What is discussed at a first consultation?
Your concerns and expectations are heard first, then you are asked about your health history, medicines and previous aesthetic treatments. After examining your face, the doctor explains the suitable options, what each can and cannot change, possible side effects and the follow-up plan. You are under no obligation to have a treatment at the end of the appointment.
A first consultation usually begins with your own account. Explaining what bothers you most in the mirror, when you first noticed the change and which features you want to keep helps the doctor define the concern accurately. Your health history comes next: long-term conditions, regular medicines and supplements, allergies, pregnancy or breastfeeding, and any previous Botox, filler, biostimulator or device treatments. This part should not be rushed, because whether a treatment suits you, or should be postponed, depends largely on this information. Details you cannot remember on the day can be added after the appointment.
After the assessment, the doctor shares what they see and its likely causes. The same concern can have different causes; a tired look, for example, may come from volume loss, changes in skin quality, the pull of facial muscles or tissue laxity. The recommendation is therefore shaped by the cause rather than by the name of the treatment you had in mind. For each option, the expected effect, when it appears and how long it may last, recovery, common side effects and rare but serious risks are discussed. Doing nothing, or continuing with skincare and sun protection alone, can also be among the options.
What should you prepare before your first consultation?
A list of your medicines and supplements, product cards or records from previous treatments, relevant medical reports and a short list of your concerns make the appointment more productive. If you have an important event or trip coming up, noting the date means the timing of any treatment can be planned around it.
Your list should include not only prescription medicines but also painkillers such as aspirin, supplements such as fish oil, vitamin E and ginkgo, herbal products and any retinoid skincare. Some of these can affect bruising or how your skin responds to treatment. If you have taken oral acne medication, mention that too. If you are under follow-up for a thyroid, autoimmune or neurological condition, bringing recent reports or the name of your treatment makes the assessment easier. Do not stop any medicine on your own before the appointment; how each one is handled is discussed, where needed, with the doctor who prescribed it.
If you have had filler, a biostimulator or a thread treatment before, the product name, date and area directly affect the new plan. A patient card, batch label or record from the facility that treated you makes this clear; if you cannot find one, noting what you remember still helps. Writing your concerns down in order of priority means nothing is missed on the day. Photos taken a few years ago in natural light and without make-up can help show the direction in which your face has changed. Whether you share such photos is entirely up to you.
How can you explain what you want to the doctor?
Describing what bothers you, when it became noticeable and which features you want to keep is more useful than naming a treatment. Saying how you do not want to look, for example with frozen expressions or an overfilled face, also helps set the limits of the plan.
Many people arrive at a consultation with a treatment already in mind, such as lip filler, tear trough filler or salmon DNA. Yet the same appearance can have more than one cause. Darkness under the eyes, for example, may come from a hollow, from blood vessels showing through thin skin or from pigmentation, and each cause calls for a different approach. Describing the concern in your own words, such as looking tired, harsh or downturned, makes it easier for the doctor to identify the cause. The suggested method may differ from the one you first had in mind; asking why is entirely reasonable.
Discussing how much change you want matters just as much. Wanting to look more rested and wanting a clear change in facial proportions call for different plans. You can share the degree of change that feels right to you, how much recovery time your work and social life allow, and whether you would like a longer-term maintenance plan. If you were unhappy with a previous treatment, explaining why helps avoid the same outcome. When an expectation seems unrealistic, discussing it openly is part of the trust between you and your doctor, and it sometimes leads to starting with smaller steps.
How is your face assessed at the consultation?
The doctor looks at your face from the front and side, at rest and while you talk, smile or raise your eyebrows. Skin quality, volume distribution, bone support, tissue laxity, symmetry and signs of previous treatments are assessed together, and the examination may be supported by feeling the tissue and taking standardised photographs.
Looking only at the area of concern is often not enough. A prominent nasolabial fold may relate to loss of support in the midface, and a downturned mouth corner to the pull of muscles around the chin. The doctor therefore assesses the upper, middle and lower face in relation to each other. The strength and pattern of your facial muscles shape the plan for treatments such as Botox, while skin thickness, elasticity and sun damage shape the choice of skin quality treatments and devices. Natural differences between the two sides of your face are also noted, as they can become more noticeable after treatment.
If you have had filler or biostimulators before, the area is examined by touch and any firmness, irregularity or displaced product is noted. Some doctors may use imaging such as ultrasound, particularly to assess older fillers of unknown content. Being shown the findings in a mirror makes the logic of the proposed plan easier to follow. If an active spot, eczema or an inflamed area is found, whether it affects the timing of treatment is discussed at this stage. Asking questions, requesting a mirror or asking to see an area again are all entirely normal. Not rushing this stage is the basis for choosing the right treatment and reducing the chance of disappointment later.
Which questions should you ask about the proposed plan?
Ask what the proposed method can and cannot change, why this product was chosen, how many sessions and how often repeats may be needed, what recovery involves, which side effects are specific to the area and what options exist if you are not happy with the result. Noting the answers makes deciding easier.
Once the plan is clear, a useful first question is what change to expect in concrete terms: in which area, to what degree and when it may become noticeable. You can then ask for the name of the product or device, the reason for choosing it and any alternatives. Duration and repeat intervals matter too; Botox is usually repeated every few months, while hyaluronic acid fillers tend to be repeated at longer intervals depending on the product and area. Biostimulators and skin quality treatments often involve a course of sessions followed by a maintenance plan. Knowing the scope of the whole plan gives a more realistic picture than judging a single session.
Safety questions are part of the plan as well. You should find out which side effects are common in that area and how long they last, how rare but serious complications are recognised and whom to contact if one happens. It is also worth asking what can be done at the review if the result is not what you expected; hyaluronic acid fillers can be dissolved with hyaluronidase if needed, whereas many biostimulators cannot be reversed in this way. Confirm whether aftercare instructions will be given in writing and when your review will be. Discussing in advance how any adjustment or top-up fits into the plan reduces uncertainty later.
Can treatment be done on the day of the first consultation?
If you are found suitable and feel ready, some treatments can be done on the same day as the first consultation. With an extensive plan, a product you are trying for the first time, a health question that needs clarifying or an event coming up soon, another day may be more appropriate. Informed consent should follow only once your questions have been answered.
A short treatment such as Botox, with no open questions in your health history, may be planned for the same day as the consultation. On the other hand, treatment may be postponed for a plan covering several areas and methods, for blood thinners that need discussing with the prescribing doctor, or for an active spot or cold sore in the treatment area. Timing a first treatment for a quiet week, when you can watch recovery calmly, is also a sensible choice. Even on the same day, there should be enough time to read the consent form and have your questions answered.
Pressure to decide quickly, offers said to be valid only for that day, or no discussion of risks at all are signs that should inform your judgement. For an elective aesthetic treatment, taking a few days to think, or talking it over with family or another doctor, is always possible. You can ask for a short written summary of the proposed plan, the products and the review schedule at the end of the consultation. If new questions come up before treatment, note them and ask before signing the consent form. The decision should be made at your own pace, and the plan can be updated at later visits as your skin responds or your preferences change.
Frequently asked questions
How long does a first aesthetic consultation take?
A first consultation has no fixed length; it depends on how much there is to discuss. A consultation about one area usually takes less time than an assessment of the whole face, previous treatments and several methods. When booking, ask how much time is set aside, and plan your day accordingly in case treatment can also be done on the same day.
Can I wear make-up to my first consultation?
Arriving without make-up, or with very light make-up, is recommended for a first consultation; foundation and concealer can hide differences in skin tone, pigmentation, fine lines and pores and make the assessment harder. If treatment is done the same day, your skin will be cleansed anyway, so coming without make-up saves time. If you do wear make-up, you may be asked to remove it first.
Is it helpful to bring a photo of a celebrity whose look I like?
A photo you like can help show which feature appeals to you, whether it is the lip shape, the jawline or the glow of the skin. Aiming to copy someone else's face exactly is not realistic, however, because bone structure, skin thickness and facial proportions differ from person to person. Published photos are also affected by lighting, make-up and filters.
Why are photos of my face taken at the consultation?
Photos taken at the consultation record your starting point so that the result can be compared in the same light and from the same angle. Judging changes from memory in the weeks after treatment is difficult; standardised photos make the comparison more objective. These photos form part of your medical record, and using them for other purposes such as promotion requires your separate explicit consent.
What is in the consent form I sign before an aesthetic treatment?
An informed consent form usually covers the procedure and area, the product to be used, the expected effect and how long it lasts, alternatives, common side effects, rare but serious risks and aftercare instructions. You should have time to read it before signing and be able to ask about anything unclear. Giving consent does not remove your right to change your mind before treatment begins.
Why is starting with a small amount often suggested for a first treatment?
Starting with a measured amount at a first treatment shows how your tissues respond to the product and allows small additions at the review if needed. The effect of Botox usually settles fully at about two weeks, while early swelling after hyaluronic acid filler can hide the true result. Reducing an over-treated area is often harder than adding to one that needs a little more.
What is discussed differently for men at a first consultation?
For men, preserving masculine features is one of the main topics at a first consultation; keeping the brows flatter and the jawline defined, for example, shapes the plan. Men's facial muscles are often stronger, so Botox doses may be planned differently. The beard area, skin thickness and shaving habits are also considered when timing injections and device treatments.
Can I bring someone with me to my first consultation?
Yes, you can usually bring someone you trust to your first consultation, and they can help you remember what was discussed. If you would prefer to talk through your health history with the doctor alone, you can say so. The final decision is yours; treatment should go ahead because of your own wishes and informed consent, not because someone close to you wants it.
Sources (3)
- NHS (UK): Before you have a cosmetic procedure (2023)
- NHS (UK): Choosing who will do your cosmetic procedure
- Goodman GJ, Liew S, Callan P, Hart S (Australasian Journal of Dermatology): Facial aesthetic injections in clinical practice: Pretreatment and posttreatment consensus recommendations to minimise adverse outcomes (2020)
This content is for general information and does not replace a personal medical assessment.