What a Good Consultation Actually Looks Like
A good consultation isn't just the first appointment - it's every appointment, including the ones where results need to be reviewed honestly. Dr Chia Min Shan on what the assessment process should involve, what a recommendation must include, and what accountability looks like in practice.
Not every treatment delivers exactly what we hoped for.
I think it's important to just say that out loud.
Skin is complex. Individual response varies. Sometimes the first approach isn't the right one. When that happens - we review, we adjust, we try something else. The goal doesn't change. Just the path to get there.
An honest review is part of good treatment. Not a failure of it.
What I'd be more concerned about is a clinic that never acknowledges when results fall short. Because that clinic isn't having the right conversations - and without honest conversations, the treatment plan can't improve.
This is what I think about when I imagine what a good consultation looks like. It's not just the first appointment. It's every appointment - including the ones where the news isn't straightforward.
What Happens Before Any Recommendation
A good consultation begins with listening - not assessing. Before I look at anything clinically, I want to understand what the patient is experiencing. What they're noticing. What bothers them. What they've tried. What they're hoping for.
This sounds obvious. It isn't always practiced.
Patients who've had consultations that felt like a product recommendation rather than a conversation - where the assessment happened before they'd finished explaining their concern, where a treatment plan appeared before any questions were asked - will recognise the difference immediately.
The clinical assessment follows the conversation. I'm looking at skin quality, structure, proportion, and movement - but through the lens of what the patient has just told me. What I observe either confirms their concern or reframes it. Sometimes it reveals something different from what they described. That reframing is part of the value.
What a Recommendation Should Include
A recommendation without an explanation isn't a recommendation - it's an instruction. And patients who don't understand why something is being suggested can't make a genuinely informed decision about whether to proceed.
At Journey Aesthetics, I try to be explicit about three things for every treatment I suggest.
What it will do - the specific mechanism, the realistic outcome, the timeline for results.
What it won't do - the limits of the treatment, what it doesn't address, what might need to be considered separately.
What the alternatives are - because there's rarely only one reasonable path, and the patient should understand what they're choosing between.
That third one is the one most often skipped. But it's the one that most respects the patient's ability to make their own decision.
What Happens After
The review appointment is where a consultation proves itself.
If results have met expectations - we document, adjust the maintenance plan, and discuss what comes next. If results are partial - we look at why. Was the treatment underdosed. Did the skin quality need to be addressed first. Was the concern driven by something the treatment wasn't designed to fix. These are clinical questions with clinical answers.
If results have fallen short - we say so. We take responsibility for what we can take responsibility for, explain what we understand about why, and propose a path forward.
This is what accountability looks like in practice. Not a perfect outcome every time - that's not realistic in any field of medicine - but an honest assessment of every outcome and a willingness to adjust.
Patients who stay with a clinic long-term, who refer their friends and come back year after year, are almost never there because everything always went perfectly. They're there because when something didn't go perfectly, the response was honest and the path forward was clear.
That's what a good consultation - and a good clinical relationship - actually looks like.
Dr Chia Min Shan is the Medical Director of Journey Aesthetics Medical Clinic in Katong, Singapore. She specialises in skin quality, facial aesthetics, and natural-looking results using treatments including botulinum toxin, dermal fillers, skinboosters, polynucleotides, Ultherapy Prime, Volnewmer, Fotona 4D, and Corage 2.0. Every treatment plan she creates is built around a thorough consultation - because understanding what a patient actually wants is where good aesthetic medicine begins.