When actor Dustin Hoffman played a middle-aged woman in the 1982 hit movie Tootsie, he had a revelation. During breaks in shooting, he’d hang out with the movie crew (all men) while still in character, his costume and makeup intact. Eventually, the crew became desensitized to the fact that he was Dustin Hoffman. They started treating him like his character, Dorothy Michaels, a thickset woman “of a certain age.”

“It was crushing,” he recalls. “The men couldn’t make eye contact with me. They’d look everyplace in the room except at me. I felt like a non-person. I’ve never had my ego battered so badly. It gave me an insight into what women go through once they’re past their sexual prime.”


Great actors are empathetic. So are top salesmen. Top salesmen confide that they put a lot of energy into probing their customers’ psyches. They cite rapport building as Step 1 in every successful sales transaction.

If you want to convert more prospects into patients and book more surgeries, hone your rapport-building skills. It’s more important than credentials or reputation. Women make decisions based on gut feelings—that and the results they see in their friends after cosmetic treatments. If you can build rapport with them, they’ll choose you over everyone else in your area.

Using the “Dorothy Michaels School of Rapport Building,” how can you strengthen your skills? One way would be to go transgender, getting costumed and made up a la Dorothy Michaels and going to some parties. At these parties, you’d try to flirt with men. You’d see if you could feel desired and important in a group of men while standing next to a 22-year-old hottie. Instant empathy? Well, you’ll never underestimate aging women’s angst again.

I’m guessing you’re not up for the Dorothy Michaels experiment, so what else can you do to develop more rapport with prospects? The following suggestions will help you. They are based on guided imagery and sales coaching. One thing first: These suggestions apply to facial rejuvenation consultations only. If you do mainly body contouring, for example, the steps outlined here will not be relevant.


Guided imagery is a technique that focuses and directs the imagination. It can be just as simple as an athlete’s “quiet moment” prior to the starting gun’s blast sending him on a 50-yard dash. It can be as complicated as visualizing your billions of cells coordinating immunization efforts around an organ to wipe out cancer cells.

Practice the art of guided imagery before each consultation. See yourself in a hospital bed, regaining consciousness after an accident. The physicians say you’re lucky to be alive; however, your hands are paralyzed. You’ll never do surgery again. Your education and all of the achievements of your youth are now irrelevant to what’s ahead. You’ll have to find a new direction for your life.

You try to wrap your mind around this. Here you are, one-third of the way through life, and everything connected to your feelings of power and security is gone. Mentors or peers will never acknowledge you again. Younger colleagues who admired you will soon claim all the prizes you thought were yours.

You must remain stoic and do not complain. The next day, the physicians tell you the situation is worse than they’d thought. Your condition is retrogressive. It will get much worse as time passes. You are left to fill in the likely scenarios.

If you conjure up the feelings in this brief bit of guided imagery before every facial rejuvenation consultation, you’ll be well on your way to a sale. It won’t take a lot more to establish an indestructible bond with your prospect.

The rest of these principles are drawn from tried-and-true rapport-building techniques suggested by psychologists and top salespeople.


When you bought your last car, did the salesman act as though he had a million other things on his mind and could barely spare half an hour for you? No. He stuck to you like Velcro until he’d made the sale.

Most physicians bring a “time is money” mentality to the consulting room. This is a big mistake, because your prospect is already feeling dismissed by the world. It’s beating her ego to a pulp. You can earn her trust by differentiating yourself from your competition. So, listen and listen closely. Act like you have all the time in the world.


Make it clear to your staff that short of the building catching fire, there is no circumstance that justifies interrupting a consultation.


It’s said that 90% of communication is nonverbal. Therefore, your body language must convey a consuming interest in everything your prospect has to say. Example: “Fascinating. Is that really what life’s like for you now?”


“So, tell me: What’s been going on in your life lately? What’s making you feel like you need my help?”

That’s a better way to open a consultation than with the standard, “What is it you don’t like about the way you look?” It’s more likely to elicit this woman’s scary real-life experiences, such as being passed over for a promotion or feeling invisible walking through the mall with her 15-year-old daughter. These are the actual problems you’re being asked to solve—not the wrinkles and the drooping. The surgery is just a means to an end.

As soon as your prospect begins confiding in you, you know you’re on the right track. Her experiences may not be relevant to the procedures you’ll be recommending, but venting them gives her a feeling of intimacy. In a woman’s mind, her cosmetic surgeon is one of the few non-family members allowed into her inner sanctum. As with lawyers and financial advisers, cosmetic surgeons are privy to those unlovely facts that lurk on the underside of even the most glamorous life. Let your patient dwell on her crushing experiences while you nod your head in an understanding way. Feel flattered to be invited into the inner circle.

Keep in mind that the best-paid professionals witness the worst suffering—and fix it.


This is a fundamental of sincere communication. However, because of your training you’ll have a tendency to break eye contact and examine the job ahead—the contours of the face, the skin texture, etc. Resist this temptation. During the rapport-building part of the consultation (at least 10 minutes before you initiate any physical examination), stare straight into your prospect’s eyes.


Here is another basic. People need to receive signals from others in order to feel understood. Silence is interpreted as lack of interest.


Summarizing what your patient has just said shows that you are listening and fully comprehend what they’re trying to express. This is not limited to facts and the technical side of cosmetic surgery, but incorporates intangibles such as feelings and attitude.

For example, “I think I hear you saying your face might take on an angry look when you concentrate, even though you don’t feel angry, because of stuff happening around your eyes and mouth, right? Does this happen only at work, or at home, too?”

Or, “I think I get it. You see a ‘hard’ face when you look in the mirror. It’s not that you’re worried about looking old per se, just looking hardened. Am I right?”

Pause while she nods, and then, “How long have you been feeling this way?”

If this seems more like a conversation she should be having with her psychiatrist, remember that you are being allowed into a private place in her life and psyche—her “inner sanctum.”

One reason you make so much money is that you fix suffering. Before you can fix it, you must witness it.


I will never understand why cosmetic surgeons hand a mirror to prospective patients at the beginning of a consultation. The mirror has become your prospect’s worst enemy. It is counterproductive—even sadistic—to make her hold it and look at her face while you show her where her best-looking parts used to be.

It isn’t good sales technique, either. If you were remodeling your bathroom, would you want the salesperson to plop one fresh tile on your countertop and expect you to picture the room fully retiled? You would want to see photos of other bathrooms done in that gorgeous travertine, with great-looking lighting and fitted with new fixtures.

Instead of the mirror, pull up some before-and-after photos on your computer screen. Show her some of your outcomes. They say top salespeople sell the sizzle, not the steak. Go straight to the sizzle.


“You have beautiful eyes,” one surgeon told me during a consultation. It so happened that at that moment in my life my eyes were the one area of my face that had escaped deterioration. “If he can see how nice my eyes are,” I thought, “he can probably bring the not-so-lovely parts into alignment.” That was my conscious thought. Subconsciously, my battered vanity got some momentary relief. At the end of the consult, and with all other things being equal, he struck me as eminently qualified.


On The Web!

See also “The New Cosmetic Surgery Consultation” by Wendy Lewis in the May 2010 of PSP.

With a firm foundation of good rapport, you should be able to persuade your prospect to undertake whatever approach you think would work best. Give her lots of options. Do not let her feel she is getting cookie-cutter answers from you. She’s already listened to every cliché in the book from other surgeons she has already turned down.

Your prospective patient believes her face is unique. You can “read” her face and her state of being, and then lead her to the most comprehensive solution. In the end, she will thank you from the bottom of her heart and recommend you to all of her friends.

Joyce Sunila is an e-marketing specialist to aesthetic practitioners. Her Web site, Practice Helpers, is available at www.practicehelpers.com. Joyce can be reached at .