Botox Consent

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

  • Post treatment discomfort, swelling, redness, and bruising. Most people have lightly swollen pinkish bumps at the injection site for a few hours or even several days.
  • Minor ptosis (drooping) of the eyebrow or eyelid; occurs in approximately 2% of injections, this usually lasts 2-3 weeks. While local weakness of the injected muscles is representative of the expected pharmacological action of botox, weakness of adjacent muscles may occur as a resultof the spread of the toxin.
  • In some cases, ptosis may lead to the inability to blink, double vision, weakened tear duct, and corneal exposure.
  • Post treatment bacterial, and/or fungal infection requiring further treatment.
  • Allergic reaction.
  • Occasional numbness of the forehead lasting up to (2-3) weeks
  • Transient headache
  • Flu-like symptoms may occur.
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