Building Trust, Transparency, and Honesty in Aesthetics By Rana Kennelly

One of the most important—yet often overlooked—skills in aesthetics isn’t how you hold a syringe or squirt the hyaluronic acid jelly… it’s the relationship you build with your patient.

Whenever I go to aesthetic conferences, the packed rooms are always the ones showing live injections. But the rooms that are empty? Those are the ones you should be sitting in—the ones teaching you how to conduct a solid consultation and how to build honest, trusting relationships with your patients.

Because trust is everything.

You’re not just injecting a face—you’re holding someone’s emotional and physical vulnerabilities in your hands. I’ve had a long career working for plastic surgeons, and I would always say how difficult it was for women to walk through the front door of a plastic surgeon’s office. The importance of making them feel comfortable and safe—quickly—was something I never took lightly. The surgeons didn’t always see it like that, but I did.

It’s incredibly vulnerable walking into an aesthetic space – surgeons office or medspa. You imagine everyone else in there is confident, flawless, and put-together—and you feel the complete opposite. Many of our patients have spent years suppressing insecurities or emotionally eating them away. And as women, we often put everyone else first—our partners, children, work—and we come last.

That’s why we often don’t meet our female patients until they’re in their late 40s or 50s. It’s not because they’ve suddenly aged—it’s because their lives have finally opened up a little space for them. The kids are out of the house, the bills are paid, and they’re finally ready to spend a little time—and some of their hard-earned money—on themselves.

So when they walk through our doors, I want to greet them with my team in the most honest and kind way and most of all I value their precious time in choosing us. Because they come in with hopes, insecurities, fears—and sometimes they’re not even sure why they’re coming in but want to chat in person. And if you want any kind of longevity in this field, your patient relationships must be built on honesty, transparency, and integrity.

I say this in every training I teach: Just do the right thing by people.

You’d think that goes without saying, but medical aesthetics is a profitable industry—and unfortunately, there are people out there pushing syringes and units for profit instead of doing what’s ethically right.

Doing the right thing starts on day one. It means having the hard conversations. Saying “no” when it’s the right thing to do. Not overpromising. Not selling a result you can’t realistically deliver. And definitely not offering something they don’t need.

Let me shout this one:

Rule number one—do not do anything you’re not comfortable with or that isn’t in your patient’s best interest. Hold that rule close to your heart and at the front of your mind.

I actually role-play saying “no” to patients with my team all the time. There are different ways to say no—polite and courteous, or a firm hard stop. Because often, we’re saying no because the patient doesn’t need anything—yet the next med spa down the street might say yes to every single request.

During your consultation, it’s your moment to share your philosophy: safe, natural, thoughtful aesthetics. It’s a time to educate—in clear, simple, and thorough language—so patients feel seen, heard, and understood.

During my consults, I always ask, “Have you understood everything I’ve explained?” And if they haven’t, I offer to explain it a different way. Then I always make a point to say, “I’ve heard everything you’ve said too.”. You must be on the same page. 

You build trust by listening. Really listening. By creating a space where they feel safe to ask questions. Where their concerns are never brushed off. Where they know you’re not in it to upsell or take their money—you’re in it for their journey. A journey of aging positively, together.

For me, the best part of any consultation is learning the emotional driver behind why the patient has come in. I’ve heard it all—from women who feel like they’ve aged overnight and don’t recognize their own reflection, to patients whose partners are ten years younger and someone mistook them for their partner’s mother. I’ve even had women tell me their husband had been having an affair with their best friend for years. 

These stories hit you deep. But when you understand the emotional driver, you gain real perspective. This isn’t just about injecting faces—it’s about supporting people emotionally. And sometimes, that support means acknowledging when aesthetics won’t fix the hurt—and referring them to a professional who can help in another way.

Transparency about risks is also crucial. Especially here in the United States—it’s not just important, it’s essential. Statistics show that clinicians are most likely to get sued when patients say, “No one told me about the risks,” or “I didn’t feel heard.” Let that be a powerful lesson to you.

In every consult, I talk about risk versus reward. I explain complications—I even tell them what’s happened in my chair. And I always remind them that doing nothing is a perfectly valid option.

Sometimes, your job is simply to educate them. Maybe they walk away with no treatment—but with a promise to start washing off their makeup at night and wearing sunscreen. If that’s the result, you’ve still done your job.

Honesty is your superpower.

It’s written in bold in our staff handbook, and I emphasize it with every new team member at The Confidence Bar: We are nothing without honesty.

It’s what separates the injector who gets one-time bookings from the one who builds a career on loyalty, trust, and referrals.

My patients have stayed with me for years because they know I care. They know I’ll never rip them off. They know I’ll always tell them the truth—even if it’s not what they want to hear.

And yes—I say no. A lot. I say it kindly. I say it with love. And always with their best interest at heart.

So what does honesty in the treatment chair actually look like?

It’s listening—really listening. Let your patients speak. Let them feel heard. Then, find the right language to walk them through options—without making them feel bad about how they look.

Use positive language. One negative word can stick in your patient’s mind forever. Words are powerful. If you were a fly on the wall in one of our practitioner's consultations, you'd hear them use language that uplifts and empowers. We start every consult by asking, “What do you love about your face?” And sadly, some people can’t name a single thing.

That’s when we see the beauty in them—and reflect it back to them. All faces are unique. All faces are beautiful. And your patients need to hear that.