The art of saying no in aesthetic medicine.

That number surprises people. In an industry where the consultation is usually a soft-focus prelude to a sale, a clinic that regularly sends people home untouched sounds like a bad business.

We think it's the only honest way to practise. Aesthetic medicine sits in an unusual place: it's elective, it's emotional, and the person asking for it is rarely the best judge of what will actually achieve the change they want. Sometimes the lips a patient requests would unbalance a face that needs structural support elsewhere. Sometimes the 'tired' look is dermatological, not volumetric, and a £160 peel will do what £800 of filler can't. And sometimes — more often than you'd think — the right answer is sleep, sunscreen and nothing else.

Saying no requires three things:

• Clinical authority. Only a clinician who can offer every option has no incentive to push one.
• A fee structure that permits it. Our consultation fee means the conversation itself is the product — we're paid to think, not to inject.
• A long-term view. The patient we turn away today trusts us completely tomorrow.

If you come to Solstice and we recommend nothing, we'll consider that consultation a success. The face you walked in with might already be the right one.