Fat Dissolving Injection Consent

Fill out the form below after keenly going through the instructions.

 

Our fat-dissolving injections are a prescription-strength compound of phosphatidylcholine and sodium deoxycholate. These substances emulsify and solubilize fats in the intestine. When injected subcutaneously, they disrupt cell membranes in adipocytes and destroys fat cells in that tissue. The body then naturally eliminates the fat slowly over a few weeks. Once these cells are destroyed, they can no longer store or accumulate fat. 

 

Risks and Complications

The possible side effects include but are not limited to:

1. Swelling (edema) in the treatment area almost always occurs.

2. Bruising (hematoma) in the treatment area.

3. Pain in the treatment area.

4. Numbness in the treatment area.

5. Redness.

6. Areas of hardness (induration) in the treatment area.

7. Ulceration of the skin in the treatment area.

8. Temporary or permanent hair loss at the injection site(s)

9. Less common side effects include, but are not limited to, tingling, nodules, itching, skin tightness, and headaches. These side effects typically resolve without treatment.

10. Other less common but serious potential side effects include temporary nerve injury in the jaw that can cause an uneven smile or facial muscle weakness, trouble swallowing, superficial skin erosions, or unsatisfactory results.

11. Can leave loose skin. 

 

Alternatives

Alternative treatments include liposuction and non-surgical treatments such as energy-based devices.

 

Photographs

Clinicals photographs shall be taken and used for the patient's medical record. Photographs are not shared with third parties. If we wish to use them for marketing purposes, we will ask you for consent.

 

Contraindications

These injections will not be performed on anyone who has an infection in the area, on pregnant women, women trying to become pregnant, or breastfeeding. These injections are not recommended for those with medical conditions affecting the areas treated or for those who have difficulty swallowing, those who are planning on having cosmetic surgical treatments, those with an enlarged thyroid gland, or those with a bleeding disorder.

 

Results

There is no guarantee of the results of any treatment, and several treatments may be needed to achieve a satisfactory result. Follow-up is required four weeks after treatment.

By signing below, I acknowledge that I have read the informed consent, I understand it, and I agree to the treatment with its associated risks and complications. The treatment has been explained to me and my questions have been answered satisfactorily. I understand that this is an elective procedure. I understand that I will be injected in the areas I have requested with the goal of reducing fat, and I understand that there is no guarantee of results of any treatment. I acknowledge that I am not pregnant, trying to become pregnant, or breastfeeding. I acknowledge that I do not have an infection in the area(s) to be treated and that I do not have any medical conditions in those areas. I acknowledge that I am not planning a surgical procedure in the areas being treated and that I do not have a bleeding disorder.

I authorize clinical photographs to be taken. I will follow all aftercare instructions as it is crucial I do so for healing. I hereby voluntarily consent to the current and subsequent injections with the above understood.