🔎 PURPOSE & DISCLOSURE STATEMENT
You are being considered for Kybella® (deoxycholic acid) treatment at Aeris Medical Aesthetics to address unwanted fat in targeted areas. Kybella is FDA-approved for the treatment of submental fullness (fat beneath the chin), and is used off-label in other areas of the body where small pockets of fat are present.
We believe in full transparency. This document is not intended to alarm you, but to provide all relevant information so you may give informed consent for treatment.
💉 ABOUT KYBELLA TREATMENT
Kybella is a non-surgical injectable that works by destroying fat cells in the treated area. Once destroyed, those cells cannot store or accumulate fat again.
Treatment involves multiple small injections
Results appear gradually over several weeks to months
Multiple sessions (typically 2–4) may be needed for optimal results
Swelling is expected and often significant, especially after the first session
Areas other than the chin (arms, abdomen, jowls, bra fat, etc.) are treated off-label
⚠️ POTENTIAL RISKS & SIDE EFFECTS
Common side effects may include:
Swelling
Redness
Bruising
Pain or tenderness
Numbness
Hardness or nodules at the treatment site
Less common but serious risks may include:
Difficulty swallowing (dysphagia)
Marginal mandibular nerve injury, causing temporary asymmetric smile or facial weakness
Tissue necrosis (skin damage)
Infection
Hyperpigmentation
Alopecia (hair loss) in the treated area
If you experience fever, persistent swelling, intense pain, difficulty speaking/swallowing, or dusky skin discoloration, contact Aeris immediately.
⏳ PRE-TREATMENT INSTRUCTIONS
To reduce risks and enhance outcomes:
Do not undergo treatment if pregnant or breastfeeding
Avoid blood thinners, aspirin, or anti-inflammatories 5–7 days before unless directed otherwise by your physician
Inform us if you:
Have had facial surgery, nerve disorders, or swallowing issues
Have any history of lidocaine/epinephrine allergies
Are prone to keloid scarring or poor wound healing
On the day of treatment:
Arrive with a clean face (no makeup, lotion, or sunscreen in treated areas)
If tolerated, you may take Ibuprofen (200–400 mg) an hour prior to reduce inflammation
🧊 POST-TREATMENT INSTRUCTIONS
Expect significant swelling, which may last 1–2 weeks
Apply ice packs for 15 minutes each hour during the first 12 hours
Sleep with your head elevated for the first few nights
Avoid rubbing or massaging the treated area
Continue Ibuprofen 200–400 mg, 2–3 times per day for 3–4 days if approved
Avoid strenuous exercise, alcohol, or high-heat environments (hot tubs, saunas) for 48–72 hours
Numbness or firmness may persist for several weeks
🛑 CONTRAINDICATIONS / WHEN TO AVOID TREATMENT
Do not proceed with Kybella if you:
Are currently pregnant or breastfeeding
Have a bleeding disorder or active infection in the treatment area
Have had previous complications with cosmetic injectables
Are undergoing other facial treatments or surgeries within the same time period
💲 FINANCIAL & MEDICAL UNDERSTANDINGS
I understand that Kybella may not produce the results I expect, and results are not guaranteed
I acknowledge that treatment areas outside the chin are off-label
I accept that multiple sessions may be required
I understand that all sales are final and non-refundable
I agree to follow pre- and post-care instructions precisely and report complications promptly
🛡️ WAIVER & RELEASE OF LIABILITY
I have had the opportunity to ask questions regarding this treatment. I understand the risks, benefits, alternatives (e.g., liposuction, CoolSculpting), and expectations. I knowingly and voluntarily consent to receive Kybella injections.
I release Aeris Medical Aesthetics, its providers, and affiliates from liability for any complications or dissatisfaction arising from this elective procedure, to the fullest extent permitted by law.