Carla Pierson

Carla Pierson – Building a Scalable Platform Business: Lessons in Growth, Risk, and Focus

Carla Pierson, DNP, RN, is the Co-founder and Chief of Business Operations at Smiley Aesthetics, a medical aesthetics company that provides clinical services, training, and business support to aesthetic providers. With over a decade of experience in nursing leadership and healthcare operations, she combines critical care, hospital administration, and business strategy. Before launching the company with her twin sister, Carla held leadership roles at major healthcare companies.

Here's a Glimpse of What You'll Learn

[2:29] Carla Pierson’s experience joining EO Nashville and the value of community and forum connections
[4:52] The origin story of Smiley Aesthetics, inspired by Carla’s twin sister’s career shift
[7:06] Carla shares her decision to leave a stable career and take the risks involved in pursuing entrepreneurship full-time
[12:29] How compliance, structure, and healthcare experience shaped Smiley’s scalable platform business model
[18:35] The division of roles between Carla and her twin sister, including balancing operations and clinical leadership
[24:43] Why Carla declined to sell her business and how EO forum discussions influenced that choice

In This Episode

Building a business often looks straightforward from the outside: identify a need, create a solution, and grow. Yet behind that simplicity are decisions that carry weight, especially when stability, identity, and risk are all intertwined. How do entrepreneurs know when to leap and when to hold steady?

Seasoned healthcare operator Carla Pierson didn’t set out to become an entrepreneur overnight. After years of managing large-scale hospital operations, she partnered with her twin sister to explore a small, scrappy idea — bringing aesthetic services directly to clients. What began as a side hustle quickly gained traction, forcing her to confront a defining moment: leave a secure career or fully commit to something uncertain. As the business scaled, Carla leaned on structure, discipline, and her clinical background to build systems that empowered others, all while navigating the complexities of partnership, growth, and opportunity. Her advice to others: focus is everything, and splitting your energy limits your ceiling, but committing fully can unlock exponential growth.

In this episode of The Decision, Robert Hartline and Eric Jackson sit down with Carla Pierson, DNP, RN, Co-founder and Chief of Business Operations at Smiley Aesthetics, to discuss transitioning to entrepreneurship. Carla talks about her transition from healthcare leadership, building a scalable platform model, and the decision to walk away from a potential sale.

Quotable Moments:

“It has been a wonderful experience so far. And not even just saying that because we’re on this.”
“We’re all looking for that camaraderie.”
“You drop that bottle of Botox, it is going to be painful. You’re going to be very upset.”
“Leaning in is the only way to get the most out of EO in my experience.”
“That was unbelievable in the best way. That is what EO is truly all about.”

Action Steps:

Fully commit your focus to one business path: Splitting your attention between multiple priorities limits growth and creates unnecessary ceilings. Choosing one direction allows you to unlock greater momentum and scale faster.
Build systems early to support scalability: Establish structure and clear processes to create consistency as your business grows. This foundation allows others to operate effectively without constant oversight.
Leverage your existing skill set in new ways: Transferable skills can give you a strong advantage when entering a new industry. Recognizing and applying them builds confidence and accelerates your learning curve.
Surround yourself with a trusted peer network: Having a space to openly discuss decisions provides clarity and reduces isolation. Outside perspectives can challenge assumptions and lead to better long-term choices.
Stay disciplined in the face of distractions and “shiny opportunities”: Not every opportunity aligns with your core vision, even if it seems attractive. Maintaining focus ensures your energy is spent on what truly drives sustainable growth.