What happens at your first consultation at Dr Tvacha

Key takeaways

• There are three kinds of first consultation: a hair diagnosis at our centres, an online weight eligibility consult by video, and the Midlife Women's Health Check at Cocoon × Dr Tvacha in Thane.
• The hair diagnosis and the weight eligibility consult each cost Rs 499.
• Every centre has a private consultation room, and you can speak in English, Hindi or Marathi.
• You leave with a diagnosis, your options, written fees, and if you go ahead, fixed review dates and a maintenance plan.
• Nobody will push you to start on the day.

How do I book a first consultation?

You can book in whichever way is easiest for you:

• Call centre: 022 7123 7000
• WhatsApp: 97685 56666. Replies come within two hours on working days.
• Call a centre directly: Thane 97685 56666, Andheri 97683 78888, Bandra 97682 42222, Dahisar 97684 51111.

The centres are open Monday to Saturday, 11 am to 8 pm. Cocoon × Dr Tvacha, for women's midlife care, has its own consult hours: Monday to Saturday, 9:30 am to 12 pm and 1:30 to 3:40 pm. Full addresses are in our guide to our centres.

If you would like to see me in person, mention it when you book. I see patients at Thane in the mornings and at Andheri in the evenings.

Which first consultation do I need?

If you are unsure which applies, say so when you book. The team will help you choose.

What should I bring?

A few things make our conversation much more useful:

• A list of medicines and supplements you take now, with doses if you know them.
• Recent reports, such as blood tests or scans, if you have them. Photos on your phone are fine.
• A short timeline. When did the problem start? Did anything happen around then, such as an illness, a pregnancy, a big change in weight or a stressful year?
• Your questions, written down. It is easy to forget them in the room.
• Someone you trust, if you like. For midlife care, partners and daughters are welcome.

For hair, the timeline matters a great deal. What I tell people is: "If you're born with hair which is thin, it cannot change. If you have lost hair in the last three, four years, that can come back." Knowing when the loss began helps me see which side of that line you are on. Hair loss after an illness, for example after COVID, often responds well.

What happens during the consultation?

The order is the same whichever programme you are seeing us for.

1. Listening. The doctor asks about your concern, your history and what you hope for. In midlife care this is a long consultation that goes through every symptom, not just the main one.
2. Examination or review. For hair, I examine your scalp and hair. For weight, done by video, I review your history, measurements and any reports you share. India's Telemedicine Practice Guidelines 2020 ask both sides to confirm identity on a video consult, and the doctor to state their name and qualifications, with their registration number shown on prescriptions and messages. For midlife care, Dr Anagha decides which tests, if any, are needed.
3. Diagnosis. You are told, in plain language, what the doctor thinks is going on.
4. Options. You hear what could help, what probably will not, and what doing nothing or waiting would mean.
5. Written fees. The cost of each option is given in writing.
6. Your decision. You can start, take time to think, or decide against treatment.

Sometimes people walk in and say, "Doctor, I want to start today." Okay, sure, we can. But first, have you really understood how it works on you? I offer options and you choose. I do not push, and you will not be asked to sign up on the spot.

What about tests?

Only the tests you need. In midlife care, Dr Anagha treats by symptoms rather than a single hormone test, because hormones swing through the day in perimenopause. That fits UK NICE guidance, which says women over 45 with typical symptoms can usually be diagnosed without confirmatory hormone tests. General bloods come first, with DEXA bone density, sonography or a Pap smear only where indicated. Tests are charged at actual cost.

What happens if I decide to go ahead?

If you choose a programme, three things are set on day one:

• Your fee, in writing, before you pay.
• Your review dates. For example, in the weight programme you have a monthly review with me. In midlife care, reviews are at three months, then yearly.
• Your plan for the end. In weight care, a written taper and maintenance plan from month one. In hair care, what maintenance looks like after the four-month course.

For hair, the in-clinic course is a monthly session of about 20 minutes, using a growth-factor and peptide solution with an Erbium laser or mesotherapy, plus medicines at home. If a hair transplant is right for you, it is quoted in writing with a named qualified surgeon.

For weight, any GLP-1 medicine, such as semaglutide or tirzepatide, is a prescription decision I make after assessment. Underneath the plan sits what I call the Triad: dose, protein and strength training, with the right supplements. See how online weight loss consults work.

What if I just want information?

That is a perfectly good reason to come. A diagnosis can tell you that you do not need treatment, or that waiting is reasonable. Honestly, I would rather tell you to wait than do something you do not need. India's Code of Medical Ethics Regulations, 2002 asks doctors to announce fees before rendering service, and that is how we work: you know the cost of the consultation before you book it, and the cost of anything else before you agree to it. More on this in why every programme starts with a diagnosis and a written fee.

How we approach this at Dr Tvacha

Choose the first step that fits: a hair diagnosis at any of our four centres, an online weight eligibility consult, or the Midlife Women's Health Check under women's health. You will leave with a clear diagnosis, written fees and time to decide.

Written by

Dr Amit KarkhanisAesthetic Physician · MBBS, Dip. Dermatology (UK) · Reg. No. 2001/02/1124

Founder of Dr Tvacha, practising in Thane since 2005. Leads the weight loss and hair programmes.