#123 Dr. Alex Roher, MD: From Anesthesiology to Building 11 Aesthetic Clinics and a Wellness Brand

Dr. Alex Roher, MD is a board certified anesthesiologist who reinvented his career after falling out of love with anesthesia and built SD Botox into a fast growing aesthetics business. He shares how he started in 2012 with only one procedure, renting a room from an esthetician, then learned business by doing it. He explains the turning point when he acquired a struggling practice that became his Pacific Beach location, and how the business expanded through organic growth and smart acquisitions, including rapid growth during the Covid era “Zoom Boom.” Today, SD Botox spans 11 locations across San Diego and Austin, built around four pillars: injectables, laser and energy based treatments, medical grade skincare, and esthetician services.Alex also explains the shift he sees in younger patients toward prevention and wellness. That led him to launch a sister company, Hormones and Wellness by SD Botox, focused on hormone replacement, peptides, diagnostics like labs and DEXA scans, and recovery tools like saunas, cold plunges, red light, and hyperbaric oxygen. He breaks down what a good aesthetic result means: subtle enough that no one can tell what you did, but clear enough that you look great. He also talks openly about safety, complications, and how learning from hard moments improved his standards, including adopting ultrasound.The conversation goes beyond aesthetics into leadership and life. Alex compares building a company to raising a teenager, describes the challenge of maturing from a small team into a more professional organization, and shares how he learned to step back from daily operations to focus on innovation. He and Federico discuss courage, failure, family support, and why real success is often built through small one percent improvements over time. The episode closes with a strong argument for preventative health and measuring what matters, so people can improve before problems become diagnoses.About Alex Roher:- https://sdbotox.com/- https://www.instagram.com/dralexnosebestAbout Federico Ramallo ✨👨‍💻🌎🚀 Software Engineering Manager | 🛠 Founder of DensityLabs.io & PreVetted.ai | 🤝 Connecting 🇺🇸 U.S. teams with top nearshore 🌎 LATAM engineers- 💼 https://www.linkedin.com/in/framallo/- 🌐 https://densitylabs.io- ✅ https://prevetted.ai🎙 PreVetted Podcast 🎧📡- 🎯 https://prevetted.ai/podcast- 🐦 https://x.com/PrevettedPod- 🔗 https://www.linkedin.com/company/prevetted-podcast00:00 Introduction to Dr. Alex Roher and SD Botox01:03 Transition from Anesthesia to Aesthetics06:10 The Wellness Revolution in Aesthetics09:43 Understanding Patient Motivations and Expectations16:46 The Joy of Instant Gratification in Aesthetic Procedures23:19 Finding Purpose and Balance in Life and Work26:02 Navigating the Growth of a Business28:30 Embracing Innovation and Risk30:09 The Value of Family Support34:49 Understanding Patient Concerns37:25 Learning from Medical Failures48:36 The Need for Preventative Healthcare