Not all surgeons charge for a consultation, and policies vary a lot by practice, surgeon seniority, location, and whether the visit is with the surgeon or another team member. In London, it is common for some specialist plastic surgeons to charge a consultation fee, while others offer a free or lower-cost initial visit. When comparing practices, ask what the fee includes: time with the surgeon, examination, implant sizing or imaging if relevant, written recommendations, follow-up questions, and whether any part of the fee is deducted from the surgery cost if you proceed. A paid consultation is not automatically better, and a free consultation is not automatically lower quality. The more important point is whether you are seeing an appropriately qualified surgeon who gives you enough time, realistic advice, and a clear written plan.