Consent is the part of an aesthetic appointment most likely to be treated as paperwork. A form arrives on a clipboard, it is signed in the two minutes before treatment, and everybody involved understands it as an administrative step that stands between the patient and the needle. That understanding is wrong, and it is wrong in a way that removes most of the protection the process is supposed to give you.
Consent is a process, and the form is only its record
In UK healthcare, consent is the conversation. The form exists to evidence that the conversation happened and what it contained. A signature on a form after no conversation records nothing worth having, and a thorough conversation with no form is difficult to demonstrate later. You want both, in that order.
The legal standard that shapes this comes from the Supreme Court decision in Montgomery v Lanarkshire Health Board, decided in March 2015. It replaced a test based on what a responsible body of clinicians would disclose with a test based on the patient: a clinician must take reasonable care to ensure the patient is aware of any material risk, meaning a risk that a reasonable person in the patient's position would attach significance to, or that this particular clinician should reasonably be aware this particular patient would attach significance to.
That second limb is why consent cannot be a leaflet. A risk of visible bruising for a fortnight is material to somebody with a wedding in ten days and immaterial to somebody with nothing in the diary. The practitioner is expected to have found out which of those you are, which is one of the reasons the assessment described in what a good consultation looks like has to come first.
Who has to take it
The person carrying out the treatment. General Medical Council guidance for doctors offering cosmetic interventions, published in 2016, is explicit that the doctor who performs the intervention seeks the patient's consent themselves rather than delegating that task, and the same expectation runs through the standards used by the voluntary registers in non-surgical practice. The GMC's wider guidance on decision making and consent, which came into effect in November 2020, sets out the general framework.
In practice this means a consent conversation with a receptionist, a therapist who is not treating you, or a form emailed the night before with no discussion, does not meet the standard. Neither does a conversation with a prescriber you have never met. Where a prescription-only medicine such as botulinum toxin is involved, the prescriber is expected to assess the patient, and remote prescribing for cosmetic purposes without that assessment is treated as unacceptable across the professional guidance in this sector.
What the process has to cover
Eleven items. A process that omits any of the first eight has left a gap you will feel later.
- Who is treating you, by name, with their professional registration and the register it sits on.
- What is being used, including the product type, the volume or units, and where it is being placed. The batch number belongs in your record even if it is not on your copy.
- What it is expected to do, stated as a change to a specific feature rather than as an outcome, and what it cannot do.
- How long it lasts, and what happens as it wears off.
- Material risks, including the common ones such as bruising, swelling and asymmetry, and the rare serious ones such as vascular occlusion, infection and, for injections near the eye area with filler, visual loss.
- Alternatives, including other treatments, doing nothing, and waiting.
- What happens if it goes wrong: who you contact, on what number, out of hours, and how quickly you would be seen.
- Who pays for correction, including reversal with hyaluronidase where the product is a hyaluronic acid filler, and whether any of that is included in the price.
- Photography, kept separately from treatment consent, with a clear statement of whether images may be used for marketing and whether you can decline that without declining treatment.
- Your records, how long they are kept, and how to obtain a copy.
- Your right to withdraw at any point, including after signing and up to the moment of treatment, without argument and without financial penalty beyond a stated deposit policy.
The cooling-off period, and what it is for
Cosmetic interventions are elective, which means there is no clinical reason to treat on the day of enquiry. Professional guidance in this area expects patients to be given time to reflect between the consultation and the procedure, and the voluntary registers build a period into their standards.
The interval is not the point. The point is that the decision is made in a different emotional state from the one produced by a persuasive consultation, and that a discount which expires at the end of the appointment removes exactly that. If a price is only available today, the price is being used to compress the reflection period, and it is worth naming that out loud in the room.
Reading the form
| What the form says | What it means | What to do |
|---|---|---|
| Names the product, volume and sites | Your record can be reconstructed by anyone treating you later | Keep your copy |
| Names the practitioner and their registration | You can verify it independently | Check the register |
| Lists rare serious risks, not only bruising | The material risk standard has been applied | Ask which apply to your anatomy |
| States the out of hours contact route | There is a complication pathway | Save the number before treatment |
| Results are not guaranteed | Standard and reasonable | Nothing |
| Correction or top-up charged separately | A cost you have not been quoted | Ask for the figure in writing |
| Consent to use images for marketing bundled into treatment consent | Two different decisions collapsed into one | Ask to separate them |
| A clause waiving liability for negligence | Not a term that removes a duty of care | Query it, and reconsider the clinic |
| No cooling-off period, price expires today | Reflection time is being compressed commercially | Leave and think |
Age, and the one hard legal line
In England, the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 made it an offence to administer botulinum toxin or a cosmetic filler by injection to a person under 18 for cosmetic purposes, and to arrange for that to happen. There is no consent that makes this lawful, parental or otherwise. Any clinic prepared to discuss it has disqualified itself from the rest of the conversation.
Beyond that line, regulation of non-surgical cosmetic procedures in the UK remains thinner than most patients assume, and the position differs between the four nations. A licensing scheme for England was enabled in legislation in 2022, and readers should check the current position rather than assume a licence sits behind any premises. Who is legally permitted to inject is covered in who can legally inject in the UK.
What this does not cover
This is a description of what a consent process is expected to contain before a non-surgical injectable treatment in the UK. It is not legal advice, it does not describe the position for surgical procedures, and it does not tell you whether consent in a specific case was adequate, which is a question about facts nobody on a website has. Complaints and redress after treatment sit outside this publication's scope; a consent record you kept is the single most useful document in any of those routes, which is the practical reason to ask for your copy at the time.
Sources
- General Medical Council, standards and guidance for registered doctors
- General Medical Council, the medical register (check whether a doctor is registered and licensed)
- Joint Council for Cosmetic Practitioners, the voluntary register for non-surgical practitioners
- Save Face, an accreditation register for non-surgical cosmetic practitioners
- National Institute for Health and Care Excellence, guidance on clinical and interventional procedures
Frequently asked questions
Is a signed consent form enough on its own?
No. The signature evidences a conversation. If no conversation took place, or it covered only the common risks and none of the serious ones, the form records a process that did not happen. The conversation is the consent and the form is its record.
What is a material risk?
A risk a reasonable person in your position would attach significance to, or one the practitioner should realise you in particular would attach significance to. The test comes from the Supreme Court decision in Montgomery v Lanarkshire Health Board in 2015 and it is patient-centred by design.
Can somebody else take my consent while the injector prepares?
Professional guidance in cosmetic practice expects the person performing the intervention to seek consent themselves rather than delegating it. A form completed with a receptionist or an untreating colleague does not meet that expectation.
How long should the cooling-off period be?
Guidance expects time for reflection rather than fixing a universal number, and the voluntary registers build a period into their standards. What matters more than the interval is that the decision is not made under a discount that expires when you leave the room.
Should photographs be part of the same form?
Clinical photography for your record and permission to use images in marketing are two different decisions. They should be recorded separately, and declining marketing use should have no effect on whether you are treated.
Can I withdraw consent after signing?
Yes, at any point up to and including the moment of treatment, and you do not have to give a reason. A deposit policy may apply to the appointment, but it cannot oblige you to proceed.
Can a 17 year old have filler with a parent's permission?
Not for cosmetic purposes in England. The Botulinum Toxin and Cosmetic Fillers (Children) Act 2021 made administering either to an under 18 for cosmetic reasons an offence, and made arranging it an offence too. Parental consent does not change that.
What should I take away from the appointment?
A copy of the consent record, the product name and volume, the date, the practitioner's name and registration, the aftercare instructions and the out of hours contact number. Ask for it before treatment rather than after, because that is when it is easiest to get.