Sculptra Dermal Filler

High, full cheeks. Defined jawline

Informed Consent. 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.


Sculptra Dermal Filler - Treatment Purpose

Sculptra is a dermal filler injection that restores or improves volume in the face. Sculptra stimulates growth of the deep, underlying structure of the skin to diminish facial wrinkles. Commonly injected areas include cheeks, the area under the eye, and the area around the mouth and nose (nasolabial fold). Typically, Sculptra is delivered in three treatment sessions spaced about 8 weeks apart. Maximum results from Sculptra are usually seen 3 to 4 weeks after your injection sessions are completed. Results can last 1 or 2 years, but vary greatly by the treated area and the individual. For your desired cosmetic changes, you may need additional Sculptra injections after your initial series. And to maintain the desired level of cosmetic improvement, intermittent "maintenance" treatments may be needed. Sculptra is composed of Poly-L-Lactic acid, which is commonly used in dissolvable stiches. Sculptra has been used since 1999 in more than 150,000 patients in more than 30 countries, primarily for cosmetic use.

Sculptra Dermal Filler - 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 Sculptra's high level 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 Sculptra treatment or decline after knowing the risks involved. This disclosure is to inform you of these risks and obtain your consent for treatment with an understanding of the risks, side effects and possible complications related to Sculptra. 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.
Sculptra is a sterile suspension of Poly-L-Lactic acid, which is a biocompatible (does not harm the body), synthetic polymer from the alpha-hydroxy acid family (fruit acids). Poly-L-Lactic acid has been used medically for many years in dissolvable stitches. Sculptra is designed to help correct skin depressions, such as creases, wrinkles, folds, scars, aging skin and facial lipoatrophy (loss of fat). This list is not meant to be inclusive of all possible risks associated with Sculptra as there are both known and unknown side effects associated with any medication or procedure.

Sculptra Dermal Filler - Risks

Potential risks and experiences include, but are not limited to:
Bruising, redness and swelling- Injection related reactions include bruising, redness, swelling, pain, tenderness, itching and discoloration of skin. These symptoms are usually mild and typically last a few days but can last up to a few months. In rare cases, bruising can last several months and can even be permanent. The use of anti-inflammatory drugs, anti-clotting agents and/or aspirin may cause bleeding which can lead to increased bruising at the injection sites. Following pre-care instructions and limiting anti-clotting/blood thinning medications and/or supplements will decrease the risk of (and degree) of bruising.
Edema (swelling)- Sculptra is prepared in a solution containing water. You may experience swelling in response to Sculptra injections. This swelling (edema) may be noticeable for at least several hours and perhaps as long as several days. The edema is temporary and does not affect the long-term cosmetic results.
Induration- A feeling of fullness or thickness can be felt in the injection areas. This is a normal response of the treated tissue in the process of inflammation and new collagen formation. Massaging the treated areas for 5 minutes, 5 times per day, for 5 days after the injection can help minimize induration (localized hardening of soft tissue).
Micro-nodules- One possible delayed side effect is small bumps under the skin, termed micro-nodules. They may be non-visible or visible and may be felt in the areas of treatment. Usually these nodules can only be felt when pressing on the skin. Micro-nodules tend to occur within the first 6-12 months after treatment. They usually do not require treatment. In rare cases, injection, freezing or excision may be used to decrease or remove nodules.
Granulomas- Visible bumps may rarely occur and may be associated with redness, tenderness, skin discoloration or textural alteration. These bumps, termed Granulomas, may or may not require treatment, including but not limited to, injection, freezing or excision.
Infections- Although infection following treatment is unusual, bacterial, fungal, and viral infections can occur. Herpetic outbreaks can be triggered by treatments. An outbreak increases the risk of scarring. This applies to both individuals with a past history of Herpes simplex virus infections and individuals with no known history of Herpes simplex virus infections. Specific medications may be prescribed and taken both prior to and following the treatment procedure in order to suppress an infection from this virus. Should any type of skin infection occur, additional treatment including antibiotics may be necessary.
Rare Adverse Events- Other rarely reported adverse events include injection site abscess, allergic reaction, skin hypertrophy (exaggerated reduction of collagen and tissue elasticity) and/or atrophy (reduction of collagen and tissue elasticity), malaise, and fatigue.
Treatments Required for Desired Cosmetic Result- More than three injection sessions of Sculptra may be needed to achieve a satisfactory result.
Allergic Reactions- In rare cases, there may be an allergic reaction to the injected product.
Numbing agent reactions- Sculptra is mixed with an analgesic numbing agent and your skin may be numbed using an analgesic agent. Analgesics typically include but are not limited to benzocaine, lidocaine, tetracaine. There is the possibility of complications, injury, and even death from analgesics.
Uneven facial appearance. There may be an uneven appearance of the face with some areas more affected by the Sculptra than others. In most cases this uneven appearance can be corrected by more injections in the same or nearby areas. However, in some cases, this uneven appearance can persist for several weeks or months.
Vision changes- Blurred vision, partial vision loss, and blindness can occur if the product is inadvertently injected into a blood vessel.

Sculptra Dermal Filler - 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.
Avoid- Avoid excessive alcohol and caffeine for 2-3 days prior to treatment. These may thin the blood and cause greater potential for bruising. Avoiding alcohol and caffeine will not stop bruising from occurring, but will help lessen the severity.
Supplements- Avoid fish oil, Gingko Biloba, Garlic, Flax Oil, Cod Liver Oil, Vitamin A, Vitamin E, or any other anti-coagulant supplements one week before treatment.
Prescription Medications- If you have a history of cold sores, take an antiviral medication to decrease the risk of a herpetic outbreak. Take your first tablet 24 hours before your treatment and follow instructions on the bottle. Take other medications as instructed on the bottle. If you develop a cold sore, blemish, or rash, etc. prior to your appointment, you must reschedule.
Over the Counter Medications- Avoid aspirin, Motrin and ibuprofen (Advil, Aleve) for 5-7 days prior to your treatment. Inform your provider if you are taking blood thinners or regularly take aspirin or Ibuprofen.
Ice Packs- Store ice packs in your freezer for use after you get home from procedure.
SinEcch (Arnica Montana)- SinEcch is an over the counter oral supplement that may decrease your risk of bruising from your injections. Ask your provider if it is appropriate for you.
Special Events- Schedule your treatment at least 4 weeks prior to a special event, i.e. wedding, vacation, speaking engagement, to allow time for the healing process.
Photographs- Take at home photos to monitor your cosmetic improvement.

Sculptra Dermal Filler - Treatment Day Instructions

Make-up- Please arrive for your appointment without wearing make-up. Bring make-up for after your treatment if you plan to return to work or other daily activities.
SinEcch- If you choose to purchase SinEcch, follow the instructions on the package. The first SinEcch will be taken right after treatment.
Massage- Massage the treated area for 5 minutes, 5 times a day, for 5 days after your treatment.
This will help decrease micro-nodule formation.

Sculptra Dermal Filler - Post Treatment Instructions

It is normal to be swollen and bruised the day after your injections. Swelling is typically more pronounced upon waking. Maintain your schedule of massage (5 minutes, 5 times a day, for 5 days) to ensure the best results. Contact Spa 35 if you have any signs of infection, excessive bruising or any other concerns.
Post-treatment redness and pain- Immediately after your Sculptra treatment you may notice mild redness, swelling, pain, and/or bruising in the treatment area. These symptoms usually go away in a few hours to a few days, with the exception of bruising, which may last longer. You may take acetaminophen or ibuprofen for discomfort if needed.
Ice the area- Within the first 24 hours, apply an ice pack, with cloth barrier, to the treatment area to help reduce swelling. Apply ice no more than 10 minutes per hour.
Massage- Massage the treated area for 5 minutes, 5 times a day, for 5 days after your treatment. This will help decrease micro-nodule formation.
Avoid sun exposure- Avoid sun exposure until the redness, swelling and bruising have disappeared.
Make-up - You may apply make-up three hours after your treatment.
Exercise- You may resume your regular daily activities immediately after treatment and may resume exercising after 24 hours.
Sculptra works gradually and naturally – Immediately after your injections you will most likely be swollen. After the swelling goes down you will not see an immediate change in appearance. Sculptra takes weeks or months to change your appearance. Taking photographs in a “time-lapse” structure will help you recognize the cosmetic improvements from Sculptra.

Sculptra Dermal Filler - Treatment Schedule

Sculptra is delivered in 3 treatment sessions spaced at 8-week intervals, for optimal correction.

Sculptra Dermal Filler - Alternative Treatment Options

No treatment is an alternative to Sculptra injections. Dermal filler injections composed of hyaluronic acid (e.g. Juvederm, Restylane) is a potential alternative treatment. Profound RF is a potential alternative treatment. Surgical implants are an alternative treatment. Surgical fat transfer is a potential alternative treatment.

Sculptra Dermal Filler - Synergistic Cosmetic Treatments

Sculptra replaces lost facial or body volume that occurs during the aging process. You may want to consider treatments for other age-related changes in the skin after your Sculptra injections. These include age spots or other skin discoloration, rough texture, loss of skin tensile strength (laxity), and decreased elasticity. Relaxing wrinkles caused by muscle movement with Botox or Dysport is the most common synergistic treatment. Another alternative treatment is the removal of age spots or red discoloration of the skin with Intense Pulsed Light (IPL). And energy-based cosmetic services can stimulate dermal tissue generation, these include Profound RF, CO2 Laser Resurfacing, and Sublative RF.

Sculptra Dermal Filler - 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 with any questions about the information on this page, or about Sculptra and other cosmetic services.


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.