I hereby consent to and authorize Beyond Beauty Medical Aesthetics to perform the following procedure:

Botox is used in the correction of mild to moderate facial lines, wrinkles, muscle tension and headaches related to muscular movement. All medical and cosmetic procedures carry risks and may cause complications. The purpose of this document is to make you aware of the nature of the procedure and its risks in advance so that you can decide whether to proceed with the procedure. This material serves as a supplement to the discussion you have with your doctor/healthcare provider.

Botox is a neurotoxin produced by the bacterium Clostridium A. Botox can relax the muscles of the face and neck which cause wrinkles associated with facial expressions or facial pain. Whether for cosmetic or therapeutic treatment, Botox can cause your facial expression lines or wrinkles to be less noticeable or essentially disappear. The most frequently treated areas are: A) Glabella (frown lines located between the eyes) B) Crow’s Feet (lateral areas of the eyes) C) Forehead wrinkles D) Radial Lip Lines (smokers lines) E) Head, neck and jaw muscles Botox is diluted to a very controlled solution and when injected into the muscles with a very thin needle, it is almost painless. Patients may feel a slight burning sensation while the solution is being injected. The procedure takes about (15-20) minutes and the results can last up to (3) months. With repeated treatments, the results may tend to last longer.

• The majority of reactions to dermal fillers are redness, swelling, bruising and tenderness after the injections. These usually subside a few days after the treatment, but can last up to a week. If any of these symptoms persist longer than a week, or if you develop other symptoms, please contact our office.

• Cold compresses may be used after the treatment to reduce swelling and decrease soreness. You may take Tylenol (if not contraindicated) every (4-6) hours after the treatment to help with any discomfort you may have.

• In the first (24) hours following treatment, limit exposure to sunlight or UV lamps. Extensive sun or heat exposure and alcoholic beverages may cause a temporary increase in redness, bruising or swelling at the injection sites. If there is persistent swelling or redness after the injections, you should limit exposure to sunlight or UV lamps until these symptoms subside (for at least (5-7 days). If sun exposure is unavoidable, use a sun block with an SPF of 30 or greater, combined with zinc oxide and/or titanium dioxide.

• Avoid taking aspirin (unless medically necessary) or other non-steroidal anti-inflammatory drugs such as Ibuprofen, Advil®, Motrin®, Nuprin®, Aleve®, Celebrex®, Fish oil, Gingko Biloba , St. John’s Wort and high doses of vitamin E for (5) days after the treatment, as these may cause an increased risk of bleeding or bruising at the injection sites