Your Immortelle: Information and Consent of Botulinum Toxin (Anti-Wrinkle Treatments)
Vaccination Policy
PLEASE BE AWARE: Covid 19 vaccinations like any vaccination such as flu jabs, they can trigger your immune system. This could lead to potential problems with dermal filler treatments and Anti-Wrinkle injections – this is extremely rare!
I have a duty of care to you to inform you that you must follow the following guidelines:
• Await two weeks after your vaccination to receive any Anti-Wrinkle injection treatment.
• Dermal Fillers please have your treatment at least TWO WEEKS before your vaccination OR at least three weeks after your vaccination.
Important Background to the Consent Process
I wish to help you make an informed decision about your treatment options and any relevant alternative options. You may at any time decline treatment even after giving your consent.
Whilst I will make every effort to understand what significance you would attach to any particular risk it is important to me that you feel comfortable enough to question any point of concern during this process. Please feel you have as much time as you wish to reflect on the information given before agreeing to proceed with the treatment.
Purpose of Treatment
You have presented with concerns that have formed the basis of a clinical discussion and examination. The purpose of the proposed treatment is to address your concerns either individually or in combination with other modalities of treatment.
Outcomes I will endeavor in good faith to employ the principles of best practice in delivering your treatment. Each patient is individual and response to treatment will vary from patient to patient and treatment to treatment. As such it is difficult to guarantee outcomes will always meet your expectations.
Background Information
Botox is a purified protein of the toxin normally produced by Clostridium botulinum. Wrinkles and fine lines develop over time through the repeated contraction of facial muscles. By injecting Botox precisely in these specific muscles, the nerve impulse traveling to the muscle is blocked. This blockage prevents contraction, therefore relaxing the muscles.
Typically, you will see an improvement in the appearance of those fine lines and wrinkles within 2 weeks following treatment, the maximum effect being observed 5 to 6 weeks after injection. The treatment effect can be seen for up to 4 months after injection.
Commonly Experienced Adverse Events
• Redness or bruising at the injection site
• Headache
• Ptosis - Drooping of the eyelid
• Localised muscle weakness
• Facial Pain
• Skin Tightness (when treating sites additional to the forehead)
Less Common Risks
• Muscular motor dysfunction
• Infection
• Anxiety
• Numbness/Dizziness
• Disturbances of the eye
• Swelling
• Nausea
• Muscle twitching
• Fever/Flu manifestations
• Pain/Bleeding/Numbness/Tingling at injection site
Continued Common Risks
• Eyebrow drooping
• Breathing difficulties and death have been reported in patients that have received high doses in unusual (non-aesthetic) applications
Important Considerations
Every care is taken to deliver the products in a manner which will minimise risk, however you should be aware of the risks, as one may exist upon which you place particular significance. Patients are advised to take in to account all these potential risks before consenting to treatment. Please make me fully aware of your expectations prior to giving consent.
Safety Profile
Botox treatment for the conditions which have been discussed with me today has been well studied over the last 40 years and no special hazard has been observed in humans except in high doses.
Contraindications and Relative Contraindications to Treatment
• Allergy to botulinum toxin type A, Human albumin, or sodium chloride (salt)
• Infection at the site of injection
• If you are pregnant, or breastfeeding
• Have ever suffered from a disease that affects your muscles or nervous system, or have any other known muscular or neuromuscular issues
• Inflammation in the muscle or skin to be injected
• Any active disease of the cardiovascular system(please discuss with your clinician prior to commencing treatment)
Continued Contraindications
• Previous history of seizures
• Closed angle glaucoma or risk of developing closed angle glaucoma
• You plan to undergo an operation soon
Limited or no clinical data exists regarding the efficacy and tolerance of this treatment in patients having a history of, or currently suffering from, auto-immune disease or autoimmune deficiency or being under immunosuppressive therapy. I shall therefore decide on the indication on a case by case basis according to the nature of the disease and its treatment and the need for monitoring posttreatment. I will discuss the need for preliminary skin testing for hypersensitivity if necessary or in the case of patients with severe or multiple allergies.
Patients on coagulation medication or other substances known to increase coagulation time must be aware of the potential increased risk of bleeding and haematoma during and following treatment.
I will also discuss the suitability of treatment having considered your medical history and any medications you currently take, as appropriate. As such, it is imperative you disclose such medications at the time of your treatment.
Additional Information
I will discuss with you, strategies I may employ to minimise pain during the procedure, such as the use of topical anaesthetics or ‘cold applications’.
Please advise me if you have an allergy to, or have ever had a reaction to, any such anaesthetic.