George Scandalis, founder and owner of The Skin Guy George Scandalis Inc., discusses the importance of a thorough consultation.
When it comes to aesthetics, we often talk about devices, protocols, and effects, yet none of that really matters without an actual consultation. Working with clinicians across North America and beyond, I've come to understand that consultations are not merely the beginning point in treatment; it's an integral part of everything else that follows. In my 18 plus years in cosmetic medicine industry and a business development coach and clinical trainer, consultations are the most defining measure of success and often the most overlooked treatment in a practice. It is by far the biggest leak in revenue when assessing the patient journey. Consultations are when we meet the person behind the skin, and when they also get to know us.
When you visit a medical spa, you are offering more than concerns about pigmentation or fine lines. They come with a story; a journey that brought them here. A good consultation allows that story to be heard. Yes, we’re trained to visualize anatomy and aging patterns, but we also need to visualize emotion, identity. and intention. This dual viewpoint makes a technical process its own transformative experience. I think consultation is part science, part psychology, part artistry, and part humanity. It requires much knowledge of skin biology and treatment strategies, but also an ability to explain that science in a way that feels accessible and empowering. Patients who know why skin works the way it does, become part of the process of treating, co-creating their skin health plan and not merely passive recipients. That education is what often instills trust. This process is critical.
In an industry where trends shift quickly and new tech arrives season after season, consultation is our anchor. It reminds us of fundamentals: safety, suitability, expectations, and planning over time. It keeps patients from unrealistic promises, and clinicians from over-treatment. It’s a way of ensuring we are not just chasing individual issues but, with intention, treating the bigger picture; tone, texture, volume and laxity—with the respect it deserves.
There is also something to be said for consultation on the psychological level. Aesthetically, a lot of people opt for the aesthetic in the face of transition, loss, or reinvention. In an environment where self-perception and self-care converge, consultation is a moment where someone feels seen. That doesn’t require grand gestures—just presence, curiosity, and listening before prescribing. Clinically, that foundation will set everything. You don’t get great results from a single device or product. You get great results from a relationship. When consultation is honest and comprehensive, patients get a sense of their journey: what they can do better, what they can keep the same, and what won’t change. They learn that aging is complicated, collagen decline is inevitable, and that healthy skin is built daily, often at home much more than in the treatment room. Satisfaction, however, arises when expectations meet reality.
To me, consultation is the quiet craft of our work. Artistry begins here, not with a needle or laser, but a conversation. No matter how high and mighty we master our craft, we have to be able to read a room and see deep behind the surface emotions with compassion and clarity in our communications. These “soft skills” are not soft at all; they are the lifeblood of ethical practice and the marker of expertise. As our industry develops, consultation is that unyielding, stabilizing force. It reminds us that our position isn’t just about changing what one looks like but rather supporting identity, confidence, and well-being. When we regard consultation as a treatment, responsibility and an art we elevate not just the patient experience but the integrity of our whole field.
George Scandalis will be teaching two classes at Be+Well | Beauty and Wellness Show New York (IECSC is now a part of Be+Well), "Business Growth Formula: 6 Focus Areas for a Thriving Esthetic Ecosystem" on March 8 and "Selling with Science: Build Excitement for At-home Care" on March 9, 2026. To learn about the classes offered at the show, be sure to register to attend Be+Well New York from March 8-10, 2026. What's more, use code EDSPA20 to get 20% off education classes.