How to keep more of what you earn, whether you’re bootstrapping at $100K or scaling past $1M
This in-depth guide is adapted from a recent episode of the Medical Aesthetics Marketing Show, where I sat down with financial expert Danielle Hayden to break down exactly what aesthetic practice owners need to know about managing their money at every stage of growth.
Let’s be real: you didn’t open your med spa, plastic surgery or aesthetic practice to become an expert in bookkeeping and taxes.
You got into this industry to transform lives, build confidence, and do incredible aesthetic work. But here’s the uncomfortable truth: if you’re not managing your money correctly, you’re leaving thousands (or hundreds of thousands) of dollars on the table.
On this episode of the Medical Aesthetics Marketing Show, I had the pleasure of hosting Danielle Hayden, Co-Founder and CEO of Kickstart Accounting, Inc. She runs a bookkeeping and accounting firm on a mission to help six-figure (and beyond) female entrepreneurs better understand their numbers so they can grow profitable, sustainable, and enjoyable businesses.
With over 15 years of experience in finance, Danielle has worked her way from accounting firm intern to Co-Founder of Kickstart Accounting. She understands how complex business finances can be, and she knows that entrepreneurs need more than just a bookkeeper. They need real financial analysis and support to get the confidence required to create sustainable wealth.
Danielle has been featured on multiple top-rated shows including A Well-Designed Business®, The How of Business, and Female emPOWERED: Winning in Business & Life. She’s also the host of the Business By the Books podcast, where she helps business owners take control of their finances.
In our conversation, we covered everything from bootstrap beginnings to million-dollar operations. Whether you’re earning under $100K or managing a multi-million dollar practice, this episode (and this guide adapted from it) has actionable strategies to help you keep more money in your pocket.
Want to hear the full conversation? Listen to this episode of the Medical Aesthetics Marketing Show wherever you get your podcasts.
The Foundation Every Practice Owner Needs (Regardless of Size)
Before we dive into specific revenue stages, let’s establish one critical truth that Danielle emphasized throughout our conversation: you are not your business.
This might sound obvious, but as Danielle shared, she’s worked with thousands of business owners over the past 10+ years, and she can’t tell you how many practice owners commingle their business and personal finances. When you do this, you’re not just creating accounting headaches. You’re literally piercing the corporate veil and exposing your personal assets to risk.
Here’s what every aesthetic practice owner needs from day one:
Your Essential Money Team
Danielle introduced what she calls “The Money Team.” Four people every business owner needs, regardless of size:
- Bookkeeper – The most important person on your team. As Danielle explained, “Imagine a puzzle. You dump a thousand piece puzzle on the table. That’s all of your income, all of your spending, everything you don’t want to think about. Your bookkeeper comes and takes all those puzzle pieces and puts together a beautiful puzzle for you.”
- Tax Accountant – But here’s the catch Danielle highlighted: “Your tax accountant can’t do their job unless you have a bookkeeper first.” Too often, business owners go find a tax accountant and just hand them a box of receipts. That’s not setting anyone up for success.
- Financial Advisor – They’re looking at your overall picture, retirement planning, and family financial security.
- CFO (Fractional is fine) – Helps you build budgets, track key performance indicators, and make strategic growth decisions.
Critical mindset shift from Danielle: “I have a hard truth I like to say: The IRS doesn’t care if you are good with money. They really don’t. I hear people saying, ‘I just, I’m not good with money. I don’t understand finances.’ And so they bury their head in the sand, and it’s not a reason for the IRS to excuse not paying taxes or not having an accurate profit and loss statement. You are the CEO of a business, and you are responsible for that business.”
Stage 1: Bootstrapping ($0-$100K Revenue)
If you’re here: You’ve just left another practice, you’re building your client base, and you’re wearing every single hat in your business.
Your Top Priorities
1. Separate Your Money Immediately
Danielle was emphatic about this: “When we are just getting started, what I really want you to be focusing on is really starting to separate yourself as a business owner. You are not your business. You are a different entity from your business, and that means that we need to have a separate business account from our personal checking account.”
Why this matters: You’re building legal protection for your personal assets. As Danielle explained, “I can’t tell you how many times I’ve seen a business owner commingling their business and personal, and what we’re doing when we do that is we’re piercing the corporate veil. We’ve now just exposed our personal assets because we’re doing commingling.”
2. Choose Your Business Structure Wisely
Danielle recommends: “Definitely talk to your attorney, your tax accountant, and look at your state. In this industry there are some state issues. But what I don’t want you to do is to operate as a sole proprietor. I do want you to form a business, but the type of business will depend on your state.”
3. Keep Every Receipt in One Place
“Make sure that you’re keeping everything in your business checking account so that when you go to work with a bookkeeper, when you go to do your tax return at the end of the year, all of your financials are in one place,” Danielle advised.
The Pricing Challenge Nobody Talks About
During our conversation, Danielle shared a powerful formula to help you set pricing without underselling yourself:
Break-Even Formula: “You can take all of your operating expenses today. Over the last three to six months, how much did it cost you on average just to operate your business? Then I want you to take that and divide that by the average number of clients and an average ticket price. Now we can see how many clients do we need to see in order to just break even. If I want to have a 15% profit, I need to add that many new clients over and above.”
Important note from Danielle: “I don’t want you to use that number to lowball your prices, but I want you to be able to use that in comparison to what other people are charging.”
We also discussed how starting with low prices creates a dangerous cycle. As I mentioned in our conversation, when you undercut everyone, “the people who are looking for the bargain shopping approach to their injectables will just look for somebody else. They’ll go on Groupon, they’ll look for any offer that they can. They’re not as loyal to you.”
Danielle agreed: “The only way is down when it comes to pricing so low. You make a good point where I often say just start and you can adjust from there. But you make a good point that when you start low, can you really make big increases?”
Danielle’s Advice for Patience
When I asked what to say to people who are struggling in those early days with cash flow, Danielle’s response was compassionate but realistic:
“Patience. It takes longer than you think. It’s just like a health journey. You don’t gain all the weight overnight, you can’t lose all the weight overnight. And it’s the same thing with business. You’re going to have so many bumps and bruises over those first few years. You’re learning how to price your services, you’re learning where things cost, what are the operating expenses you need to actually operate your business. I like to approach those first few years with curiosity and not judgment and shame.”
Your Action Steps:
- Open separate business checking account and credit card
- Choose and register your business entity (consult attorney and tax advisor)
- Find a bookkeeper (yes, even at this stage)
- Calculate your break-even number using Danielle’s formula
- Research competitive pricing in your area
- Set up a simple system for tracking expenses
Stage 2: Full-Time Practice ($100K-$250K Revenue)
If you’re here: You’re fully committed to your practice, probably doing most treatments yourself, and starting to feel the burnout of wearing all the hats.
The Critical Mindset Shift
This is where Danielle says you start buying back your time.
“Every hire and expense in your business is a way to buy back your time. Every team member, every consultant, every subscription, every new software. Everything that you’re putting into your business is an opportunity to buy back your time.”
She continued: “This is often the time we start at Kickstart Accounting. We know that we need bookkeeping help. A lot of our new clients will come to us in this range because they’ve been trying to do the bookkeeping on their own, and they’re like, ‘I need to buy back my time. I don’t want to sit here on Sundays trying to do my own bookkeeping. I want to go play with my kids because I’ve been working 50, 60 hours a week.'”
Strategic Investments at This Stage
Systems and Software: As Danielle explained, “I can’t manually put in every client’s information. I need to have a system. I need to have a process. I can’t be taking notes manually for every single client that I see. I need to have a system and a process.”
Outside Services: “I consider an outside service anybody who is an expert in another field. Bookkeeper, tax accountant, attorney, business developer, coach. They’re an expert. You don’t have to train them, you don’t have to manage them. They can come in, share their expertise with you, and you’re just benefiting from that expertise.”
The “Can I Afford to Hire?” Calculator
This was one of the most valuable parts of our conversation. Danielle shared the exact formula she uses with her clients:
“Every single one of our clients at Kickstart Accounting receives their financials every single month. This is one of the biggest questions that we get from our clients: Can I afford to hire? Can I afford to pay myself more?”
Here’s the tool:
- Go to your income statement by month (make sure your books are current and accurate)
- Run it for the last 6-12 months
- Calculate these averages:
- Average sales
- Minus average cost of goods sold
- Minus average operating expenses
- = Your average profit
“This is your average profit, and that’s the money that you have to either pay yourself a draw and/or invest back into your business through hiring those team members. When you have those exact numbers, you hire with confidence.”
Important caveat from Danielle: “Your bookkeeping has to be current and it has to be accurate to use this tool. I was on a group coaching call last week, and the client said, ‘I don’t know, March just seems off to me. The revenue isn’t very high, my expenses were really low.’ When I helped her look, her husband hadn’t updated any of her transactions all year. I said, ‘You can’t use this at all.'”
Common Mistakes at This Stage
Mistake #1: Not looking at your numbers
“Not ensuring that your money team is sending you financial statements, or when they send them to you, not actually opening their email,” Danielle shared. “I know we have clients, all of a sudden they’re like, ‘I see your emails, I’m just not opening them.’ I’m like, ‘Why? Come on, we’re so nice. Open your emails, look at the numbers.'”
Her perspective on this is refreshing: “It’s not a report card. There’s nothing in those financial statements that say you pass or failed. You don’t fail entrepreneurship until the day you close your doors. I want you to look at those financial statements with grace and empathy and curiosity of what worked and what didn’t work.”
Mistake #2: Making decisions without checking your financials
Danielle identified two types: “Some of us are free spenders. We love to spend money without looking at our financial statements. You see it, you want it, you get it. And I ask everyone to pause and practice the 48-hour rule. Give yourself time and space to connect with your money team to look at your financial statements before you spend.”
Mistake #3: Subscription creep
We discussed how those small tools add up. As Danielle noted, “If you’re not looking at your statement at the end to say, ‘Okay, marketing tools $499,’ when mentally I’m probably thinking I’m only spending $99 on those tools, that can be a problem.”
Your Action Steps:
- Calculate your average profit using Danielle’s formula
- Determine how much you can afford to pay yourself
- Calculate how much is left for strategic hires
- Implement the 48-hour rule for purchases over $500
- Review and cancel unused subscriptions
- Schedule monthly “money dates” to review financials
Stage 3: Scaling Up ($250K-$500K Revenue)
If you’re here: You have a team, you’re considering equipment investments, and sales reps are knocking on your door promising that their laser will “pay for itself.”
The Equipment Investment Question
I asked Danielle how to handle sales reps who promise their device will pay for itself in 6 months. Her answer was brilliant:
The 48-Hour Rule Is Your Best Friend
“I recently had a personal purchase that I made and I said to the guy, ‘I can’t make purchases same day, but I’ll call you back in 48 hours.’ You let the emotion and the rational part of your brain kick in to really actually think about that purchase.”
She continued: “I’ve owned this business for 10 years and I have a laundry list of things that haven’t worked. Marketing and concepts and things that we’ve invested in. When we decide to try a new strategy, I have to emotionally decide: Am I okay with knowing that these dollars did not have a return? There’s been tons of strategies that have come back to me tenfold, but you as a business owner need to decide what your risk tolerance is.”
Pro tip from Danielle: “Use your money team. I have a client down the street that has people who stop in for donations all the time and she’s like, ‘Oh, sorry, Danielle, my money team, she told me I could only invest 10% of my gross sales here. And unfortunately, I’ve already hit that quota for the year.’ Use your money team, let them be the bad guy.”
The Budget: Your Decision-Making Tool
During our conversation, Danielle emphasized the power of budgeting: “I love the tool of a budget. Here at Kickstart, we have our CFO team, and that’s one of the things our CFO team does. They look at our client’s 10-year plan, 3-year plan, and then one year, where do we want to see the business go over time? And how are we going to do that through debt, marketing, and growth?”
“We build out a budget so we can paint the picture, create guardrails. Guardrails for overspending and permission to spend where it’s needed.”
Her advice when you have multiple “shiny objects”: “Take that sales rep, take that new opportunity and map it out because you might be thinking, ‘I got three opportunities and I want to implement all three of them this year.’ Let’s pause, map all three out and choose which one is the most intentional for where you want to take your business.”
What to Consider Before Major Investments
When I asked about opening second locations or making major equipment purchases, Danielle’s checklist included:
1. The Health of Your First Location
“I want to look at your overall financial picture to see how much you’re paying yourself, how much profit you still have in the business, what the profitability of each of your team members are. How healthy and sustainable is this first business?”
2. The Hidden Debt Issue
“What I often see happen is that the first business still has debt. It’s not on the income statement, so it’s this really sneaky little thing. Your debt payments and your owner’s draws, they don’t land on your income statement, they land on your balance sheet. You might have built your first location by taking on debt and you are repaying that debt.”
3. The Reality Check
“I think we forget how hard it was to bootstrap and get up and going. You get a few years in, you’re profitable, you’re paying yourself, you’re hitting that half a million dollars a year in revenue, and you forget how hard it was to open that first location. It’s going to take that second location that same one to three year mark of pain, of investment, of growth, to be able to get that to be a healthy, sustainable, profitable business.”
Your Action Steps:
- Create a 12-month budget with your CFO
- Calculate your debt-to-income ratio
- Build 3-6 months of operating expenses in savings
- Practice the 48-hour rule on equipment purchases
- Map out your 3-year growth plan before committing to major investments
- Use your “money team” as the “bad guy” when needed
Stage 4: Established Practice ($500K-$1M Revenue)
If you’re here: You have a solid team, you’re thinking about expansion, and you need systems that scale.
The Service Mix Question
During our conversation, I brought up a common question: How do you decide between niching down (like a plastic surgeon who only does surgery) versus offering comprehensive services (plastic surgery plus full med spa)?
Danielle’s response was illuminating: “It’s really personal to you. It is your area, your market, your core values, what’s important to you, and where you want your growth to look like. Maybe there’s people in your community that you really want to help, and so you’re allowing them to come in for some treatments even though it’s not the highest ticket dollar because you want to really be able to help people. That’s part of your core value. Other people are like, ‘Yeah, it’s not really my core value. I want to hit the people who can afford to be here, and that’s who I’m going to focus on.'”
She emphasized: “This is why it’s so important to have the right money team. This fourth person is your CFO. We offer fractional CFO services. What we are is a fractional CFO where we can help you build out specialized key performance indicators. Where do we want to go in the long term? They’re going to be the ones to help you decide what the best growth strategy is for you and your business.”
Understanding Profitability by Service Line
Danielle explained how to track this: “I suggest having a mechanism in your financials to be able to monitor progress. Could be things like locations in your QuickBooks or classes in QuickBooks so that you can see what is profitable and what isn’t profitable. And it doesn’t mean just because it’s not profitable, you’re not going to do it anymore. But you need to know what is the most profitable and what is driving the business.”
Target profitability: “Overarching, net net net net net, I want every business owner to be somewhere between 10 and 15% profitable. Profitability after we pay you as a business owner. You might have some services that are less profitable and some services that are more profitable. We want to look at each division separately and then the whole business as a whole.”
The Second Location Reality Check
I shared stories I’ve heard about second location challenges, and Danielle confirmed: “Before you open a second location, I want to see the overall health of the first business. At this point we’re probably an S corp. You don’t commingle business and personal expenses anymore. You’re consistently taking a draw. You’re paying yourself a reasonable compensation, you’re paying yourself a salary, you’re taking draws.”
She continued: “What do you have in savings and what does your personal life look like? Does your personal life actually allow you to be able to take the extra cash and invest it in that location?”
Your Action Steps:
- Convert to S-Corp if you haven’t already (consult your tax advisor)
- Set up tracking by location/provider/service line
- Calculate profitability for each division
- Build 6-12 months operating reserves before expansion
- Define your vision: niche specialist or comprehensive provider?
- Create a 3-year expansion roadmap with your CFO
Stage 5: Million-Dollar Practice ($1M+ Revenue)
If you’re here: You’re running a significant operation with multiple providers, possibly multiple locations, and you need enterprise-level systems.
The Uncomfortable Truth About Scale
This was one of the most eye-opening parts of our conversation. Danielle shared: “Here’s the biggest thing that I see, and this has been really interesting for us to see over the last 10 years: Bigger isn’t always better, bigger isn’t always more profitable.”
She explained why: “Around that million dollars, now we need people to manage people. You’re growing a business with both cost of goods sold, facility costs, and people. This can be a very expensive business to build. At a million dollars, we’re hiring people managers to make sure everybody’s doing what they need to be doing.”
“Often what we see at this stage is people having that realization that just because I’m bigger doesn’t mean I’m more profitable. And that’s why it’s more important than ever that you put in all those good business practices back when you were at 100K, back when you were at 250K, and half a million.”
The Two Growth Philosophies
Danielle outlined two distinct approaches:
“You need to know what kind of business you’re running. Maybe your goal is ‘I just want to make as big of an impact on my community as possible. I want to hire as many people as possible. I want to serve as many people as possible.’ That’s very different than ‘I want to be as profitable as possible.'”
I added my observation: “When I speak to people in the million-dollar range, they are at a whole other level. Some of them might still be the doctor practicing in surgery, but they are basically a marketing manager, operations manager. They know all the details. How much it costs to acquire a lead from Facebook ads, from Google. It’s a whole entire level from what I see when I deal with practices who are just starting.”
Danielle agreed: “It’s important. You don’t know how big another business owner is. When you see them walking down the street or across their business or in an industry conference, we don’t know how big their business is. We need to worry about what we’re doing and how, what our goals are, the business that we want to build, and take into consideration these things that we’ve laid out today and monitoring our financial progress against where we want to see our business go.”
Your Action Steps:
- Define your growth philosophy (impact vs. profitability)
- Implement advanced KPI tracking with your CFO
- Create partner compensation and lead distribution systems (if applicable)
- Build management layers to reduce your operational burden
- Focus on enterprise value, not just annual profit
- Plan for eventual exit or succession
The Tax Myths That Cost You Thousands
One of the most valuable parts of our podcast conversation was when Danielle debunked dangerous tax advice circulating on social media.
Myth #1: “Spend your profits to avoid taxes”
Danielle’s take: “I think there’s two kinds of mindsets that I see in entrepreneurship. We have some business owners who say, ‘I’m going to write off everything I possibly can. To me, having a business is going to be all about minimizing my tax liability.’ That is a strategy. It’s not the strategy that I advise.”
She shared a powerful real-world example: “We had a client who came to us and it was February, March when she came to us. Her previous tax accountant had told her in late November to go spend as much money as possible so that she didn’t have to pay money in taxes. Well, what the tax accountant didn’t take into account was that she was planning on opening up her second location in March. She went and spent all this money and then she ended up having to take on debt. It has been a cycle to watch her go through trying to overcome the cycle of debt because she opened her second location with debt rather than her cash savings.”
The alternative approach: “The other mindset is: I am going to have a healthy, sustainable, profitable business. If somebody comes along in five years that wants to buy my business, I’m going to have a sellable business. If I go to buy a car or a home or invest in a new business and I need lending, I’m going to have profit to show that I’m a real business.”
Myth #2: “Write off your entire family vacation if you have a conference”
During our conversation, Danielle gave a specific example from her own life:
“I went to a conference in August last year, and I knew my ticket was going to be a tax deduction and the hotel during the conference was going to be a tax deduction. I did have my kids and my mom and my husband. They all came with me and we went to Disney for four days beforehand. My kids, that was a personal expense. When I paid for their flight, it’s personal. When I paid for the car I rented for the time that they were there, that’s personal.”
“Once I dropped my family back off at the airport and I went to the conference, all those expenses during the time of the conference, those were a business expense. The only thing that I was really able to write off was my own plane ticket.”
Her final thought on this: “I see some tax influencers out there. It’s so bad. Trying to get you to write off the flights for your entire family. You need to choose what your strategy is for owning your business.”
What You Can Actually Write Off
The litmus test Danielle recommends: Would this expense exist if you didn’t have a business? If yes, it’s probably personal.
Your Money Management Checklist (Print This Out)
Based on everything Danielle shared in our podcast conversation, here’s your checklist:
Monthly Must-Dos:
- Review your financial statements (income statement and balance sheet)
- Check your cash flow projection
- Review your budget vs. actual spending
- Meet with your bookkeeper for questions
- Review your KPIs dashboard
- Calculate your profit margin
Quarterly Reviews:
- Meet with your full money team (bookkeeper, tax accountant, CFO)
- Review and update your budget
- Calculate estimated tax payments
- Review subscriptions and cancel unused services
- Analyze profitability by service line/provider
- Update your 12-month forecast
Annual Planning:
- Meet with your tax accountant BEFORE December
- Plan tax-saving strategies
- Set revenue and profit goals for next year
- Update your 3-year growth plan
- Review and adjust pricing
- Plan major purchases or expansions
What You Need to Remember
Here are the key takeaways from my conversation with Danielle:
- Separate your business and personal finances from day one. As Danielle emphasized, “This isn’t optional.”
- Build your money team early. Don’t wait until you’re in crisis mode. Remember: bookkeeper first, then tax accountant.
- Look at your numbers monthly. As Danielle said, “You can’t manage what you don’t measure.”
- Practice the 48-hour rule on any significant purchase. Let emotion settle before committing.
- Bigger isn’t always better. Danielle’s observation after 10+ years: “Profitable growth beats revenue growth every time.”
- Know your break-even number and track your profitability by service line using the formulas Danielle shared.
- Don’t spend profits just to avoid taxes. Be strategic with your cash, not reactive to tax advice.
- Target 10-15% net profit after paying yourself as the owner.
- Build 3-6 months of reserves before expanding or making major equipment purchases.
- Use your money team as the “bad guy” when you need to say no to purchases or donations. Danielle’s client script: “Sorry, my money team told me I’ve already hit my quota for investments this year.”
Listen to the Full Episode
This blog post covers the highlights from our in-depth conversation, but there’s so much more value in the full episode. You’ll hear:
- Danielle’s specific advice for handling sales reps
- More real-world examples from her 10+ years working with business owners
- Her compassionate approach to helping entrepreneurs who feel overwhelmed by finances
- Additional strategies for different practice types and situations
Listen to the full episode of the Medical Aesthetics Marketing Show wherever you get your podcasts.
Ready to Get Your Finances Under Control?
The difference between a struggling practice and a thriving one often comes down to financial management.
If you’re:
- Not sure if you’re profitable
- Wondering if you can afford to hire
- Considering equipment purchases or expansion
- Feeling overwhelmed by your finances
- Not getting financial statements monthly
…it’s time to build your money team.
Connect with Danielle Hayden:
Start here: Download Danielle’s Top 10 Tax Deductions checklist at kickstartaccountinginc.com/gift
Then book a discovery call with Kickstart Accounting to see how they can help you keep more of what you earn. As Danielle mentioned in our conversation, “We are super friendly accountants. I don’t believe it’s like talking to your old stuffy tax accountant. We’re a group of really friendly women who offer bookkeeping, CFO and tax services, and we would love to be a resource for any of your listeners.”
Listen to Danielle’s podcast: Business By the Books wherever you listen to podcasts for more financial wisdom specifically for female entrepreneurs.
When she’s not in her money mindset work, you can find Danielle hiking or spending time with her family.
Your Next Steps
- Listen to the full podcast episode for even more insights and real-world examples
- Download Danielle’s Top 10 Tax Deductions checklist at kickstartaccountinginc.com/gift
- Calculate your break-even number using the formula Danielle shared
- Schedule a discovery call with Kickstart Accounting if you need help getting your finances organized
- Subscribe to the Medical Aesthetics Marketing Show so you never miss episodes like this one
Remember what Danielle said: “You deserve to have a profitable practice that supports your life, not consumes it. Your first step is understanding your numbers.”
Want more strategies for growing your aesthetic practice?
Subscribe to the Medical Aesthetics Marketing Show podcast wherever you listen, and join our community of practice owners who are building sustainable, profitable businesses.
Resources mentioned in this episode:
- Kickstart Accounting: kickstartaccountinginc.com/gift
