Cosmetic Medicine is a complete platform I built for a HIPAA-regulated medical practice. Over close to two years I took a business that ran on a fragile patchwork of off-the-shelf tools and rebuilt it, piece by piece, into a single modern system. I owned it end to end: the backend API, the admin back-office, and the architecture, plus the design and build of the patient-facing site.

Where it began

It did not start as a task handed to me. It started at the operational level, processing orders by hand through the flow the business actually ran on. Doing that job first hand is what made the business legible: I could see the real bottlenecks, the failure points, and what it would genuinely take to fix them.

What existed was a setup stitched together by hand: a Wix site, a CRM, spreadsheets driven by scripts, an early automation service, and staff manually keying orders into pharmacy and provider systems. It worked, but it did not scale, it was never built for a regulated medical context, and every step of growth multiplied manual labor and the chance of human error. So I proposed and built the thing that needed to exist.

Built without ever going offline

The hardest constraint was that I could not start from zero. The business was live and had to stay live. So I inherited the existing machinery, kept it running, and re-architected it in place: consolidating data out of spreadsheets and the CRM into one source of truth, automating what people had been doing by hand, and standing up new applications on top, all while the old systems kept carrying real traffic. I designed a repeatable migration pipeline, including a dynamic CSV mapper that could ingest any standard CRM export without hand-mapping columns, so the cutover was auditable rather than a one-time manual scramble.

What I built

Three layers, all mine:

  • A backend API for authentication, orders, payments, and webhooks, with a central normalization layer that maps events from five external providers (telehealth, payments, vouchers, email, and SMS) into canonical internal events.
  • A 14-module admin back-office, each module with its own analytics, data tables, filtering, and operational controls, all built from scratch: orders, payments, CRM, catalog, automation, observability, and more.
  • A patient-facing storefront and portal on Cloudflare Workers, running at the edge: a treatment catalog, an interactive advisor that routes patients without forcing an account, order tracking, and the full UI and interaction design.

The engineering that lasts

The parts I care about most are the ones you cannot see from the outside. Every external dependency sits behind a service/provider interface (SOLID), so a provider can be swapped or added without touching business logic. I built a full sandbox that mirrors production, engineering realistic fake providers for the vendors that offer none, so the entire integration path can be exercised without real data or real APIs. The automation is a custom event-driven engine, not a third-party tool: triggers, state machines, conditional branching, scheduled runs, and outbound webhooks. A payment matching engine reconciles payments to orders with confidence scoring and a manual review queue. A CLI toolkit and a structured observability layer made it possible to operate and debug the whole thing as one person.

One person, many roles

In a normal organization this is a cross-functional team: architect, backend, two frontends, DevOps, QA, product, design, data, docs, and on-call. Here it was one person wearing all of those hats. That meant every decision was made by the same person who had to live with it, with no fragmentation between design and implementation, but also no one to hand the pager to. I wrote the requirements, designed the data model and the interfaces, built the systems, documented every significant decision in ADRs, and answered every production incident myself.

Handoff

When I left, I handed over everything: all source code, exhaustive documentation, and credentials, with the platform live and the intellectual property transferred in full. I am proud of what the system does and what it enables, for the staff who use it every day and the patients it serves. It looks like one person. It was not one person's worth of work.