An Interview With Shino Bay

An interview with Shino Bay Aguilera, DO, on the current state of the aesthetic industry.

An Interview With Shino Bay Aguilera, DO

Shino Bay Aguilera, DO, is a world renowned cosmetic dermatologist and surgeon. He is board certified with a fellowship in dermatology from the American College of Osteopathic Dermatology, and a highly requested speaker for noninvasive cosmetic dermatology around the world. For the past decade he has developed groundbreaking signature techniques at his award-winning aesthetic medical practice in Fort Lauderdale, Florida. On October 15, Shino Bay will be speaking at the Prollenium Revanesse Lip+ event in Cabo San Lucas.

Q: I’ve known you personally for over two decades and I’m thrilled to be able to sit down with you for this interview. Now, you might not even remember this, but when I was a third-year medical student and you were a fourth-year medical student, we ran into each other during a call night in the hospital cafeteria of a small Florida facility and you told me that one day, you and I would both be world-famous dermatologists. It seemed impossible at the time. And yet, here we are! Let’s get started. I know you have a rather adverse backstory.Would you feel comfortable sharing it with us today?

A: I was born in Panama City, Panama and raised by my grandmother, who was an illegal alien when she came to this country with 8 children and had to work as a lady of the night in order to bring food to the table.Due to her vocation, I was treated quite poorly, finding myself in constant physical altercations with others who ridiculed our family. Because she was gone most evenings, this left me susceptible to an array of abuse, including sexual, physical, and emotional by relatives and neighbors since 3 ½ years of age. As a child, I never knew this was wrong or abnormal because I felt loved, and that felt good. This was a love I yearned for since neither of my parents were able to raise me.

Being brought up Catholic, it wasn’t until completing my first communion that I learned sexuality during childhood was a sin. The guilt and fear became so intense to the point of breaking me, and at the age of 9, I had attempted to end my life. Ridicule and judgement have been a part of my life for as long as I can recall; even presently I experience mockery from others because of my sexuality. I was also chronically sick as a child, suffering from asthma and furuncles, and I spent a majority of my upbringing confined to a hospital bed. It was there in those hospital walls where I fell in love with medicine. I learned at an early age that I was born to be the kind of doctor that would help people physically and emotionally. All of my struggles as a child and young adult were the foundation to my success later in life, and I wouldn’t be who I am today if I had not endured those adversities.

That’s an extremely difficult start to life. How did you specifically channel that adversity and transition to an aesthetic career path?

All the bad that I had experienced was for a greater purpose and shaped me into the person I am now. I am a healer because I have compassion and empathy. I listen with the intention to help a person become better. People often ask me: “How can you say you are spiritual if you are submerged in the world of vanity?” I always reply with the same answer: "This is exactly where I am needed.”As a cosmetic dermatologist, people come see me with vulnerabilities and fears regarding aging. They see me as the light at the end of the tunnel; and that it is precisely why they come to me—to receive "light". It is my talent to use my hands and expertise to alleviate, reverse, and maintain an aging face. However, the key aspect I try to instill in my patients is this: fear-derived vanity is relentlessly sabotaging us from living in the present and enjoying our blessings.If you are committed to maintaining your youth, you must live a life without fear, resentment, or judgement and practice self-love and self-acceptance daily. I think that’s what led me into this field because I know what it’s like to look into the mirror and dislike the reflection, even when there is nothing wrong with you. I practice self-love and acceptance every day, and it is my passion and purpose to teach others how to do the same.

What about degree adversity? Was that ever an issue for you on your journey?

During the early years of my career, I endured discrimination of a different type.It was not because of my race, my sexual orientation, or the color of my skin.This discrimination was because I was trained as a Doctor of Osteopathic Medicine (DO) instead of a Doctor of Allopathic Medicine (MD), which have the same level of education with a different philosophy to look and treat the human body during sickness. For years, DO Dermatologists were not considered members of the American Academy of Dermatology (AAD) or American Society for Dermatologic Surgery (ASDS); we were treated like second class citizens.Remembering one event at AAD’s first meeting in Florida at the Convention Center of Miami, anti-DO flyers against DOs were being distributed.I remember reading it with tears in my eyes, as I told my colleagues out loud that by my own merit, I was going to change this consciousness.I quickly became a key opinion leader in aesthetics. With the help of other DOs and MDs colleagues such as Brad Glick, DO, Jeremy Green, MD, and all the MD dermatologists who appreciated my work and position in the industry, we are now able to say that we are fellows of both organizations.This is a dream come true.

As a fellow DO, I know exactly what you mean. And I’d love to see what the author(s) of those flyers have to say today. The irony is that their prejudice probably motivated some of us to make be changes to the industry. Knowing that degree bias still exists what can the aesthetic industry do to increase diversity and inclusion? And what about all other biases we see in our field?

Inclusion and diversity in aesthetics relates involves more than learning about differing races and their unique way of aging; it extends even beyond Pride, the LGBTQ+ community, and ageism.Inclusion and diversity in aesthetics has to do with the diversity amongst all of us as healers. Our primary mission is to help our patients achieve their aesthetic goals with safe and effective techniques.Regardless of your educational background, level of expertise, and the title behind your name, we are uniquely intertwined in this industry to assist our patients in thriving or coping through the aging process better. It is no longer non-surgical vs surgical; it is no longer core vs non-core; it is no longer physicians vs extenders.It is an evolutionary change to work as a team to protect our patients and protect the industry.We must not forget our commitment to healing and restoring health in our patients.Academic arrogance, egotism, self-importance, and pretentiousness are among the most unattractive attributes of any professional who has the unique opportunity to teach and inspire others in this field.At the end of the day, we are here in a mutual effort and collaboration to empower each other to be better healers, teachers, and colleagues.Let’s not lose sight of our calling, and let’s not create more rivalry, separation, and exclusion in our aesthetic industry.

What is something interesting about you that you have never publicly revealed or isn’t widely known?

The story of my name, Shino Bay, is due to a lucky racehorse. My father was a professional jockey, and when I was born, he had recently won a race with a horse named Shino Bay. He felt the horse carried a winning name and bred the meaning behind my unique epithet.He had the opportunity to come to the United States and race when I was 2 years old. My mother remarried and could not raise me, so my grandmother took me in. I am a firm believer in everything happening for a reason, and I know I would not be in the United States today if it weren’t for my father’s decision to leave Panama. I yearned for the day when I could leave Panama and become a successful doctor in the United States. Now, behind my desk hangs a beautiful portrait of a racehorse that symbolizes wherever you are in life, never forget where you came from.

What a fascinating story. Why do so many people feel that the aesthetic industry is ripe for disruption?

I believe in regenerative aesthetic medicine, and for the progression of this industry to take place, we need to rely on these types of treatments (biocollagen stimulators, exosomes, stem cells, etc.) to truly slow the process of aging. Providers should take advantage of these regenerative alternatives to preserve the youth of patients, instead of merely faking it with hyaluronic acid (HA) fillers. HA fillers will continue to have an integral part in the evolution of aesthetics, but they will eventually lose their capabilities of staving off the aging process.

In many ways, the concept of a ‘key opinion leader’ seems to have become synonymous with nepotism and greed in our industry because some conference leaders endorse products for payment with no real concern for the clinical outcomes.Why does our industry still tolerate these antiquated ‘KOLs” and how can true leaders like you set themselves apart from the historic pay-to-play paradigms that still unfortunately plague our field?

Key Opinion Leaders—a concept quite controversial recently in our industry. I firmly believe this relates back to individual perspective. I’ve never held high regard to the titles that follow my name and I prefer people call me Shino rather than Dr. Aguilera; I feel the same way about an appointed title of key opinion leader. However, this doesn’t take away from the colleagues in our industry that selflessly dedicate their free time outside of their businesses to educate, research, and contribute to the progression of the aesthetic industry. Are they compensated for this time? Of course, they should be, but is this compensation sufficient to reflect their sacrificed time out of their individual practices? It absolutely is not. Let’s use me as an example.I train residents and fellows after a day full of work until late at night weekly.I travel at least 40 weekends/year, lecturing all over the world in congresses where I am not always paid to attend. In some of these events, I pay for my registration even though I am faculty. I speak on behalf of major pharma companies, yet I am compensated fair market value.I lose on average of $60-$120K in the 3 days I am off leaving a busy practice for a small taxable check of few thousand dollars. The circulating rumors of KOLs living this lavish lifestyle with the surplus of work outside of their practices is a myth.Yes, there are perks to this title, but these are met with sacrifice of time, effort, and income. Regardless, the advancement of aesthetics by continued education, trainings, and research is possible through the sacrifice of our industry’s leaders. I do believe the term KOL is antiquated. I prefer to refer to these individuals as Key Leading Mentors (KLMs) because opinions don’t translate to success. It’s continued mentoring, research, open discussion, practice, and application that progresses the industry. I don’t receive financial compensation for hundreds of research articles, book chapters, and trainings I’ve conducted over the years, and I never really cared because of my love for aesthetics. This pertains to many other colleagues in the industry, and regardless of their “title” and social persona, they deserve to be recognized and respected for their work to the betterment of our field. To get to that level of recognition goes beyond “instafame” or merely having an outrageous personality.It takes time, selflessness, hard work, commitment, and dedication.

I really recommend we use another name, such as Key Leading Mentors, to those who are doing the extra work for the betterment of the aesthetic industry. How we view those with these titles also relates to individual perspective; some regard with reverence while others look on them begrudgingly. I feel that leaders in the industry, who come and go with the evolution of aesthetics, ultimately do their best to make sure that our industry is safe, inclusive, fair, and advancing.

I agree. That’s a much better title and we will hopefully witness some of the traditional ‘KOLs’ exit soon due to forced attrition allowing a new era of integrity to be ushered in. So, we know that work can be stressful; What advice do you have for people in the aesthetic space to avoid ‘burnout’?

I stopped seeing new patients when I saw that my schedule was consistently full and booked out for months. I aspire to have a life well lived and I can’t take my money with me, so I have to a have balance between work and play. This should be a priority for everyone, regardless of occupation. I also stopped doing procedures that I did not enjoy performing, such as liquid rhinoplasty. It doesn’t make me any less or more of a qualified injector, but I sleep better at night.

What is your current biggest personal operational hurdle and what could be done to fix it?

I don’t know how to say “NO.” I spread myself too thin constantly. I do this because I love to inspire and help others be better. Any moment that I can be given to present and teach is another opportunity to help others be successful.

If you weren’t an aesthetic expert, what would you do for a living?

A:I would be an inspirational speaker, a hairdresser, or a makeup artist. I feel called to create beauty in any capacity, and any career that makes people feel and look beautiful would suffice.Teaching others how to love themselves at face value is my greatest purpose.

Moving forward, what's the best piece of aesthetic career advice you have received?

After age 50, everyone gets the face that they deserve. Therefore, always be cheerful, kind, and grateful to maintain an appearance that reflects the beauty of the soul.

With so much confusion in the industry, where do you personally go for trusted aesthetic information?

I love to attend conferences where the greatest minds of the industry, like Key Leading Mentors, are teaching and collaborating because I learn the most from their discussions.

What changes would you like to see take place in the aesthetic industry?

Stop relying solely on injectable fillers to help patients stay youthful. Other places, like Europe, are ahead of the curve when it comes to infusing micronutrients into the skin through mesotherapy. The FDA makes it near impossible for these treatments to be allowed in this country. Some of these innovations have been safely and effectively used in Europe for over 40 years yet the vigorous inspection by FDA negates several treatments from being implemented in a timely manner if at all. There is a great deal of money, time, and research involved for any company attempting to receive FDA approval in the US, which is why we are still using hyaluronic acid as “skin boosters” instead of utilizing real micronutrients that promote real physiological benefits to the skin.

What will the aesthetic industry look like 10 years from now?

With the understanding and integration of regenerative medicine, we are going to enjoy reversing more and more signs of aging.

What does your aesthetic legacy look like?

I am going to live forever—ha ha! Rumi once said that we experience two deaths. The day that we physically die and the last time someone mentions your name. I have trained hundreds of residents, dermatologists, plastic surgeons and aesthetic providers.I am already witnessing many of them around the world become Key Leading Mentors. Being part of their journey will allow me to live eternally and for that I am forever grateful.

As an expert in the aesthetic industry in a powerful position, people are looking at you to lead. If you could inspire a movement in our industry, what would it be?

1) It is our moral and ethical duty to use social media responsibly. We need to remember that there are young kids that start watching us as early as 14 years of age and we must promote self-love and self-acceptance.

2) Do not desecrate the human face. Always aim for a natural look with injectable fillers and never be afraid to say no to patients with dysmorphias.

Thank you so much, Shino. I can’t wait to work with you later this year in person at the event in Mexico we are scheduled for. In addition to in-person conferences, how might one get more information from you?

You can find me on Instagram at @shinobayderm discussing aesthetics and @shinobay where I provide spiritual advice.