“Your body is crying out for self-care,” said the masseuse after my hour-long ‘relaxation massage’. My shoulders, which were knot-free seconds ago, tensed as she wrote down her number, saying that two sessions a month, at £75 an hour, should do it. To shake off the slimy feeling of that interaction, I booked a facial a few weeks later. It went similarly: “You’re so sensitised,” the £195-an-hour aesthetician exclaimed. She recommended I book a course of facials, which together cost more than my monthly rent.
It’s a privilege and part of my job to test treatments, which I otherwise couldn’t afford. The majority of practitioners I see are incredibly skilled (and emotionally intelligent to boot), but I have been noticing the above phenomenon more and more, especially since turning 30. Unsolicited, some will suggest additional, pricey, and sometimes invasive treatments for areas I’ve never mentioned. It stings: afterwards, I will catch myself millimetres from my mirror, calmly weighing the pros and cons of, say, filling my tear troughs.
And it’s not just me. “It’s for this reason that I won’t go to aestheticians anymore,” filmmaker and content creator Alex Bailey says. “They tried to convince me so much was wrong with me, pointing out ‘flaws’ in my face that I hadn’t requested feedback on to push services. Eventually, I stopped going because the experiences felt stressful and were built on bringing out so-called ‘imperfections’, rather than being relaxing. The upselling backfired, but I saved lots of money doing things myself.”
“Afterwards, I will catch myself millimetres from my mirror, calmly weighing the pros and cons of, say, filling my tear troughs.”
Nessa Humayun
One week out from her 30th birthday, Fashion Editor Roberta Schroeder visited a well-known aesthetician. “I remember it, because once I told her my age, she responded by saying, ‘I can tell, it’s the lines around your eyes’… I’d gone in for a simple skin treatment, not injectables. It didn’t put me off having treatments, but I despaired for the industry. This approach would have had a real adverse effect on some people.”
It’s safe to say that this isn’t standard practice, nor is it within the code of conduct for aesthetic practitioners.
Dr Christine Hall of Knightsbridge’s Taktouk clinic is one of my go-to practitioners and is renowned in the industry for her K-beauty expertise and impeccable bedside manner. “In medicine, the principle of ‘do no harm’ is fundamental,” she comments. “Actively tapping into insecurities is unethical. That said, I do feel that sometimes patients are told what they should be doing, rather than being advised, and are then shocked by the cost. It can plant insecurities…The line between being a doctor and a businessperson can become blurred.”
Of course, patients must be aware of everything available on the market. “But our job as doctors is to educate and guide, not dictate,” she continues. As such, practitioners should approach consultations with open questions. “If a patient asks me, ‘What do I need?’ I turn the question back to them. We are our own worst critics. When patients look in the mirror, they focus on negatives. They worry about asymmetry—but everyone is asymmetrical. Treatments can have a knock-on effect. Tear troughs are normal—children have them. Nasolabial folds are normal. If you erase them, you risk looking unnatural. That’s why it’s important to stay grounded, realistic, and proportionate—and to use before-and-after photos to track progress.”
Dr Hall emphasises that practitioners should only advise patients on their next treatments if explicitly invited to do so. “Personally, I would never say, ‘We’re going to do this next’. I’m very conscious of patients’ money and of the influence we have—people listen to what we say, so the decision should always be theirs.”
A cooling-off period is also recommended; practitioners should not allow treatments at the first consultation.
“They tried to convince me so much was wrong with me.”
Alex Bailey
Dermatologist, hair specialist, and president of the Institute of Trichology, Sharon Wong, always considers a series of questions before recommending treatment: “Is the treatment genuinely necessary? Does it align with the patient’s goals? Is there strong collective clinical experience? What are the risks? Are there alternative options the patient should consider?” This approach ensures patients leave feeling “Fully informed, confident, and empowered—never coerced—and assured that they have made the right decision for them, knowing that their overseeing specialist fully supports them.”
It’s also important that practitioners are honest with their clients. “Sometimes I have to explain that the gold-standard treatment for what they’re describing is surgery,” Dr Hall adds. “I’ll deliver it very carefully, but I’ll say it because I don’t want patients spending thousands on non-surgical treatments only to feel disappointed or underwhelmed in the end.”
The scope of practitioners varies widely. For those working outside aesthetics—for example, in acupuncture—patients must be considered holistically. Registered acupuncturist Asha Chong explains that she frequently refers clients to other professionals. “If a patient presents with red-flag symptoms—such as unexplained weight loss, neurological changes, severe or worsening pain, or signs of an infection—and acupuncture alone could delay necessary care, it is both imperative and ethical to refer them to a GP or an appropriate medical professional for assessment and diagnosis.”
To avoid these scenarios, it’s important to ensure that your practitioner has been properly vetted. Check they and the procedure have been supported by reputable bodies—the British College of Aesthetic Medicine (BCAM) provides invaluable guidance via their “Vet it Before You Get it” checklist. But as with me, people slip through the net—if something feels off, or someone feels pushy, they probably aren’t for you. The goal, always, is to feel happy and confident during and after whatever you’re having.