Home / How I decide
How I decide what to recommend.
If you are trying to work out whether to book, this is the reasoning you would get in the room anyway. It is here so you can rule yourself in or out before you spend money finding out.
The three questions I am actually answering
Is this skin, volume, or structure?
Almost every concern people bring in is one of those three, and they do not lead to the same appointment. Skin quality responds to resurfacing and microneedling. Volume responds to filler and collagen stimulators. Structure (the support underneath) responds to neither, and that is the one where the honest answer is sometimes a surgeon. Sorting this out is most of what a consultation is for, and it is why I assess device work in person rather than from a photograph.
What does your calendar look like?
Bruising and swelling run on their own schedule regardless of how good the appointment was. A wedding, a photograph, a trip inside about four weeks changes what I would book and when. Collagen stimulators and device protocols are courses rather than appointments, so if the calendar or the budget will not carry the whole course, I would rather start it later than start it half-finished.
What do we do first, and what waits?
Wherever you want to end up, the first appointment is rarely the last one, and the order matters more than the amount. Adding is straightforward, and it is straightforward again in six weeks. Taking something back out is its own treatment, with its own swelling and its own recovery, so overshooting costs more time than it saves. If you want an obvious change, say so and we will plan for it. We just get there in a sequence, and I write down what we did so the next appointment starts from a known point rather than a guess.
In consultationWhere I would send you somewhere else
Not hypothetical. Each of these happens here in an ordinary month.
- When the answer is structure, not skin. A few times a month a consultation ends with me writing down a surgeon's name and handing it over before the person leaves, because in most cases nobody goes looking for it later.
- When filler would add weight where weight is the problem. Volume loss is not the only reason a face changes, and another syringe is not the answer to all of them.
- When resurfacing lands in the wrong month. It asks for real sun avoidance for weeks afterwards. Some people genuinely will. For everyone else October is a better answer than August.
- When someone wants a specific brand I do not stock. I would rather you went where it is carried than had me talk you into a substitute.
- When what looks like a result is still swelling. At day three or day five after an appointment, a fair amount of what someone is unhappy about resolves on its own.
Book a consultation with Jamie.
The consultation is where we work out what is right for you, and you will always hear exactly what I would do, and why.
Payment plans are available through Affirm and Cherry, arranged with the lender at your consultation and never sprung on the day.