Your first consultation: what actually happens

People arrive for a first consultation expecting to be sold something. What actually happens is closer to a medical appointment than a shopping trip, and it is worth knowing the shape of it in advance.

The appointment runs forty-five minutes. Nothing is injected on the day unless you ask for it, you are medically suitable, and you have had time to read the consent form properly. Plenty of people book a consultation and leave with a skincare recommendation and no treatment at all. That is a legitimate outcome.

We start with your history, not your face. Medical conditions, prescription and over-the-counter medications, supplements, allergies, previous cosmetic treatment — including anything done elsewhere and anything you are not certain about. Blood thinners and fish oil increase bruising. Autoimmune conditions and some biologics change what is appropriate. A history of cold sores matters before any treatment around the mouth. Pregnancy and breastfeeding rule out injectables entirely. None of this is box-ticking; it changes the plan often enough that we ask every time.

Then we talk about what is bothering you, in your words. This part is more useful than it sounds. Looking tired and looking angry point to different anatomy, and the treatment for one is not the treatment for the other. We ask what you notice in photographs, in the mirror in the morning, on video calls. We ask what you have already tried.

Next is the assessment. We look at your face at rest and in animation, sitting upright in good light, and we take standardised photographs from a fixed set of angles. Those photographs are part of your medical record. They are stored securely, they are never used publicly without separate written permission, and their purpose is honest: memory is a poor witness to gradual change, and at your review we will look at them together.

Then we tell you what we think. Sometimes that is a specific plan. Sometimes it is a sequence — treat the skin first, revisit volume in three months. Sometimes it is that the thing you are describing is better addressed by a dermatologist, an orthodontist or a decent night's sleep, and we will say so. We do not treat people who want something we do not believe will help them.

If there is a plan, you get it in writing: prices, expected number of sessions, realistic timelines and the specific risks of each treatment. You can take the consent form home. Informed consent means genuine time to read, ask questions and change your mind.

One thing worth saying about price. We quote the full course rather than the first session, because a treatment needing four visits and one needing a single visit are not comparable at a per-session price. If a plan comes out higher than you want to spend, say so — there is very often a sensible smaller version of it, and we would rather build that with you than have you start something you cannot finish.

A few practical things. Come without makeup if you can, or arrive ten minutes early to remove it. Avoid alcohol the night before if there is any chance you will proceed to treatment. Bring your medication list. If you have had filler before, bring records of what was used and when — some filler, a few years ago is common and workable, but specifics are better.

Bring your questions written down. In a forty-five-minute appointment about your own face it is remarkably easy to forget the one thing you meant to ask. Good questions include: what happens if I do not like it, what is the reversal process, who will actually perform the treatment, what happens if there is a complication after hours, and what does maintenance cost over a year rather than over a session.

If you leave with nothing but a clear idea of what is going on and what your options are, the appointment did its job.