Dermal Filler Consent EdenMed Aesthetics

 When we are discussing dermal filler consent we first need to understand what this means in the contet of cosmetic medical procedures. 'Dermal filler consent' will naturally mean different things to different people. What we inherantly understand by any definition or conversation in any given cicumstance is based on our very person points of reference, which in turn come from every experience we have ever had in our lives.

What does EdenMed and Dr. Sam mean by 'consent to treatment'?

Firstly, consent to treatment is always taken to be in the context of discusions held during the consultation. These discussions are there to provide you with an opportunity to clarify any uncertainties you may have, discuss realisic, acheival expectations and ensure that 'on balance' the treatment opted for is in your very best interest when considering all the pros, cons and altenative treatments, including doing nothing at all.

What are some of the important ethical considerations of consent to treatment?

In this age of tecnhology and information, it is important you are as informed as possible when considering any form of cosmetic medical procedure. There is no such thing as life without risk and so it is with medical, minimally invasive and surgical procedures. It's all a questioon of making an informed decision. 

It is important to understand that dermal filler treatments are minimally invasive non-surgical medical treatments. They are not in and of themselves purely beauty treatments. The effects are obviously to restore replenish and beautify, but they are still very much medical in nature.

Dr. Sam's ethos is that function (how the structures of the face perform, e.g. muscle contraction and expression, tear trough placement and natural tear drainage, etc) and form ( e.g. how the skin over the mucles look, how the tear trough under eye bag area looks, etc) are the same thing. The reason we humans, find certain characteristics inherantly beautiful is because the Universal Intellignce created us that way. The most beautiful form also has the most efficient function. So when you are correcting defective function, like a watery eye or wrinkled skin as the primary aim, you will create beauty. And when your primary aim is to create beauty, you will natually improve, restre and replenish function.

The understanding and consideration of cosmetic medical procedures goes beyond that from Dr. Sam's stand point. We are all equally what we feel and perceive as much as what we think, see, hear, touch, smell and taste. Therefore following the same argument that form and function are the same thing in the context of cosmetic medical treatments, when we look to enhance natural beauty or correct defective function we often also improve the way we feel about ourselves. And as having feelings defines us as human beings, what could be more important.

What are the practical implications to informed consent for cosmetic medical procedures?

Most of you are areading this because you are thinking abou having some sort of treatment for something you are concerned about. Practical things you should consider include,

who your treating surgeon / doctor is and how muc knowledge and experience do they hold. In the UK the industry is completely unregulated. With dermal filler consent to treatment, you are about to inject substances in to various parts of your face or body. This is not risk free, so you should ask yoursef how much confidence you have in the injector. The artistic end result is of course what most people focus on, it's what you see in the mirror evey day. Of course this is very important. When we consider that form and function are the same thing, 2 sides to the same coin, those injectors (and the patients that go to them) that only understand form OR function, art OR medicine, are at a distict disadvantage. Ask yourself, "where would I rather be if something were to go wrong?". A wise choice of injector is the single most important factor in your decision making process once you are fairly certain that cosmetic medical treatments are a serious consideation. A good njector will never pressurise you to have a treatment you are not happy with.

Futher considerations include, alternative treatment options, including doing nothing at all. But if dermal fillers are discussed and felt to be a good option to help address your concerns then some of the information outlined in the consent form below is important. Injectng into a blood vessel leading to blindness or stroke is a rare, but serious risk. Dr. Sam prefers the use of a microcannula over standard needle techniques used in most other clinics, greatly reducing (but not eliminating) the chance of this potentially devastating complication.

YOUR DECISION: This form is not just a formality- it’s a record of your decision to willingly consent to a medical procedure
having considered the likelihood of both positive and negative outcomes and medical risks listed below, and the impact they may
have on your immediate and later well-being. The list below is an indication of the potential risks and is not exhaustive.

Please initial each paragraph to indicate you have read, understood and discussed as required with your clinician.

What is being injected? Hyaluronic acid injectables include branded products such as Juvederm, Restylane, Boletero, Profhilo and
others improve the appearance of lines, correct volume loss or alter proportions. They include in their makeup mainly water,
hyaluronic acid, lidocaine anaesthetic, and stabilising molecules such as BDDE (1,4-Butanediol Diglycidyl Ether).
initials:................................

Risks of injection: Trauma during the procedure is caused by needles and cannulas passing through tissue, and includes bleeding,
bruising, haematoma (a larger collection of blood in the skin, outside of blood vessels), damage to underlying structures including
veins, arteries, nerves, salivary glands, lymph nodes, bone, muscle and other soft tissue structures are possible. In rare cases this
could cause continuous problems in appearance, sensation or function and may require medical intervention to treat or may be
permanent. Most traumatic injuries heal completely on their own.
Initials:.................................

Infection: Bacterial, viral or fungal infections can occur post procedure. Infections can cause redness and swelling and resolve or
progress into abscesses or boils which can be slower to recover. Rarely infections occur months later as ‘biofilm reactions’.
Symptoms include itching, and a lumpy or “thick” feeling at or just under the skin. Injections into the lip area could trigger a
recurrence of cold sores (Herpes simplex infections) which may require treatment. These problems may resolve in time, but medical
intervention may be required in some cases, and long-term effects may persist in rare cases.
Initials:.................................

Reactions: Reactions rarely occur but can include an immediate reaction causing swelling, and very rarely life threatening
anaphylaxis. Delayed reactions localised to the skin can cause nodules, lumps or bumps or very rarely sterile abscesses. These
may occur soon after the procedure or months later. They may require treatment and may leave permanent effects on the
appearance, sensation and function of the areas affected. The chance of a reaction is reported to be 0.5% or 1 in 200. The chance
of delayed reaction increases if you have active autoimmune disease or an active immune system including viral or bacterial
infections elsewhere.
Initial:..........................

Lumps, Bumps, Swellings- Unwanted visual side effects may cause dissatisfaction or distress, and include an increase in
asymmetry, swelling, lumps, bumps or surface irregularities. These non-inamed side effects are usually temporary and treatable with
full resolution likely. This may take days, weeks or months.
Initial:...........................

Skin Changes-Procedures are rarely associated with pigment changes, the formation of thread veins or new capillaries, and other
blemishes. These may either recover, require further treatment or be permanent.
Initial:............................

Blood Vessel Blockage: In rare instances the blood supply can be blocked by filler. This can cause local tissue injury called
‘necrosis’, which can result in permanent scarring. There are extremely rare cases in which blood supply to the eye or parts of the
brain being affected causing blindness and stroke. The risk is quoted to be in the region of 1 per 100,000. Seeking help immediately
if you suspect blood vessel occlusion is vital to prevent scarring. Your clinician will act in your best interest if there is a suspected
blood vessel occlusion. This may require immediate dissolving of the filler with a substance such as hyaluronidase +/- treatment with
other medication. All medication carries risks of side effects. You may also be referred to hospital or medical specialists.
Initial:..........................

Follow-up: I understand adjustments requiring more product incur a charge.
Dissatisfaction: I understand that with all treatments the precise degree of improvement cannot be guaranteed. The outcome is
subjective in nature which also means dissatisfaction is a possible outcome regardless of effectiveness of treatment. I understand
that the effect of all treatments may gradually wear off , additional treatments may be necessary to acquire the desired result, and
further charges will apply if more product is required.
Initial:............................

Agreement: By signing this form, you agree that you have read this form carefully and considered the side effects, risks and
uncertainty of the outcome and decided the treatment is still in your best interests. You have discussed all the details of the
treatment plan, past treatments and your medical history with your clinician and shared all the information your clinician may need to
plan a treatment. You agree that in weighing up the balance of the benefits and risks to you, overall you and your clinician favour the
use of dermal filler. You understand that the initial treatment of side effects and complications is included in the cost of the
procedure and therefore no refunds are issued due to any of the above occurring. You understand photographs are taken and
stored for 7 years as part of your clinical record. Photos may be used for commercial, medical and marketing purposes and all
photos taken are the property of EdenMed Aesthetics Ltd.

Client: Name: ……………………………………..Signature:………………………….Date: ……….

Clinician: I confirm I have summarised the relevant consent information verbally and checked understanding.

Clinician signature: ………………………………………. Date: .................................

Notes:

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