What Happens During an Aesthetic Consultation? A Doctor’s Step by Step Guide for Hale and Altrincham

Last updated: 3 November 2026

The commonest thing new patients say to me, usually in the first two minutes, is some version of "I don't want to be sold to". They have read the reviews, looked at the before and afters, and still have no idea what actually happens when they walk through the door of an aesthetic clinic in Hale or Altrincham, or whether they will be able to leave without a syringe near their face. This guide answers that, in the order it happens, with the practical details most clinics leave out: how long it takes, what it costs, what to bring, what I am looking at when I look at you, the questions worth asking me, and what happens if the honest answer is that you do not need anything.

I run my consultations as a doctor first, because that is what I am. The outcome of any aesthetic treatment is decided in the consultation, long before a needle is involved, and the quality of that conversation is the single best predictor of whether you will be pleased in six months. It is also, in a largely unregulated industry, the part of the process you can judge for yourself.

In this article:

• Why does the consultation matter more than the treatment?
• The practical details: time, cost, booking and what to bring
• Step 1: understanding you, not just your lines
• Step 2: medical history and safety
• Step 3: what a doctor looks for in your face
• Step 4: skin health comes first
• Step 5: discussing options, including no treatment
• Step 6: consent, time to think and treating on the day
• Step 7: your plan and what you leave with
• Questions worth asking at any aesthetic consultation
• Frequently asked questions

Why does the consultation matter more than the treatment?

A syringe of filler or a vial of anti wrinkle product is the same in any clinic. What differs is the judgement about whether to use it, where, how much and whether something else would serve you better. That judgement is formed in the consultation: by understanding your face anatomically, your skin medically, your expectations frankly and your medical history fully. Skip any of those and the treatment is a guess. The General Medical Council, which regulates doctors, is explicit about what that conversation has to include.

"You must satisfy yourself that the patient's request for the cosmetic intervention is voluntary... You must give the patient the time and information they need to reach a voluntary and informed decision." General Medical Council, Guidance for doctors who offer cosmetic interventions.

Those are rules I am bound by, and they are a good test for any clinic, doctor led or not. If the time and the information are missing, so is the medicine.

The practical details: time, cost, booking and what to bring

Detail	At my clinic in Hale
Who you see	Me, every time. There is no separate consultant, prescriber or treatment nurse; the person who assesses you is the person who treats you and the person you call afterwards
How long	Around 45 minutes for a new patient consultation; longer if we treat on the day
Cost	£75, redeemable against any treatment you go on to have. It is a fee for a doctor's time and opinion, and it is why the opinion is allowed to be "nothing, yet"
Treatment on the day	Often possible when it is appropriate and you want to go ahead; equally welcome to go away and think. Neither choice changes the price
When	Tuesday 10.30am to 6pm, Friday 2.30pm to 9pm, Saturday 10am to 6pm and occasional Sundays, at 2 Crown Passages, Hale
How to book	Online through the booking page; my sister Louise handles appointments, so you can ask her anything practical before you commit
What to bring	A list of your medicines and supplements; the names of any skincare you use; a photograph of yourself from five or ten years ago if you have one; and, if you have had treatment elsewhere, roughly what and when
How to arrive	Make up is fine; I will cleanse the areas I need to see. Skin that is mid flare, sunburnt or freshly waxed is worth mentioning when you book

Step 1: understanding you, not just your lines

The consultation starts with a conversation, not a clipboard. I want to know what prompted you to book now, what you see when you look in the mirror, what you would like to be different and, just as important, what you are worried about. "I don't want to look done" and "I still want to look like me" are not vague remarks; they are the brief, and they shape every decision afterwards.

What I ask	Why I ask it
What bothers you most, and when did you start noticing it?	The first thing you mention is usually the thing that matters; a recent change points to hormones, weight, stress or sleep rather than ageing alone
What would a good result look like to you?	"Less tired" and "a smooth forehead" are different treatments; "like my friend" is a conversation about why that will not translate
Have you had treatment before, and what did you think of it?	What you liked and disliked tells me your taste and your tolerance for change faster than anything else
Is anything about this making you anxious?	Needle anxiety, fear of looking different and fear of being judged are all common and all manageable once named; see how I support nervous patients
How much does your appearance occupy your thoughts, and is anyone else's opinion driving this?	GMC guidance asks doctors to look for vulnerability and psychological need. A couple of gentle screening questions are not a diagnosis; they are how I make sure treatment is for you and likely to help

Step 2: medical history and safety

Aesthetic medicine is medicine, and this part is not optional. I take a full history as I would in general practice, because it changes what is safe and what will work.

What I need to know	Why it changes the plan
Every medicine and supplement, including over the counter	Blood thinners, aspirin and anti inflammatories change bruising; some medicines interact with anti wrinkle treatment; I will never ask you to stop a prescribed medicine for a cosmetic result
Pregnancy, breastfeeding or trying to conceive	Injectables wait; we can still plan skincare and a timeline
Autoimmune, neuromuscular and bleeding conditions	Some treatments are unsuitable, others need modifying; a GP's training in these conditions is useful here
Allergies and previous reactions	Including fish allergy for polynucleotides, local anaesthetic reactions and any reaction to previous filler
Skin conditions, cold sores, recent procedures and dental work	Active flares, infection and recent dental treatment all change timing for injectables
Upcoming events, holidays and sun exposure	Bruising windows, peel timing and SPF realities all depend on your diary

One thing I will not do at the clinic is diagnose or treat medical conditions. If something in your history or on your skin needs medical attention, whether that is a mole I am not happy with, rosacea, acne that needs prescribing, or hair loss that needs blood tests, I will say so and point you to your own GP. Recognising when a concern is not cosmetic is part of a safe consultation.

Step 3: what a doctor looks for in your face

This is where a medical consultation diverges from a menu. Rather than looking at the line you point to, I look at the face it sits in, in layers and in motion.

What I assess	How	What it tells me
Bone and structural support	Looking at cheekbone projection, temple hollowing, chin and jaw from the front and the side	Whether a fold or a jowl is really a support problem from above, which changes the treatment entirely
Volume distribution	Where fat has shrunk or slipped; comparing with your old photograph if you brought one	What has actually changed, as opposed to what was always there
Muscle activity	I ask you to frown, raise, squint, smile and purse; I watch which muscles are strong and which side works harder	Whether a line is dynamic or static, and the dose and placement any anti wrinkle treatment would need
Asymmetry	Brow height, eye size, smile, jaw, at rest and moving; often pointed out in the mirror	Everyone has it; knowing yours before treatment stops it being blamed on treatment afterwards
Skin quality	Thickness, elasticity, sun damage, pigmentation, pores, redness, hydration, under good light	Whether the problem is the skin itself, in which case no injectable will fix it
Photographs	Standardised clinical photographs, kept confidentially in your record	The only honest way to judge change later; memory is a poor witness

Ageing happens in several layers at once, and treating one in isolation is how faces end up looking odd. The aim of this part of the consultation is to work out which layer your concern actually lives in, because that, not the trend of the month, decides what might help. I describe the layers in more detail in which treatment do I need?

Takeaway: a good consultation looks at the whole face in motion, takes a full medical history and asks what you actually want. Anything less is a sales appointment with a clipboard.

Step 4: skin health comes first

Healthy skin is the foundation of every good aesthetic result, and it is often the right first step on its own. We will talk about your current routine (and, gently, what in it may be working against you), sun protection, sensitivity and redness, breakouts, pigmentation, scarring, and the difference between dehydrated skin and dry skin, which need different things. For many patients in their thirties and forties, a proper medical grade routine built around a retinoid, vitamin C and SPF changes more than any single injectable would, and for everyone it makes later treatments work better and last longer. Where a skin condition needs medical treatment, your GP comes first and I say so.

Step 5: discussing options, including no treatment

Only now do we talk about treatments, and it is a discussion rather than a recommendation list. For each option that fits your concern I will tell you what it can realistically achieve, what it cannot, how long it lasts, what it costs, what the downtime and risks are and what maintenance looks like. I will also tell you what I would not do and why.

Possible outcome of a consultation	How often it happens	What it looks like
Treatment that day	Common, when the plan is clear, you are certain and it is appropriate	Consent, photographs, treatment, aftercare and a review booked
A plan to start later	Common	You go away with a written plan and prices, think about it, and book when ready; nothing expires
Skincare first, injectables later or not at all	Frequent, especially under 40 and for skin quality concerns	A routine, a review in three months, and treatment only if still wanted
A different treatment from the one you came in for	Very common	People ask for filler in a fold that needs support higher up, or for anti wrinkle treatment of a line that is really skin quality; I explain why and what would work
No treatment	Regularly	Because there is nothing that would help, because the timing is wrong, or because what you need is reassurance or a GP. You still leave with a clear understanding of your face
Referral elsewhere	Occasionally	A surgeon for true laxity, a dermatologist via your GP for a skin condition, a laser clinic for something I do not offer

Step 6: consent, time to think and treating on the day

If we agree on treatment, consent comes next, and it is a process rather than a signature. You will have the procedure explained, the risks and alternatives set out, and the chance to ask anything. If you want to go ahead the same day and it is appropriate, we can; many patients prefer to, having already done their thinking before they booked. If you would rather take time, that is encouraged, and the GMC guidance is clear that you can change your mind at any point, including after you have said yes. Anti wrinkle treatment is a prescription only medicine, so it is always preceded by this face to face assessment with me as the prescriber; it is never arranged remotely or by someone else.

Step 7: your plan and what you leave with

You leave with	Whether or not you have treatment
An explanation of your own face	Which layer each concern lives in, what has changed and what has not, in words you can repeat to your partner
A written plan with prices	Phased sensibly over months where needed, structure before skin, with maintenance timelines that fit your diary and budget
A skincare recommendation	Sometimes the whole plan; always the foundation of it
Honest expectations	What will improve, what will not, how long it will take and what it will cost over a year, not just today
A way to reach me	For questions after you have gone home, and for anything urgent after treatment
No pressure	No follow up sales calls, no expiring offers; book when and if you are ready

Questions worth asking at any aesthetic consultation

Whether you see me or anyone else, these are the questions I would want a friend to ask. A good practitioner will welcome every one of them.

Ask	A reassuring answer sounds like
Who is assessing me, who is prescribing and who is injecting?	The same person, who is a registered healthcare professional you can look up, and who you can contact afterwards
What would you not recommend for me, and why?	A specific, reasoned answer; everyone has something that would not suit them
What happens if something goes wrong, and do you hold the medicines to manage it?	A clear emergency process, hyaluronidase on site for filler, and a direct number
What will this cost over a year, including maintenance and reviews?	A realistic figure, not just the first appointment
Can I go away and think about it?	Yes, with the plan in writing and no change in price
What results should I realistically expect, and when?	Specific timelines, "improvement" rather than "perfection", and photographs to judge it by

If you leave any consultation feeling rushed, confused, talked into something or vaguely ashamed of your face, trust that feeling and go elsewhere. The best consultations feel like a good GP appointment with more time: you are listened to, examined properly, told the truth and left to decide. That is what I try to provide in Hale, and it is what most of my patients from Altrincham, Bowdon, Wilmslow and Knutsford say they could not find before.

Takeaway: a consultation is a medical assessment with a plan at the end, not a sales appointment with a needle at the end. The right outcome is sometimes treatment that day, sometimes skincare, and sometimes nothing at all.

Frequently asked questions about aesthetic consultations

How long does an aesthetic consultation take?

Around 45 minutes at my clinic for a new patient, longer if we treat on the day. A thorough history and facial assessment cannot be done well in ten.

How much does a consultation cost, and why is it not free?

£75, redeemable against any treatment. Charging for the appointment is what makes "you don't need anything" an answer I can give; a free consultation has to be paid for by something.

Can I have treatment at the first appointment?

Often, yes, if the plan is clear, you are certain and it is appropriate. You are equally welcome to take the plan away and book later. For anti wrinkle treatment, the face to face assessment with me as prescriber always comes first, by law.

Will I be pressured to have something done?

No. There are no sales targets, offers that expire at the door or follow up calls. The GMC requires me to be satisfied that your decision is voluntary and informed, and I take that seriously.

What should I bring to an aesthetic consultation?

A list of medicines and supplements, your current skincare, an old photograph of yourself if you have one, and details of any previous treatment. Come as you are; make up is fine.

Will you tell me if I don't need treatment?

Yes, and it happens regularly. Sometimes the answer is skincare, sometimes patience, sometimes your GP, and sometimes that your face is doing exactly what faces do and nothing needs changing.

Do you diagnose skin conditions at the clinic?

No. The clinic is for cosmetic assessment and treatment. If I see something that needs medical attention, such as a changing mole or a skin condition that needs prescribing, I will tell you and direct you to your own GP.

Is a doctor led consultation different from any other?

It includes a full medical history, an anatomical assessment of the whole face, the ability to prescribe and to manage complications, and a regulator (the GMC) with rules about consent and time to decide. Those are the differences I would look for anywhere.

Can I bring someone with me?

Yes, if it helps you feel comfortable. Part of the consultation will still be a conversation between you and me, so that I can be sure the decision is yours.

What if I am nervous about needles?

Tell me when you book and again when you arrive. Numbing, pacing, local anaesthetic at cannula entry points and simply going slowly make a large difference, and nobody is ever treated before they are ready.

How soon after a consultation can I start?

The same day where appropriate, or whenever suits you afterwards. Plans do not expire and prices are the ones you were given.

Next steps

If you would like an honest, unhurried assessment of your face and skin from a doctor, with a plan you can take away or act on, book a consultation at the clinic in Hale. Whether you leave with a treatment, a skincare routine or simply a clearer picture of what is going on, you will leave better informed than you arrived.

Learn more about Dr Caroline Warden Clinic

Click here for price list

Learn more about other treatments offered

Further reading

• How to Choose an Aesthetic Clinic Safely
• Your Aesthetic Treatment Journey: From First Enquiry to Review
• What an Aesthetic Consultation Should Feel Like
• Which Treatment Do I Need? Matching Concerns to Treatments
• Why We Struggle to See Our Own Beauty
• The Hale Clinic
• Book a Consultation

Dr Caroline Warden (GMC 6157708) is an NHS GP with over 19 years of clinical experience, an independent prescriber, and holds a Level 7 postgraduate diploma in cosmetic injectables. She has practised aesthetic medicine since 2017 and runs Dr Caroline Warden Skin & Aesthetic Clinic with her sister Louise at 2 Crown Passages, Hale, Cheshire, WA15 9GN, serving patients from Hale, Altrincham, Bowdon, Hale Barns, Timperley, Sale, Alderley Edge, Wilmslow, Knutsford, Didsbury and across Cheshire and South Manchester. You will only ever be seen and treated by Dr Warden. The clinic does not diagnose or treat medical conditions; medical concerns are directed to your own GP. Prescription only medicines are prescribed following a face to face consultation and are not promoted in this article. This article provides general educational information and does not replace an individual assessment. Information correct as of November 2026.

References

1. General Medical Council. Guidance for doctors who offer cosmetic interventions, 2016. Read the guidance
2. General Medical Council. Decision making and consent, 2020. Read the guidance
3. Department of Health. Review of the Regulation of Cosmetic Interventions (the Keogh review), 2013. Read the review
4. UK Government. Botulinum Toxin and Cosmetic Fillers (Children) Act 2021. Read the Act