Aesthetic consultation: which questions matter beforehand?
4 min read
Aesthetic Medicine
4 min read
Aesthetic Medicine
Before an aesthetic treatment, the first step is to establish what is actually causing concern: a line that appears only with movement, a loss of volume, a contour or a change in skin texture. These findings are not interchangeable and do not automatically lead to the same treatment. A product name alone is therefore not a treatment plan.
By the end of the consultation, the objective, proposed procedure, realistic limitations, relevant risks, alternatives and aftercare should all have been explained clearly. The decision may also be not to treat for the time being. Under Section 630e of the German Civil Code (BGB), information must be provided in good time and in an understandable manner so that consent can be considered properly.
Botulinum toxin selectively affects the activity of treated muscles. Fillers, by contrast, are used to add volume or alter contour. A line that appears only during facial movement is therefore assessed differently from a volume deficit at rest.
The exact product should be named during the consultation. With botulinum toxin, it is also relevant whether the proposed use is covered by the product authorisation. Off-label use must be explained expressly; dosing information for different products is not simply interchangeable.
Benefits and burden need particularly careful consideration for a procedure that is usually not medically necessary. This includes less invasive alternatives, treatment at a later date or deciding not to proceed.
Relevant pre-existing conditions, allergies, earlier aesthetic treatments and any reactions to them should be discussed openly. All medicines and dietary supplements taken regularly or as needed are also important. In particular, anticoagulant medication must never be stopped or changed without medical advice.
Acute inflammation or infection in the proposed treatment area may be a reason not to proceed. Before botulinum toxin treatment, factors including neuromuscular disorders, pregnancy and breastfeeding, and possible hypersensitivity must be assessed. Contraindications depend on the exact product and procedure.
A clear sequence helps prevent the desired outcome and the proposed method from being confused with each other.
01
Instead of simply saying “look fresher”, identify which region is concerning, in which situation, and which change is expressly not wanted.
02
Static and movement-related findings differ, particularly in the face. Photographs can document the initial finding, but consent is required for taking and storing them.
03
This includes the treatment area, product, planned quantity or dosing strategy, expected course, limitations and possible alternatives.
04
Before consent, it should be clear which reactions are expected, when a review is appropriate and how the practice can be reached if an unexpected development occurs.
A written information sheet can supplement the personal consultation, but cannot replace it. Under German patients’ rights law, the nature, extent, performance, expected consequences and risks of a procedure must be explained, as must suitability, prospects of success and relevant alternatives.
Answers such as “This is how we always do it” are insufficient if the individual starting point remains unclear. Useful information is specific to the treatment area, product and personal medical history.
Which finding is to be treated, and with which objective?
Which product will be used, and is this use authorised?
Which common and serious risks apply in this case?
What alternatives are available, including no treatment?
What aftercare, downtime and total costs should be expected?
If the objective or limitations cannot be expressed in an understandable way, making an immediate decision is not advisable.
Redness, swelling or bruising can occur after an injection. The consultation should explain how long reactions typical of the exact product are usually observed and which aftercare is recommended.
After filler treatment, Germany’s Federal Institute for Drugs and Medical Devices (BfArM) recommends promptly contacting the treating practice or a specialist medical centre if there are marked changes in sensation such as numbness, pain or pressure.
A rare but serious filler complication is vascular occlusion. If visual disturbances occur, the BfArM advises seeking medical attention immediately or attending an emergency medical facility.
Risks and contraindications differ according to the product, treatment area and personal medical history. Individual medical consent based on the current product information is therefore authoritative.
Medical information reviewed: July 2026.
Bring details of previous treatments, products used, medicines and known reactions. This makes it possible to determine whether a procedure is suited to the desired change and which limitations or risks are relevant in your individual case.
