The Consultation as Diagnostic Process
The consultation is not a sales conversation. It is a structured assessment that determines whether the procedure should happen, which archetype to apply, and what the client should realistically expect. A practitioner who conducts a thorough consultation will occasionally decline to proceed. That is not a failure — it is the framework working as intended.
The Four-Point Skin Assessment
Lip skin differs from facial skin in hydration, thickness, texture, and healing behaviour. Assess each independently using the four-point framework: texture (smooth, rough, lined, scarred), hydration (well-moisturised, dry, cracked, peeling), integrity (intact, compromised, scar tissue present, previous PMU visible), and tone (even, patchy, hyperpigmented, hypopigmented). Each finding feeds directly into technique selection.
Dehydrated lips retain pigment differently than well-hydrated lips — the tissue is less plump, the dermis sits closer to the surface, and needle penetration depth requires adjustment. Lips with scar tissue from previous cold sore outbreaks present unpredictable retention zones. Lips that have had filler require assessment of tissue displacement and potential migration pathways.
Use magnification during assessment. A 2-3x loupe reveals texture details and micro-scarring that are invisible to the naked eye. Scarring from previous cold sore outbreaks often appears as subtle shiny patches that only become apparent under magnification — these zones will behave differently under the needle and must be noted on the treatment plan.
The Three-Phase Consultation Workflow
Structure the consultation in three phases: medical screening, aesthetic assessment, and expectation alignment. Medical screening identifies contraindications and must be completed before any aesthetic discussion begins — there is no point designing a treatment plan for a client who cannot safely proceed. Aesthetic assessment determines the appropriate archetype using the mapping and anatomical frameworks from Modules 1 and 2. Expectation alignment ensures the client understands the healing process, session count, and realistic outcomes.
Never combine the aesthetic assessment with pigment selection in the same conversation. Assess first, recommend an archetype, explain why, then move to colour. Rushing this sequence leads to pigment choices driven by excitement rather than diagnosis.
Photography Protocol
Photograph the lips before consultation in three positions: relaxed, smiling, and with the mouth slightly open. These three views reveal asymmetries, commissure behaviour, and tissue mobility that a single photograph misses. Use natural daylight or a standardised lighting setup — not the ring light from your treatment room, which flattens shadows and conceals texture.
Store these photographs alongside the written assessment for comparison at follow-up. When a client contacts you at day 10 concerned about uneven colour, you need the pre-procedure photographs to determine whether the unevenness is a healing artefact or a pre-existing condition that was already documented.
The Expectation Conversation
Expectation alignment is where consultations most frequently fail. The client arrives with a reference photo from Instagram showing a freshly applied result under ring light. The healed result will look nothing like that photo. The diagnostic practitioner addresses this directly: show the client healed results at 6 weeks, not fresh results at hour zero. Explain the healing timeline. Discuss realistic colour outcomes for their specific skin type and undertone.
The practitioner who over-promises at consultation creates a satisfied client at the reveal and an unhappy client at the follow-up. The practitioner who sets accurate expectations creates a slightly nervous client at consultation but a delighted client when the healed result exceeds what they were promised. Under-promise, over-deliver. This is not a cliché — it is a client retention strategy built on diagnostic honesty.
Managing Reference Photos
Reference photos are useful but dangerous. They show someone else's lip anatomy, someone else's skin type, someone else's healing response, under someone else's lighting conditions. When a client presents a reference photo, use it as a starting point for conversation, not as a treatment target. Ask what specifically they are drawn to: the colour? The saturation level? The border definition? The overall effect? Then translate that preference into what is achievable on their specific anatomy.
When to Decline
Not every consultation should result in a booking. If the client's expectations cannot be met within the diagnostic framework — they want a result that their anatomy, skin type, or healing history will not support — the appropriate outcome is a respectful decline with an explanation. This protects the client from disappointment and protects the practitioner from complaints, negative reviews, and potential correction liability. A declined consultation is a diagnostic success, not a lost sale.
Case Study: The Instagram Reference
A 26-year-old client brings a reference photo showing a vivid, saturated coral lip blush result. She has Fitzpatrick V skin, naturally dark lip pigmentation, and requests the exact shade in the photo. Skin assessment reveals well-hydrated, healthy tissue with no contraindications. The four-point assessment is positive across all criteria.
The diagnostic conflict: the reference photo shows a fresh (day-zero) result on Fitzpatrick II skin. The colour that appears coral on pale skin will not read as coral on dark lip tissue — it will either be invisible under the existing pigmentation or require neutralisation before any enhancement colour can be achieved. Proceeding directly to coral lip blush on this presentation would produce a disappointing, muddy result.
The consultation approach: explain the relationship between natural lip pigmentation and pigment layering. Show the client how their darker base changes the outcome compared to the reference photo. Present two options: a Lip Blush that enhances their natural lip colour to a warmer, brighter version of what they already have (achievable in 1-2 sessions), or a neutralisation-then-colour approach to achieve something closer to the reference (requiring 3-4 sessions over 4-5 months). The client chooses based on informed understanding rather than false expectations.