Your Immortelle: Information and Consent for Dermal Filler Injections
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! But I have a duty of care to you to inform you that you must follow my guidelines of:
• Awaiting two weeks after your vaccination to receive any Anti-Wrinkle injection treatment.
• For Dermal fillers, receiving your treatment 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 that you feel comfortable enough to question me on 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
These injectable products are a sterile, pyrogen-free physiological solution of hyaluronic acid of non-animal origin. The products have been extensively tested and found suitable and safe as an injectable implant intended for injection to correct facial and body structural defects such as asymmetry, contour deformities, and volume loss in the lips, cheeks, chin, and lower face. The range is also suitable for enhancement, and fine line treatment.
Each product has a different consistency, and I will advise on the appropriate product to be used to give the desired results. In addition to hyaluronic acid, some syringes contain a small amount of lidocaine hydrochloride and a phosphate buffer. It is important to advise me if you are allergic either to hyaluronic acid or lidocaine.
Dermal Filler Consent
Commonly Experienced Adverse Events:
• Redness Swelling
• Paresthesia (nerve problems, loss of sensation, loss of motor function)
• Itching
• Bruising
Less Common Risks
• Hematoma formation
• Induration or nodules at the injection site Staining or discoloration
• Poor or weak filling effect Infection/abscess formation Immediate or delayed hypersensitivity reactions to hyaluronic acid or lidocaine
Rare but serious adverse events may be associated with intravascular injection or tissue compression which have been reported to cause temporary or permanent vision impairment, blindness, cerebral ischemia, or cerebral haemorrhage, leading to stroke, skin necrosis and/or damage to underlying structures.
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 into account all these potential risks before consenting to treatment. Please make me fully aware of your expectations prior to giving consent.
Safety Profile
The incidence of allergic reaction has been found to be low and as the products are non-animal based, usually no test patching is required. Should I have concerns about your history of allergies it may be prudent to test a small amount of product before commencing treatment.
Contraindications and Relative Contraindications to Treatment
Hypersensitivity to lidocaine, other amide-type local anesthetics, or gram-positive bacterial proteins untreated epilepsy
Clients who tend to develop hypertrophic scarring (the treatment must be used with caution)
If you are pregnant or breastfeeding
Porphyria
Dermal Filler Consent
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.
Clients on coagulation medication or other substances known to increase coagulation time must be aware of the potential increased risk of bleeding and hematoma 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 and any updates to this at the time of your treatment.
Additional Information
Depending on the specific product used the aesthetic effect can last 6 – 18 months. Please ask your doctor to advise you regarding specific expected longevity for your treatment. Hyaluronic acid is a non-permanent treatment that is fully biocompatible, degradable, and dissolvable.
You should avoid aspirin and non-steroidal anti-inflammatory medication prior to treatment, where possible to minimise the risk of bruising. I may wish to defer treatment should you have an active cold sore lesion in the vicinity of proposed treatment.
Most treatments are relatively painless but for more superficial treatment you may require a topical anaesthetic to be applied for at least 30 minutes pre-treatment.
Please be aware that if filler needs to be dissolved for any reason, you must wait 2 weeks after being dissolving before attending another filler treatment in that area.
Post Treatment
There may be some tenderness, redness and swelling to the site, this is very normal, and this usually subsides within a few days. Bruising is an occasional outcome and generally resolves. It is important to let me know prior to treatment if you have important work or social engagements which may cause you embarrassment should you bruise excessively.
It is recommended not to wear make up for to 12 hours post-treatment in most cases. It is advisable to avoid extreme temperatures until tenderness and redness subsides.
Similarly, strenuous exercise or alcohol would best be avoided for 24 hours.
You can visit this aftercare page which will give important contact details and a summary of our advice. Please do not hesitate to contact me should you have any concerns post-treatment.