Most people have no reference point for what a cosmetic consultation should contain, so they judge it by how they were made to feel. Feeling comfortable is worth something, and it is not evidence of anything. Published professional standards give you something better: a written list against which any consultation can be measured.
Where the list comes from
The General Medical Council publishes guidance for doctors who offer cosmetic interventions, and separate guidance on decision making and consent. Other regulators publish equivalent expectations for their own registrants. These documents are public, free and readable in an evening.
Reading them changes your position. Instead of a feeling that something was rushed, you have a specific expectation that was not met, expressed in the regulator's own words. That is the difference between an unhappy review and a complaint that can be considered.
| Element | What it looks like when present | What its absence means |
|---|---|---|
| Medical history | Taken by the treating clinician and discussed with you | No assessment of your specific risk took place |
| Examination | The area is looked at and findings explained | The plan was made without seeing you |
| What it can achieve | Specific, and includes what it cannot do | Expectations were not managed |
| Material risks | Common and uncommon serious risks, in plain words | Consent cannot be informed |
| Alternatives | Including doing nothing | The discussion was structured around a sale |
| Who will treat you | Named, with registration if asked | You cannot check anybody |
| Aftercare and escalation | Written, with an out of hours contact | You are on your own if something happens |
| Time to reflect | Offered without pressure | The process is transactional |
A framework written by this publication to organise the procedure. It is not a measurement, a guideline or a regulator's classification.
Medical history and medication
A proper consultation takes a full history: existing conditions, previous procedures including those elsewhere, medication and supplements, allergies, pregnancy or breastfeeding where relevant, and any history of problems with previous treatments.
Two markers of quality here. First, whether anyone reads it back to you and asks follow up questions, rather than simply collecting a form. Second, whether the person taking it is the person treating you, or someone else. Information collected by one person and glanced at by another is not the same as a clinician taking a history.
Examination of the area
The clinician should look at the area, assess it, and explain what they see. For toxin treatments this means observing muscle movement. For fillers it means assessing structure and asymmetry. Almost everyone has some facial asymmetry, and a clinician who points it out before treatment is doing you a service, because a difference you were unaware of before will be attributed to the treatment afterwards.
If nobody looked at the area properly, no meaningful plan can have been made, and no meaningful assessment of risk for you specifically can have taken place.
Risks, including the ones people do not mention
Consent guidance is built around material risks: the risks that matter to this particular patient, discussed in a way they can understand. That includes common and minor effects and also uncommon but serious ones.
You should be told what the recovery looks like, what is normal in the days afterwards, what would be abnormal, what you should do if something abnormal happens, and how to contact someone urgently including out of hours. If you cannot answer the question who do I ring at nine on a Sunday evening, that part of the consultation did not happen.
A specific and reasonable question for filler treatments: what happens if there is a vascular complication, who would manage it, and how quickly. The seriousness of the question is not a reason to avoid asking it.
- Open
- The professional regulator's own published guidance
gmc-uk.org, the professional standards, cosmetic interventions and consent - Type in
- Search the regulator's site for its guidance on cosmetic interventions and its guidance on decision making and consent. Read them before your consultation if you can.
- A good result looks like
- Published guidance you can read in full, setting out expectations about assessment, information, consent, time to reflect, and the responsibility of the person carrying out the procedure.
- An ambiguous result looks like
- Third party summaries of the guidance with no link to the source. Clinic pages describing their own standards without reference to any regulator.
- What it does not prove
- That any particular practitioner follows it. Guidance sets the expectation. Whether it was met in your case is a question about what happened in the room.
- Note
- If you later complain, quoting the specific expectation that was not met is far more effective than describing how the appointment felt.
Alternatives, including doing nothing
Consent guidance is explicit that alternatives, including the option of no treatment, form part of the discussion. In a commercial setting this is the element most likely to be omitted, because it is the only one that does not lead to a sale.
A clinician who volunteers that a different treatment might suit you better, or that they would wait, or that they would not treat you, is demonstrating exactly the professional obligation the guidance describes. It is one of the strongest positive signals available.
Who will treat you, and who is taking consent
Ask, and get the answer in writing. The person who carries out the procedure is responsible for it, and guidance is clear that consent should be sought by the person performing the intervention, not delegated to someone unable to answer questions about it.
If a consultation is with one person and the treatment is carried out by another, that is a question to raise before the day. Where a prescription only medicine is involved, add the prescribing questions from the remote prescribing article, because the prescriber is a third role and may be a third person.
Time to reflect
Guidance in this field expects patients to be given time to consider before committing. That is why same day treatment on first contact deserves attention, and why a discount that expires at the end of the appointment is a structural problem rather than a bargain.
Note the distinction from consumer law. The cancellation rights under the Consumer Contracts Regulations 2013 are a separate legal matter with their own conditions, covered in the cooling off article. Professional expectations about reflection time and legal cancellation rights are different things, and confusing them will leave you relying on a right you may not have.
- Before: read the regulator's guidance and write down the four or five things you want covered.
- During: note anything not covered, and ask one flat question about each before you leave.
- Before paying: ask for the treatment plan, the written risk information and the consent documents.
- After: file everything with your register screenshots and the written answers about prescriber and injector.
- If anything was missing: ask for it in writing rather than deciding to let it go.
What you should leave with
At the end of a proper consultation you should be able to state, without looking anything up: what will be injected or applied, how much, by whom, on whose prescription if it is a medicine, what it costs in total, what the risks are, what recovery looks like, who to contact if something goes wrong including out of hours, and what happens if you are unhappy with the result.
You should also physically have: a written treatment plan or quotation, the information leaflet or written risk information, and the consent documentation. If you left with nothing on paper, ask for it before you pay, and see what you can ask for.
How to use this without being difficult
None of this requires confrontation. It requires you to notice omissions and ask one flat question about each: I did not catch what the alternatives are, could you go over those. What would count as abnormal afterwards. Who would I contact at the weekend. Who will carry out the treatment on the day.
Four sentences. A good clinician answers them and thinks better of you for asking. A sales process treats them as friction, and you will feel the difference immediately, which is the subject of the next article.