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The art of cosmetic consultation


Your cosmetic consultant should fit your practice, represent your ideals, understand the industry and procedures, and feel comfortable discussing prices with patients. Four experts offer insight on their consult best practices.

Melanie D. Palm, M.D., M.B.A“Yes.” The power of this word from a patient choosing to undergo a procedure in your hands holds great weight. It suggests trust, understanding, and confidence in your abilities. Getting there takes great skill, and this month I have enlisted the help of three cosmetic dermatology experts to guide us through the successful cosmetic consultation - the pathway to “yes!”

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Our experts this month represent varied geographies and patient populations but many constants in the premises of outstanding patient experiences. Vince Bertucci, M.D., FRCPC is the director of Bertucci Medspa outside Toronto, Canada. Cheryl Burgess, M.D., is the founder of the Center for Dermatology and Dermatologic Surgery in Washington, D.C. Shino Bay, D.O., is the founder of the eponymous institute for cosmetic dermatology, laser, and plastic surgery in Fort Lauderdale, FL.

Engaging the patient

The cosmetic consultation begins with patient engagement and credentialing. Three of the four of us charge for a cosmetic consultation, legitimizing our expertise in the eyes of the patients. I personally use this as a bit of a vetting mechanism for more serious, invested, and long-term patients that understand the value of a skilled consultation.

All of us have designated staff that function as cosmetic consultants, although some doctors have employees that wear multiple hats. Dr. Burgess utilizes “cosmetic assistants because they function in several capacities in the office,” she says.

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Dr. Bay has two cosmetic consultants. 

“This is a sales position, and they have to be warm and caring and have amazing customer service skills,” he says. “They close all the deals so they must make patients feel like they came to the right place.” 

All of us agree that your cosmetic consultant should fit your practice, represent your ideals, understand the industry and procedures, and feel comfortable discussing prices with patients.

NEXT: Use of visuals


Use of visuals

Dermatology is inherently a visual field, and the art of conveying information to the cosmetic patient during a consultation is no exception. All four of us use visual aids during the patient consultation, from a handheld mirror and flat screen TVs in the consultation room to a short video on facial aging. 

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We are divided, however, in whether to explore patient’s former self through older photographs. Dr. Bertucci prefers photos. 

“We ask patients to bring a photo in their 20s,” he says.

I ask for a photo from around age 30 or something within the last 10-15 years. Dr. Bay opts not to solicit patient photographs.

“I don’t because I think it opens a different can of worms where they have expectations of what they should look like after procedures,” he says.

Consultation flow

The cosmetic consultation flow is very similar amongst all four of our offices. All of us obtain baseline photos in the office.  The initial consultation is obtained through the cosmetic consultant, followed by the physician evaluation. All of us allow our cosmetic consultant to close the consultation with a thorough discussion of the treatment plan and associated costs.  

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The cosmetic consultation process is between 30-60 minutes for a new patient across all clinics. Most of us will treat patients the same day under certain circumstances: out of town patients or those receiving brief, limited downtime procedures, such as injectables or minimal downtime laser procedures.

NEXT: Pricing



Pricing for procedures varies by the practice. Ideally, the patient charge equates to your expertise and the overall outcome. Mature practices may be fortunate enough to follow Dr. Bay’s pricing algorithm, where set prices exist for various procedures and outcomes, rather than charging per syringe. 

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“I have named every single procedure in my practice to weed out syringe shoppers and to promote me and the practice instead of the products,” he says. 

Dr. Burgess charges per procedure but encourages maintenance programs. 

“Some patients get excited with the initial improvement and are pleased enough not to continue treatments,” she says. “I do, however, set up a treatment plan for all patients similar to dentists.”

Closing the consult

All of us have successful closure rates following cosmetic consultations, meeting or exceeding 90%. All four of our practices have a follow-up plan with new patients, from a clinic follow-up visit to phone or email contact depending on the recovery from a particular procedure.

Some final advice that carried through all of our experiences is to maintain high standards, educate patients, and ensure a good physician-patient relationship is established.

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Dr. Bertucci demonstrates the value of charging for a cosmetic consultation adding, “The cosmetic closure rate went up once we started charging a consultation fee.” 

Dr. Burgess informs patients of the procedure several times during the visit.  “Everyone needs three reminders:  1.  You tell them, 2.  You tell them again, and 3.  Then you tell them that you told them!” 

Similar to myself, Dr. Bay encourages patients seek multiple opinions from other cosmetic practices. We both also select patients for treatment that are a good fit for the practice. Dr. Bay asserts, “They need to like me and I need to like them. This allows me to create a practice with very nice patients.”    

Keep in mind that this should be fun. It is a wonderful experience to share in the joy of restoring confidence in a patient’s appearance. If you keep the patient’s best interest at heart, and not your bottom line, you will find that you cultivate a successful practice in which long-term patient relationships and financial success follows.


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