Independent · London · Published by Northbank Media
Cosmetology London

A city guide to aesthetic medicine

The unsaid

What a London treatment price includes, and what it usually does not

Two London clinics can quote for the same treatment and be selling different things: different volumes, different review policies, different positions on who pays if it needs correcting. The line items inside and outside a quoted price, and the questions that make two quotes comparable.

Most common ambiguityHow much product the figure buys
Most common exclusionThe review appointment
Why brands are missingPrescription-only medicines cannot be advertised to the public
VAT positionCosmetic work is not automatically exempt

The short answer

A quoted price is a bundle, and the bundles differ. The items most often outside it are the review appointment, any adjustment or top-up, correction or dissolving if needed, aftercare products, and the later sessions of a course. The item most often ambiguous is how much product the figure buys, because area, unit and syringe pricing are not interchangeable.

Two clinics quote for the same treatment and the figures differ. Before concluding anything about either of them, it is worth establishing whether they are quoting for the same thing, because in this market they frequently are not. A price in aesthetics is a bundle, the contents of the bundle are a commercial choice, and almost none of the contents are standardised.

What the figure buys, in volume

The largest source of confusion is not a hidden extra. It is the unit.

Botulinum toxin is priced by area in some clinics and by unit in others. Area pricing is a package: a defined region of the face, treated with however much product the practitioner judges necessary. Unit pricing bills for the product actually used. Neither is wrong, and they are not comparable without knowing which is which, because a low area price with a conservative dose and a higher unit price with a fuller dose can produce the same total and a different result.

Filler is priced by syringe, and syringes are not all the same size. A price quoted for a treatment may be for a full millilitre or for half of one. Ask which, and ask what happens to the remainder if the practitioner uses part of a syringe, because clinic policies on that differ and it is a real cost either way.

Courses are the third version of the same problem. A per-session figure and a course figure are different prices for different commitments, and the question that matters is what happens if you stop after session two.

The review appointment

Injectable treatment is normally reviewed: commonly around two weeks for botulinum toxin, around four for filler. Whether that appointment is inside the price is one of the sharpest differences between clinics and one of the least often stated.

Related and equally variable is what happens at the review if an adjustment is needed. Some clinics include a top-up within a defined window. Some charge for it. Some include it only if the original dose is judged to have been insufficient, which is a judgement they make. This is worth settling before treatment because it is difficult to negotiate afterwards, and because a clinic's answer tells you how it thinks about the first appointment: as a finished transaction or as the start of a plan.

Correction, dissolving and complications

The item patients least expect to pay for is putting something right. Positions differ, and all of the following exist in the London market: correction included within a stated window, correction charged at full price, dissolving of a hyaluronic acid filler charged as a separate treatment, and complication management provided at no charge as a matter of policy.

There is no standard here, which is exactly why it belongs in the conversation before treatment rather than after it. The question is short: if this needs correcting, dissolving or managing, who pays. A clinic that cannot answer that quickly has not thought about it, and that is the more useful piece of information.

The line items, and the question that settles each

Line items commonly inside or outside a quoted London treatment price
Line itemUsually insideUsually outsideAsk
ConsultationSometimes, or redeemableSometimes charged separatelyIs the fee redeemable, and against what
Product volumeStated as area, units or syringesRarely stated in millilitresHow much product does this figure buy
Review appointmentOften for fillerOften for toxinIs the two or four week review included
Adjustment or top-upSometimes within a windowOften chargedWhat is the top-up policy and its time limit
Correction or dissolvingRarelyUsuallyWho pays if this needs reversing
Complication managementPolicy variesPolicy variesWhat does it cost me if there is a problem
Aftercare productsRarelyUsuallyIs anything I have to buy afterwards required
Later sessions of a courseIn a course priceIn a per-session priceWhat is the total for the whole course
VATShould be statedShould not be a surpriseIs the figure inclusive of VAT

VAT, which is not the simple part people assume

Medical care provided by registered health professionals can be exempt from VAT where the primary purpose is protecting, maintaining or restoring health. Purely cosmetic work does not meet that purpose, and HM Revenue and Customs sets out the position for health professionals in its published guidance. The practical consequence for a patient is that the treatment of VAT can differ between two clinics offering similar-sounding services, and that a quoted figure should state whether it includes VAT.

This is not a reason to expect a discount or to ask a clinic to characterise a cosmetic treatment as medical. It is a reason to make sure you are comparing two inclusive figures rather than one of each.

Why price lists do not name the product

Patients often read a price list, see anti-wrinkle injections rather than a brand name, and assume the clinic is being evasive. It is not. Botulinum toxin products are prescription-only medicines, and advertising prescription-only medicines to the public is prohibited under UK medicines law. Advertising rules applied by the Advertising Standards Authority follow the same line.

So the absence of a brand on a public price list is compliance rather than concealment. The name of the product being used in your treatment is a different matter entirely: it belongs in your consultation, in your consent record and in your notes, and you are entitled to ask for it.

Deposits, cancellations and expiring offers

A price also comes with terms. Deposits, cancellation windows, expiry dates on courses and package conditions are contract terms, and consumer protection law applies to them as it does to any other service sold to the public. The Competition and Markets Authority publishes guidance on unfair contract terms and on how consumer law applies to businesses.

Two patterns are worth naming. A course that expires before it can reasonably be completed transfers risk to the patient in a way worth querying. And a price available only if you agree today compresses the time for reflection that professional guidance in cosmetic practice expects patients to be given. Neither is a pricing question so much as a question about how the clinic operates, and both are visible before anybody signs anything.

What this does not cover

This describes what a price is made of. It quotes no figures, names no clinic and assesses nobody, and it is not tax, legal or clinical advice. It covers the London non-surgical market, where these conventions are reasonably consistent, and it does not extend to surgery. What a given clinic includes is set by that clinic, and the only reliable way to find out is to ask before treatment. The wider structure behind the numbers is set out in what rent does to price, and the pattern by area in the district guides.

Commercial disclosure

This article contains no commercial links. Nothing on this page is sponsored, paid for or placed on behalf of any clinic, practitioner or supplier. No business has been paid for, has approved or has previewed anything written here. Our full position is set out in the editorial policy.

Sources and registers
  1. HM Revenue and Customs, VAT for health professionals, Notice 701/57. www.gov.uk
  2. Advertising Standards Authority, the UK advertising regulator and the CAP Code. www.asa.org.uk
  3. Competition and Markets Authority, consumer protection and unfair contract terms. www.gov.uk
  4. Care Quality Commission, find and check services. www.cqc.org.uk
  5. General Medical Council, the medical register. www.gmc-uk.org

Frequently asked questions

Why do two London clinics quote such different prices for the same treatment?

Often because they are quoting for different bundles. Product volume, whether a review appointment is included, top-up policy and whether correction is chargeable all sit inside or outside the figure depending on the clinic, before any difference in appointment length or seniority is considered.

What is the difference between area pricing and unit pricing?

Area pricing sells a defined region of the face treated with whatever dose the practitioner judges appropriate. Unit pricing bills for the product actually used. They are not directly comparable, and a low area price can involve a conservative dose while a higher unit price does not.

Is the review appointment normally included?

It varies, and it is one of the most common unstated differences. Filler reviews at around four weeks are more often included than botulinum toxin reviews at around two. Ask directly, and ask what happens at the review if an adjustment is needed.

Who pays if filler has to be dissolved?

There is no standard position in the London market. Some clinics include correction within a window, some charge for dissolving as a separate treatment, and some provide complication management at no cost as policy. Settle it before treatment, because it is hard to raise afterwards.

Why do price lists say anti-wrinkle injections instead of a brand name?

Because botulinum toxin products are prescription-only medicines and advertising prescription-only medicines to the public is prohibited in the UK. It is a legal requirement rather than evasion. You can still ask which product is being used in your own treatment.

Should a quoted price include VAT?

It should be clear either way. Medical care by registered health professionals can be exempt from VAT where the purpose is protecting or restoring health, and purely cosmetic work does not meet that test, so treatment can be standard rated. Make sure you are comparing two figures on the same basis.

Is an offer that expires today a problem?

It is worth noticing. Professional guidance in cosmetic practice expects patients to be given time to reflect before an elective procedure, and a price that expires at the end of the appointment works against that. It is a question about how the clinic operates rather than about the number itself.

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