Purpose: This form is to ensure that you understand the risks and benefits of the injection of hyaluronidase so that you can make an informed decision about whether to proceed with treatment with Hyaluronidase for the purpose of dissolving hyaluronic acid dermal fillers. It is very important that you take your time to read this form carefully and discuss any questions you have with your provider before providing your consent.
Rationale: Hyaluronic acid (HA) fillers are sterile gels consisting of non-animal stabilised hyaluronic acid for injection into the skin to correct facial lines, wrinkles and folds, for lip enhancement and for shaping facial contours. Occasionally these fillers need to be dissolved when the aesthetic treatment has not produced the desired outcome or there is a possibility of vascular occlusion or impending necrosis (tissue death) which could lead to compromise of healthy tissue.
Hyaluronidase is an enzyme which dissolves or “breaks down” hyaluronic acid fillers. It can also break down naturally occurring hyaluronic acid present in the body. The results may not be entirely predictable in regard to how much filler dissolves depending on the type and amount of filler present.
Alternatives to treatment: Do nothing (observation); anti-inflammatory treatments with oral or injected steroids; other anti-inflammatory medication; local massage.