As an Aesthetic Nurse Practitioner with a sharp eye for detail and a deep love for aesthetics, Emily Sespaniak, NP brings both artistry and precision to our San Francisco Plastic Surgery practice. One of the things she appreciates most about working with Dr. Karen Horton’s Office is that it’s entirely women-led—a dynamic that inspires her daily and fuels a sense of collaboration, creativity, and shared purpose.

Emily has always been drawn to roles that challenge her curiosity and problem-solving skills. If she weren’t an NP, she imagines she’d still pursue something entrepreneurial or strategic, gravitating toward work that lets her build, analyze, and innovate. A fun fact from her childhood: she once landed a small acting role in a syndicated kids’ TV show. Even though her scene didn’t make the final cut, she loved getting a behind-the-scenes look at production and being part of the excitement.

In her aesthetic work, Emily thrives when injecting neuromodulators and dermal fillers. She loves the blend of anatomy, artistry, and individualized treatment planning—no two faces are the same, and she enjoys crafting results that look beautifully natural. For her own go-to treatment, she reaches for BOTOX® or Dysport, calling them quick, easy, and reliably refreshing.

Her favorite skincare product we carry? The custom-compounded brightening pads. She loves that they can be tailored to each patient’s needs and provide standout results for hyperpigmentation and sun damage.

Emily is also honest and direct about what she wouldn’t recommend: any device or non-surgical treatment that claims to “lift” or “tighten” the skin. These results, she emphasizes, can only be achieved meaningfully with surgery—and some of these devices carry a real risk of tissue damage when misused.

When patients ask for advice, Emily encourages them to choose experienced Board-Certified Providers who perform aesthetic treatments regularly and can build a long-term plan that fits their lifestyle. Non-surgical treatments can do a lot, she says, but it’s important to understand their strengths and limitations—and to beware of big promises that seem too good to be true. Emily’s combination of thoughtful guidance, scientific understanding, and genuine patient connection makes her an essential part of our team.

Learn more about our team.