Botox and Dysport
Informed Consent. Before and After Care
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.
Botox and Dysport Before and After Treatment Instructions
(neuromodulators)
Botox and Dysport - Treatment Purpose
Botox, Dysport and Xeomin belong to a class of FDA approved cosmetic products commonly referred to as neuormodulators. Neuromodulators are commonly used to decrease the appearance of wrinkles and lines caused by muscle movement and aging skin. Examples of typical treatment areas include crow’s feet around the eyes, the forehead and the glabella (area between the eyebrows).
Neuromodulators are used medically to treat certain muscular conditions and used cosmetically to relax wrinkles by temporarily stopping muscle contractions. This reduces or substantially eliminates the ability of the injected muscle to contract and produce overlying skin wrinkles. When injected by a properly trained medical professional a neuromodulators injection is considered an extremely safe treatment. The effects of a neuromodulator treatment typically last approximately three months and re-treatment recommended every ninety days. Re-treatment can be dependent upon your desired cosmetic results and your bodies response to the neuromodulator.
There are several Neuromodulators available in the United State. Botox, Dysport and Xeomin are the most common. Neuromodulators are engineered proteins derived from a Neuromodulators that have been FDA approved for use in the cosmetic treatment of wrinkles caused by muscle movement. Botox injections have been FDA approved for use in the cosmetic treatment of glabellar frown lines (the wrinkles between the eyebrows), crow’s feet and forehead wrinkles. FDA approved areas vary by product. Your treatment may include areas outside of the specific FDA approved areas. A common medical practice referred to as “off-label use”.
You are encouraged to request and read the patient labeling information from the neuromodulator manufacturer.
Botox and Dysport - 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 Neuromodulators high levels of efficacy and safety, they are 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 neuromodulator treatment or decline after knowing the risks involved. This disclosure is to inform you about the risks, side effects and possible complications related to Neuromodulators 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.
Botox and Dysport - Risks
There are both risks, and complications associated with Neuromodulators. Although the majority of patients do not experience these complications, you should understand the risks and potential complications. Neuromodulators (Botox, Dysport, etc.) are administered in a series of subcutaneous injections.
You can find an FDA overview of Botox Cosmetic at https://www.fda.gov/media/77359/download
This list is not meant to be inclusive of all possible risks associated with a Neuromodulators as there are both known and unknown side effects associated with any medication or procedure. Pregnant or nursing women should not have neuromodulator treatment.
As neuromodulators are not an exact science, there might be an uneven appearance of the face with some muscles more affected by the neuromodulator than others. In most cases this uneven appearance can be corrected by injecting Neuromodulators in the same or nearby muscles. However, in some cases this uneven appearance can persist for several weeks or months.
This is a cosmetic treatment that could potentially conflict with other medically necessary medications used to treat disease. Full disclosure of medical conditions (past and current) is necessary to determine if this treatment is appropriate for you. Complete information on your medical history minimizes your risks from this treatment. If you under a physician's care for a serious medical condition Spa 35 may require the permission of your health care provider for cosmetic treatments.
Potential risks and experiences include, but are not limited to:
Infections- Infections can occur and, in most cases, they are easily treatable but, in rare cases, permanent scarring in the area can occur.
Swelling- Most people have lightly swollen pinkish bumps where the injections were placed. These bumps may last for a few hours or possibly longer.
Headaches- Although many people with chronic headaches or migraines often get relief from a neuromodulator, a small percent of patients get headaches following treatment. In a very small percentage of patients, these headaches can persist for several days or weeks.
Respiratory problems- Respiratory problems can occur, such as bronchitis or sinusitis
Bruising is possible anytime you inject a needle into the skin- This bruising can last for several hours, days, weeks, months and in rare cases the effects of bruising can be permanent.
Muscle weakness- While local weakness of the injected muscles is representative of the expected pharmacological action of a neuromodulator, weakness of adjacent muscles may occur as a result of the spread of the product.
Reduced blinking- When injecting a neuromodulator around the eyes, people may not be able to blink the eyelids as often as they should to protect the eyes from corneal exposure. This inability to protect the eye has been associated with damage to the eye, such as: impaired vision, or double vision, which is usually temporary. This reduced blinking has been associated with corneal ulcerations.
Eyelid ptosis (drooping eyelid)- There are medications that can help lift the eyelid, however, if the drooping is too great, the eye drops are not highly effective. These side effects can last for several weeks or longer. This occurs in 2-5 percent of patients.
Other possible symptoms- Local numbness, rash, pain at the injection site, bleeding, flu like symptoms with mild fever, back pain, nausea, dizziness, and tightness or irritation of the skin and allergic reaction.
Botox and Dysport - Pre Treatment Instructions
It is prudent to follow some simple guidelines before your treatment. These guidelines can reduce possible side effects associated with the procedure and make all the difference between a fair result and a great result.
Alcoholic and caffeinated beverages- Avoid at least 24 hours prior to treatment. These beverages may thin the blood and increase bruising.
Over the Counter Medications- Avoid aspirin, Motrin and Ibuprofen for one week prior to your treatment. Inform your provider if you are taking blood thinners or regularly take aspirin or Ibuprofen.
Supplements- Avoid fish oil, Gingko Biloba, Garlic, Flax Oil, Cod Liver Oil, Vitamin A, Vitamin E, or any other supplements one week before treatment.
SinEcch (Arnica Montana)- SinEcch is an over the counter oral supplement that may decrease your risk of bruising from your injections. Ask your provider it is appropriate for you.
Special Events- Schedule your treatment at least 2-3 weeks prior to a special event i.e., wedding, vacation, speaking engagement, to allow time for the healing process. Bruising is always possible with injections, plan for time to heal before a special event.
Contraindications for Treatment- Include but are not limited to; neuromuscular disorders (Myasthenia Gravis, ALS, etc.) , autoimmune disorders, pregnancy, breastfeeding, allergy to human albumin and soymilk (Botox brand ok with soymilk allergy). Please read the complete list of contraindications on the product insert.
Photographs- Take at home photos to monitor your skin improvement.
Botox and Dysport - Treatment Day Instructions
Clean skin- Please arrive for your appointment without make-up. Bring make-up for after your treatment if you plan to return to work or daily activities.
Botox and Dysport - Post Treatment Instructions
Remain upright- Please remain upright (do not lay down, nap, etc.) for four hours post treatment.
Exercise- No vigorous exercise, straining or heavy lifting for four hours following treatment.
Treatment Area- Avoid manipulation (rubbing, massaging, etc.) of the treated area for 4 hours following injections.
Monitor for full results- Neuromodulator injections can take 2-14 days to achieve maximum effect. Please contact Spa 35 between fourteen and twenty-one days after treatment if the desired effect was not achieved.
Heat- Avoid excessive heat, such as extended time over a hot stove, for four hours post treatment.
Skincare- Retin-A, Glycolic acid, and Vitamin C may be used 24 hours post treatment.
Makeup- Makeup may be applied before leaving our office with a clean make-up sponge.
Botox and Dysport - Treatment Schedule
We recommend re-treatment every 90 days (if optimal amount of neuromodulator used.)
Botox and Dysport - Alternative Cosmetic Treatments
There may be other treatment options available such as laser ablation, chemical peels, dermal fillers and face lifts. Alternative forms of treatment are all associated with certain and varying risks.
Botox and Dysport - Synergistic Treatments
In some cases, repetitive muscle movement and skin aging can create static lines and wrinkles that are not improved by neuromodulators. Dermal Fillers, Laser Resurfacing and other energy-based treatments may improve static lines.
Botox and Dysport - 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 scarring, and other side effects and 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.
By signing below I consent to and authorize Spa 35 to perform this treatment(s) and to deliver any post treatment medical services that may be necessary.
Please contact the Spa 35 team if you have questions regarding this information.
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.
Experience - Spa 35 Med Spa has been helping clients Look and Feel their Best for twelve years.
Medical Staff - The team is led by Nurse Practitioners and composed of Registered Nurses and aesthetic skin care professionals. Botox and filler injections are performed by medically trained injectors, not estheticians.
Industry Leadership - Warren Danforth, the Spa 35 owner, is a Key Opinion Leader for Syneron-Candela's Medical Spa Program. Syneron-Candela is a global non-surgical aesthetic device company.
Broad Scope of Expertise - From Botox to CoolSculpting Fat Reduction and Vaginal Rejuvenation, Spa 35® Med Spa has an extensive set of experience to help you reach your goals. This means you get the expertise to help you select the service(s) are right for you and your budget.
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.