If the answer is yes to any of the above, your medical practitioner may ask for further details, and treatment may be refused if it is not considered in your own interest to proceed.
Dermal Fillers are made from sterile and transparent gel based cross-linked non-animal synthetic hyaluronic acid. Hyaluronic is a natural substance present in the human body. The cross-linked hyaluronic acid in fillers mimics the natural hyaluronic acid already present in the human body.
Dermal fillers utilize an innovative spherifcation technology, which soothes Hyaluronic Acid’s traditionally angular rhomboid molecular structure, leading to smoother, more natural results, which can last 6-12 months.
However, it is important to emphasize that the effect is very individual and can vary depending on the skin type, age, treated area and possible previous treatments in the same area. A follow up of the treatment can contribute to prolonging the effect of the initial treatment.
Although hyaluronic acid is a natural component of the skin dermis, its injection may in very rare cases provoke undesired reactions such as hematoma, necrosis, pigmentation and granuloma. After a treatment with fillers, certain reactions of short duration can occur. Common and expected reactions are skin redness, tenderness and swelling or pain in the treated area. These inconveniences may last from one hour up to a week. After treatment the patient should avoid strenuous activities and protect the treated area from intense sunlight and extreme temperatures.
I hereby acknowledge that the practitioner performing the treatment has in a satisfactory way informed me about the characteristics and usage of fillers. The practitioner has thoroughly described the reactions that can occur after treatment and informed me on how to care for the treated area after performed injections.
By signing this document I confirm that I have answered the questions from the practitioner regarding my medical history in an honest way. I have also informed the practitioner about possible allergies and previous treatments in the same area. My signature confirms that I agree to go ahead with this treatment.