What I Actually Look for During a Consultation
Structure before surface - why I won’t always give you what you ask for.
Most people walk into a consultation already knowing what they want. A smoother forehead. Softer lines. “Just fix this.” And most of the time, I can help with exactly that. But not always. And I think that’s worth explaining, because it says a lot about what I’ve learned over the years and how that has shaped the way I practice today.
Neurotoxin Isn’t Always the Answer.
Almost every consultation starts the same way: someone wants a smooth forehead. It sounds simple enough. But every face is built a little differently, and those differences can make the decision to treat with neurotoxin (like Botox or Dysport) more complicated than it looks.
One of the most common things I see is hooded eyelids. This is a completely normal part of aging; it happens to almost everyone eventually, but it changes how I’m able to treat the forehead. In a lot of these cases, I’ll actually recommend against forehead neurotoxin altogether.
Here’s why. Your forehead muscle, called the frontalis, is an “elevator” muscle and its job is to lift the upper part of your face, including your eyebrows. When your eyelids start to hood, your frontalis has to work harder to keep them lifted and out of your line of sight. Over time, that extra work creates deep lines just above the eyebrows, the ones often called “rainbows” or “commas.”
If I relax that muscle completely with neurotoxin, it can’t do its lifting job anymore. The result is that your eyelids may sit even heavier than before which feels uncomfortable and doesn’t look good either.
So when someone asks me for a completely smooth forehead, the honest answer is: it depends. It depends on your anatomy, and it depends on what result you’re actually hoping for.
What I Do Instead …
In these cases, treatment has to be more thoughtful. Sometimes that means placing the neurotoxin carefully and conservatively so the forehead stays balanced; treating the glabella (the “11’s” between your brows) without leaving the rest of the forehead untreated, which can cause an unnatural, overly arched look sometimes called a “spock brow.” Other times, it means stepping away from neurotoxin in that area completely and considering something like PRP microneedling instead, which works by supporting your skin’s own collagen production rather than relaxing the muscle underneath it.
It also means having an honest conversation about value. If your results aren’t lasting as long as they used to, that’s worth saying out loud because that’s a lot of money to keep spending on something that isn’t holding up anymore. Aesthetics isn’t limited to neurotoxin and we can discuss your options in a consultation.
Why I Practice This Way …
My job isn’t to give you what you ask for. It’s to tell you what’s safe and realistic for your face; even when that’s not the answer you came in hoping to hear.
Sometimes that means less treatment than you expected. Sometimes it means a different approach altogether. And sometimes it means you leave without booking anything, so you can go think it over. I respect that completely. I’d rather earn your trust than your appointment.
Structure before surface. That’s not just a tagline for me; it’s how I was trained to look at a face, and it’s the only way I know how to practice with integrity.
Curious whether your treatment plan should look different?
Book a consultation at Subtle T Aesthetics in Wakefield, RI 02879. We’ll tell you the truth about what your face actually needs.