeking a medical director. As for the expertise and complications with lasers and minimally invasive procedures like fillers and neurotoxins, you definitely need training for good outcomes, especially in facial anatomy. After that it comes down to number of procedures, appropriately managing patient expectations, and your artistic sense. Did you know there's a thriving walk-in aesthetic shop right across the street from Bloomingdale's in the city run by an internist? Numerous companies provide aesthetic training (for a fee) and the companies that make devices/products also provide training options for "non-core" physicians, though they will never admit that to plastics, derms, facial plastics, and ophthos. In my earlier post I was in no way suggesting performing actual surgery without proper training or outside a credentialed theater, though it is funny that ob/gyns and dentists are the largest growing segment for injectables.