The authors present an insightful overview of the rare condition, Russell-Silver syndrome (RSS), with focus upon the psychological impact and required support for affected individuals. The challenge of ascertaining the prevalence of RSS is argued to be due to ill-defined features which may vary in severity, with a description of referenced clinical characteristics. Preliminary objectives and findings from researchers in Southampton undertaking the Study of Adults and Adolescents with Russell-Silver Syndrome (STAARS UK Study) are discussed with an aim to establish insight into how affected individuals perceive their appearance and the associated impact on quality of life. A useful piece to reinforce to aesthetic nurses that younger adults are not routinely screened for psychological support for appearance-related concerns in endocrine clinics, as clinicians may focus heavily upon treating growth. The piece may have benefited from the addition of some examples of referral pathways for individuals requiring psychological support, should aesthetic nurses encounter such presentations.