By signing this consent, I understand that:
- Hyaluronic acid is a naturally occurring sugar found in the human body. It works by drawing in water into surrounding skin and tissues. Hyaluronic acid injections are indicated to restore volume, sculpt, and reshape the face, and soften lines.
- Side effects and complications include:
o injection site redness, bleeding, swelling, bruising.
o Visible raised areas or bumpiness at and around the treated area
o Asymmetry, overcorrection, or under correction
o Migration of filler to unwanted areas
o Formation of granulomas or firm nodules
- Serious adverse reactions include:
o allergic reactions resulting in breathing difficulty and shock
o damage to deep structures
o infection
o vascular occlusion resulting in skin necrosis, blindness, or stroke.
- These side effects can occur despite correct application by a
licensed injector
- Results can vary and therefore no guarantee can be given as to the results of the treatment.
- The goal of the treatment is improvement, not perfection.
- For maximum results, more than one treatment may be required. Hyaluronic acid injections are temporary, as the body will break it down over time. To maintain or improve the results, repeated injections will be needed in the future.
- Photographs will be taken to monitor treatment effects.
- I understand that this treatment is an elective and voluntary cosmetic procedure and is not medically necessary.
All aspects of this treatment and potential risks and complications have been fully explained to me. I have had the opportunity to ask questions about the procedure and fully understand all the answers that have been provided to me.
I have disclosed my personal history of any possible allergies to medications, any diseases, current medications that I am taking, and previous aesthetic treatments that I have had.
By signing this consent, I certify that I have read and fully understand the above information and give my consent to receive this treatment.