The author advocates that aesthetic nurses are potentially well placed to offer patients the opportunity to engage in conversations relating to intimate visible differences, proposing the use of an EX-PLISSIT model of interaction (Davis & Taylor, 2006). This is a clinical model which incorporates guidance for everyday clinical consultations where intimacy and sexual relationships may be relevant topics for discussion. The author alludes to components of the Nursing & Midwifery Council (NMC) Code of Conduct for nurses, reinforcing that patients’ physical, social and psychological needs are addressed, to advocate using this framework. Within aesthetic medicine, aesthetic rejuvenation procedures of the genital region for male and female patients are growing in popularity and the author presents an interesting argument for incorporating a stepped care model, with the needs of the patient dictating progression within the framework. Each descending level is associated with increased patient need and requiring greater knowledge, training and skill on the part of the health professional, from permission-giving, limited information, specific suggestions and intensive therapy. Whilst the EX-PLISSIT model may provide a useful framework to facilitate interactions between clinicians and patients, it’s utilisation in aesthetic medicine may be limited by the scope of practice and individual competence in using such a specialised tool.