What a consultation should cover

6.1.1The order matters

A consultation that starts with your concern and works towards a proposal is doing assessment. A consultation that starts with a treatment and works towards your agreement is doing sales. Both can be pleasant, competent and well intentioned, and they are structurally different exercises.

You can usually tell within the first two minutes. The question is whether the first substantive thing said is about you or about a product.

6.1.2The components

What you want, and why now

An open question, followed by listening. A good practitioner will also ask what prompted you to look into this, because the answer to that is frequently more informative than the answer about the concern itself.

Medical history, used rather than filed

Covered in full in the safety chapter. The test is whether the answers visibly change anything.

Examination, and an account of what is contributing

Looking at the area properly, in good light, and telling you what is producing the appearance you are concerned about. Under eye appearance in particular has several distinct contributors and most of them are not skin quality.

What this treatment can and cannot do

Explicitly naming the parts of your concern it will not address. A practitioner who can do this is giving you something usable, and one who says it will help with everything you have mentioned is not.

The product

Name, manufacturer, regulatory status, composition, whether the manufacturer's intended use covers the proposed area. Covered in the chapter on the substance.

The realistic range of outcomes

Including the possibility of no visible change, which is a real outcome and is rarely mentioned. If you are not told what it would look like for this not to work, you will have no way to assess afterwards whether it did.

Risks, and the response to each

Expected effects, side effects, complications, and specifically what would be done about each one. Including the serious one, and including the fact that there is no reversal agent.

The whole cost

Of the entire proposed course, not of one session, and of the proposed maintenance. Plus what happens to money already paid if you stop.

Time

An offer to go away and think, without pressure and without a discount that expires. Professional guidance on consent contemplates time to consider as part of the process.

6.1.3Signals worth noticing

These are not proof of anything on their own. Several together describe a pattern.

• Treatment offered on the same day as a first consultation, without a specific reason.
• A discount that expires if you leave to think.
• A consultation conducted by someone other than the person who will treat you, with no handover.
• Additional areas or treatments proposed that you had not raised.
• A consent form presented at the end of a conversation that did not cover its contents.
• No mention of the possibility that the treatment produces no visible change.
• No mention of the absence of a reversal agent.
• No out of hours contact route.

6.1.4Free consultations

Many consultations in this sector are free, and that is worth thinking about for a moment. A free consultation is paid for by the treatments that follow it, which means the economics reward consultations that convert. That does not make anyone dishonourable and it does create a structural pressure that a paid consultation does not have.

Some practitioners charge for a consultation and deduct it from treatment if you proceed. Others charge and do not. Both arrangements remove some of the pressure and are worth considering, particularly if you want an assessment rather than a proposal.

6.1.5Getting a second opinion

Entirely reasonable, and more useful in this field than people expect, because practitioners differ substantially in what they would recommend for the same face. If two independent practitioners propose different treatments for the same concern, that is informative in itself and tells you something about how much judgement rather than assessment is involved.

You do not owe anyone an explanation for seeking one, and a practitioner who reacts badly to being told you are going to think about it has answered a question you did not need to ask.

6.1.6What you should leave with

• The name of the product and manufacturer proposed.
• The areas proposed and the number of sessions.
• The total cost of the course and any maintenance.
• Written information about risks and aftercare.
• A contact route including out of hours.
• The name and registration details of the person who would treat you.
• Time to think about all of it somewhere other than the clinic.

If you leave with only a price and an appointment, you have had a sales meeting. That may be all you wanted, and it is worth knowing which one you had.