Hyaluronidase Injection

Reduce or remove appearance of hyaluronic acid based dermal fillers

Informed Consent and

Before and After Care Instructions

Spa 35 Med Spa

208-367-0700

403 S. 11th Street

Suite 135

Boise, ID 83702

 

Congratulations on scheduling your cosmetic procedure at Spa 35 Medical Spa.

Use the Information below to learn how to prepare for your treatment and how to maximize your experience after your procedure.  

The informed consent form for each procedure also provides important information. Please be sure to read it before signing. Ask a Spa 35 team member to answer your questions before scheduling your procedure.

Call Spa 35 with any questions or concerns regarding your treatment at 208-367-0700. After business hours select option 4 for urgent after-hours assistance. If you have an emergency call 911.


Hyaluronidase - Treatment Purpose

Hyaluronidase injections are used to remove unwanted hyaluronic acid (HA) based dermal filler material. Common examples of HA based dermal filler are the family of Juvederm and Restylane (e.g. Voluma, Vollure, Lyft, Refyne). Hyaluronidase is an enzyme that dissolves excessive quantities of injected HA, and subcutaneous nodules that can form after dermal filler injections.
Hylenex and Vitrase are common brand names of Hyaluronidase used in Spa 35.

Hyaluronidase - Consent for Treatment

Informed consent documents are used to communicate information about the proposed cosmetic treatment along with disclosure of risks and alternative forms of treatment(s). Despite Hyaluronidase’s high levels of efficacy and safety, it is not free of side effects. As a patient you have the right to be informed about your treatment so that you may make the decision whether to proceed with the Hyaluronidase injection treatment or decline, after knowing the risks involved. This disclosure is to inform you about the risks, side effects and possible complications related to Hyaluronidase injections prior to your treatment. This disclosure should not be considered all-inclusive in defining other methods of care and risks encountered. Spa 35 may provide you with additional or different information which is based on all the facts in your particular case and the state of medical knowledge.

Hyaluronidase - Risks and Treatment Experience

There are both risks, and complications associated with Hyaluronidase injections. Although the majority of patients do not experience these complications, you should understand the risks and potential complications of Hyaluronidase injections.
I understand the following experiences and/or risks:
Sensitivity- You may have a hypersensitivity to Hyaluronidase, or you may develop a hypersensitivity to Hyaluronidase. Discontinue Hyaluronidase if sensitization occurs.
Spread of Localized Infection- Hyaluronidase injections can spread skin infections.
Adverse Reactions- You may experience redness, swelling, itching, or pain. Anaphylactic-like reactions, and allergic reactions, such as hives, have been reported rarely in patients receiving hyaluronidase.
Multiple treatments may be needed- Hyaluronidase degrades HA Dermal Filler material over a 24-hour period. Every person absorbs and utilizes Hyaluronidase differently. For this reason, a minimal amount of Hyaluronidase is injected at the first treatment and the amount of correction is reassessed after 24 hours. Two or more treatments are usually performed to see desired results.
Undesired cosmetic outcomes- You may experience undesired cosmetic changes after your injection(s). Every patient absorbs and utilizes Hyaluronidase differently and each HA product responds uniquely to Hyaluronidase. You may need injection(s) of additional dermal filler after your Hyaluronidase injection to achieve your desired appearance.

Hyaluronidase - Acknowledgement

I have read and understand the Informed Consent documentation and been informed about what I must do and "not do" before, during and after my treatment. I agree to follow the pre and post care instructions carefully. I understand that compliance with recommended pre and post procedure guidelines are crucial for healing, prevention of side effects and other complications.
I completed an accurate medical history document. If there are any issues that are not covered by the medical history form which I think are relevant to my treatment, I will inform Spa 35 prior to my treatment. I will also notify Spa 35 of any changes in my health or medical care as they occur during my treatment program.
I confirm that I am not pregnant or breastfeeding at this time.
Photographs: I give permission for my photographs to be used to help document my treatment course. Complete confidentiality will be maintained.
No guarantee, warranty, or assurance has been made to me as to the results that may be obtained. I am aware that follow-up treatments may be necessary for desired results. Clinical results will vary per patient. I agree to adhere to all safety precautions and regulations during the treatment. Some people are unable to complete the treatment due to discomfort. No refunds will be given for treatments received.
I recognize that during the course of the treatment, medical treatment or anesthesia, unforeseen conditions may necessitate different procedures than those above. I therefore authorize Spa 35 providers to perform such other procedures that are in the exercise of his or her professional judgment necessary and desirable. The authority granted under this paragraph shall include all conditions that require treatment and are not known to the provider at the time the procedure is begun.
I understand and agree that all services rendered to me are charged directly to me and that I am personally responsible for payment.
The nature and purpose of the treatment have been explained to me. I have read and understand this agreement. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. Alternative methods of treatment and their risks and benefits have been explained to me and I understand that I have the right to refuse treatment.
If I experience any major or life-threatening symptoms, I will call 911 immediately. For non-emergency questions I will call Spa 35 at 208-367-0700, (for after-hours concerns selection option #4).
I release Spa 35, medical staff, and specific technicians from liability associated with this procedure. I certify that I am a competent adult of at least 18 years of age. This Consent Form is freely and voluntarily executed and shall be binding upon my spouse, relatives, legal representatives, heirs, administrators, successors, and assigns.

Please contact the Spa 35 team if you have questions about Hyaluronidase and/or information on this webpage.


Why Chose Spa 35 Med Spa for Your Cosmetic Treatments?

The medical providers at Spa 35 Med Spa have been delivering cosmetic services for thirteen years. Our staff includes Nurse Practitioners, Registered Nurses and Aestheticians.

 

Photographs on this website are used to illustrate how services are used and their potential impact on your appearance. Your results will not completely match any photographs. Genetics, sun exposure, diet and exercise all influence your results. The Spa 35 Med Spa team strongly encourages all of our clients to maximize their lifestyle choices.