When a patient comes in for cosmetic consultation, where exactly do we begin?
I like the RULE OF 3.
- Three cosmetic complaints
- Three opportunities for the patient see things differently through photos
- Three Must-Haves in Every Cosmetic Treatment Plan
If a new patient has both face and body complaints, I typically ask the patient to choose to focus on one or the other to maximize for the time that is scheduled. The best cosmetic consultations are typically 30 minutes to an hour at most. Beyond that, you will simply see eyes glazing over and your schedule will begin to run behind. All patients want to be respected and appreciated, and their time is a valuable commodity. To run on time speaks volumes to your new and existing patients.
Step 1. Ask the patient to name 3 cosmetic complaints.
I find a consult sheet is helpful in delineating up to three items the patient can list. More than three is overwhelming to the consultation process. Besides, we are establishing a life-long relationship. Aging is a journey, and this will be one of many visits you can discuss her cosmetic wish list. Thus, the anti-aging journey will not be a once & done visit.
Step 2. Take photos.
Take photos of the area of concern—frontals, obliques, and side profile views. Take close up views as well if the patient is concerned about a particular area such as the lips. A body series is appropriate if the patient is interested in body contouring or body laxity. Dynamic photos showing movement in areas of the face and neck are helpful.
I highly recommend a photography program or app which allows for “ghosting”–consistency in before and after photos, both in positioning and lighting. If only these programs were available twenty years ago, it would have saved me heart ache and time spent in attempted explanations to patients who had difficulty discerning results when shown after photos which looked worse than before photos due to overexposure and improper positioning!
Once you have the photos, always land on the oblique or side profile view to discuss the patient’s primary complaints.
Step 3. Ask the patient if the 3 cosmetic complaints have changed after seeing photos.
Most patients visualize themselves in 2D. They look at themselves every day standing in front of a mirror. They might see themselves in a photo, or in selfies. They might occasionally turn to the side and see view their profile of their body, but they cannot visualize the silhouette of their face and neck. The rest of the world views them in 3D, in a combination of ever-rotating oblique and side views, not directly face-forward. It is our job to educate our patient on this concept. As my Psychology 101 professor used to say, “Shift the paradigm!” ‘
Show your patient a different perspective by allowing visualization of the obliques and side views. You may be surprised. Sometimes, the list of complaints just might change. By shifting the paradigm, you might shift the priority list of cosmetic complaints.
Step 4. Focus on the Big 3 to create a Cosmetic Plan.
The Big 3 include Injectables, Lasers & Devices, and Skincare. Create a plan that will give your patient the optimal outcome, customized to her unique aesthetic challenges.
Injectables include neuromodulators and fillers. Neuromodulators achieve rest in muscles of facial and neck expression, while fillers address lines and wrinkles, create volume and can even stimulate collagen.
Laser & Devices can include both ablative and non-ablative modalities designed to effectively treat both skin tone and texture. Some devices are even able to create replicate volume and to lift tissue. Threads, such as Silhouette Instalift, can be included in this category.
Your patient should always be given a skincare regimen complete with physical block sun protection. If you do not provide them with skincare, they will seek it out on their own from a wealth of unreliable and uneducated sources—social media, the makeup store down the street, the mall, on-line, her BFF. However, you are the expert when it comes to the skin. Remember that!
Never make assumptions about what your patient can afford. I once had a patient come to for Botox. I had to carefully cleanse the dirt from his face because he worked outdoors planting flowers. Over a dozen years later, he still comes in faithfully for his Botox. If I had made assumptions about his profession or his appearance, I might have lost a lifelong patient.
Patients are unique and different. If an older patient has never made the foray into aesthetics, it makes sense to consider she will expend more monetary resources to achieve similar outcomes as her same-age counterpart, but one who has been performing preventive procedures and skincare since the first signs of aging.
If price is an issue, it is best to not spend the bulk of your time, reviewing price options, but recommend what your patient needs for optimal results, and remind your patient that the cosmetic journey is just that. It is a plan which can be implemented over time and can be achieved in financially increments as well.
Step 5. Follow up is Key.
Congratulations! You just made a new friend. Statistics show that if a patient returns to you three times, you will have a patient for life. Perhaps your patient purchased that recommended package of photofacials, facial filler, and skincare. Good job! Or maybe they didn’t. That’s ok, too. Pat yourself on the back. You taught someone something today.
I am from the South, and a written thank you is always appropriate and appreciated. If the patient is “on the fence” as they say where I am from, an email summarizing the benefits of your conversation will go a long way. Chances are high your patient is shopping around, and the decision may not simply be about what services you offered her, but about the way you made her feel.
Giving your patient both will differentiate you from the pack.
If you are a healthcare provider, check out Dr. Turner’s new website DrEllenTurner.com and sign up for her e-newsletter to receive tips, tricks and updates on injections, devices and life in this incredible but, sometimes overwhelming space we call aesthetic medicine.