Almost every clinic in this sector offers a free consultation. Some of them are genuine clinical assessments. Some are sales appointments with clinical vocabulary. They can be difficult to distinguish while you are in one, which is why this article describes the structure rather than the content.
The order, which is the tell
A clinical assessment moves from problem to mechanism to plan. A sales appointment moves from product to justification. The direction of travel is visible within a few minutes and it is much harder to disguise than the words used.
One: what you are unhappy about
The appointment should begin with you describing, in your own words, what you have noticed and what you would like to be different. A good practitioner asks what changed and when, whether your weight has been stable, and what you are hoping will be different afterwards.
That last question is the one that separates a careful practitioner from a competent one. The answer sometimes reveals that the person is asking for something a treatment cannot provide, and a practitioner who hears that and says so is behaving well.
Two: examination
Somebody should look at and assess the area. Specifically, they should establish whether the tissue in question is pinchable subcutaneous fat, whether there is skin laxity and of what kind, whether there is muscle separation in the case of an abdomen after pregnancy, and whether the abdomen is soft or firm.
These four findings determine whether any treatment in the building is addressed to your concern. An appointment that proceeds to a recommendation without them is not an assessment. Our guides to the fat compartments and skin laxity let you check the conclusion.
Three: history
You should be asked about medicines, medical conditions, implanted electronic devices, metal implants and coils, pregnancy and breastfeeding, previous procedures in the area, and any relevant conditions such as liver disease or bleeding disorders.
This is not paperwork. Several of these are absolute contraindications for particular mechanisms, as set out in the candidacy article. If nobody asks, you have not been screened, and that is a safety failure rather than an administrative one.
“Free consultation, with a discount if you book on the day.”
What would have to be true
- That an appointment structured around a same-day incentive can also be an unpressured clinical assessment.
- That the discount reflects a genuine cost saving rather than a decision-forcing device.
What is actually established
- Consent requires that a person is informed about risks and alternatives and has the opportunity to consider them.
- Same-day incentives are designed to prevent the interval in which consideration happens.
- Advertising rules address pressure selling and the trivialisation of procedures with clinical risk.
A free consultation is not a problem. A same-day discount attached to it is, because it converts an assessment into a transaction and removes the interval in which a person would ordinarily think. The two elements are frequently advertised together because they work together.
Four: whether anything here helps
This is the stage most often skipped, because it is where the appointment can end.
The practitioner should state plainly whether the treatments they have address the tissue producing your concern. Sometimes the answer is no, and the correct thing to do is to say so and to explain what would. A clinic that routinely finds that its own equipment is the answer to every presentation is not assessing, it is allocating.
Five: realistic outcome, risks and alternatives
A realistic outcome should be described in words, about you, not shown in photographs of other people. Ask for this explicitly if it is not offered. A practitioner unwilling to describe a likely result verbally is telling you about their confidence in it.
Risks should be named specifically, including the uncommon ones. For cryolipolysis that includes paradoxical adipose hyperplasia by name. For injectables it includes nodules and irregularity. For thermal devices it includes burns.
Alternatives should include treatments the clinic does not sell, and should include doing nothing. The absence of that last item is not a small omission: consent involves understanding the alternatives, and the alternative of not proceeding is one of them.
Six: written information, cost and time
You should leave with written information about the procedure and the risks, a written total cost including maintenance, and no obligation. A cooling off period before treatment is good practice for a procedure with clinical risk, and same-day treatment after a first consultation removes the interval in which people reconsider.
Say at booking that you will not be deciding at the appointment. It is a simple sentence and it changes the appointment entirely.
Signs you are in a sales appointment rather than a consultation
- The treatment was named before you were examined.
- Nobody asked what medicines you take or whether you have any implanted devices.
- The alternatives discussed were all treatments sold by the same business.
- Doing nothing was not mentioned.
- A price appeared early and a reduced price appeared later.
- You were asked to decide before you left.
- Photographs of other people did more work than any description of you.
None of these mean the treatment is bad or the staff are dishonourable. They mean the appointment was structured to produce a sale, and that you should take the decision somewhere else and make it there.
Who is in the room
Ask who is assessing you and who will perform the treatment, because they are often different people. Ask what qualifications and registrations they hold. In most of the United Kingdom there is no general legal requirement that either person holds a healthcare qualification for non-surgical procedures on adults, which we set out in how these devices are regulated.
Where a registered professional is involved, their registration is checkable free on the relevant public register, and where premises are registered with a regulator such as the Care Quality Commission in England, that register is public too. Checking takes minutes and is worth doing before rather than after.
The summary
Watch the order. Notice whether you were examined before a product was named. Notice whether anybody asked what you take. Notice whether doing nothing was mentioned. Notice whether a price arrived before an assessment.
Then leave, whatever you have decided, and decide somewhere else.