REVISION SURGERY/PROCEDURES

I am about to undergo a corrective procedure to improve the function, contour and my appearance. This procedure is needed due to complications arising from a past procedure. I understand the following:

I understand that revision surgery/procedures is more complicated than primary surgery/procedures.

I understand that revision surgery/procedures is more unpredictable than primary surgery/procedures.

I understand that revision surgery/procedures has a higher incidence of complications including but not limited to scarring, bleeding, infection and nerve damage.

I understand the recovery period is longer for revision surgery/procedures than for primary surgery/procedures.

I understand that it is impossible to get back the contour and function the way it was prior to any surgery.

I understand that revision surgery/procedures often needs multiple stages to achieve the desired results.

I understand that the goal of revision surgery/procedures is improvement and not perfection.

I understand that complete removal of scar tissue is impossible.

I have read the above information and have discussed it with my physician. I understand that it is impossible for the physician to inform me of every possible complication that may occur. My physician has told me that results cannot be guaranteed and that adjustments and more surgery may be necessary. By signing below, I agree that my physician has answered all of my questions and that I understand and accept the risks, benefits, and alternatives of revision surgery.