Makushina developed a strong work ethic early on. "In Russia, if you want to be an esthetician, you have to have a medical education", she says. She completed a pharmaceutical degree, but "wanted to make people beautiful". After nine years in the esthetic field, Makushina came to New York and landed jobs at Bergdorf Goodman, the Four Seasons Hotel, and eventually, Bliss.

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So what does she feel sets Maksim apart from other spas? "We work with difficult skin," she says, "Other places don't like to deal with clients with acne, because it's more time-consuming. I like the challenge. And I like to see the person come back happy." Indeed, Makushina's approach is no-nonsense, but her touch is gentle and assured. After determining the client's needs, she not only treats the skin's current condition, but also works to prevent its premature aging. "People with acne don't realize that they also have to think about wrinkles," she says, "I try to educate people about their skin. I am thorough. When I clean, I clean. I show the person that I care."