Cosmetic Injections

You may visit your surgeon or nurse as many times as you wish, to have all of your questions answered. You will confirm that you understand the procedure to be performed, that this material has been explained to you, that you have read and understand these information sheets, and that you accept the risks by signing the informed consent forms.

The injection will be performed in the office or, if done in conjunction with another surgical procedure, at an outpatient facility. A very small needle is used for each injection. No incisions are required.

POST - COSMETIC INJECTION CARE

There are no restrictions with regards to activity. Minimal redness is expected at the injection site and should disappear in a few days. Icing afterwards may reduce swelling and discomfort. A small percentage of patients may develop a noticeable bruise, and if this occurs, the bruise could take weeks to dissipate.

SOCIAL ACTIVITY

There is no “down time” to speak of, aside from the aforementioned small possibility of bruises forming. Patients can immediately resume normal activities.

FEES

All fees will be discussed freely in advance by the office staff. In compliance with suggestions adopted by the American Society of Plastic Surgeons, it is customary for the patient to pay all fees for cosmetic treatments when rendered.   This insures that the patient is sincere in his/her motivation and can afford the treatments, thus creating a better patient/physician relationship.   It is important that you understand that the patient is responsible for all costs associated with secondary treatments and “touch-ups”, and for costs associated with any complications that may arise as a result of this elective treatment.

Pre and post-op photos may be taken of the treatment site for record purposes. I understand that these photos/videos will be the property of the attending physician.  I do____, do not ___ agree to allow these pictures to be used for publication, teaching purposes or the practice web site. If I agree, I understand that my name will be kept confidential and protected.

IF YOU HAVE ANY QUESTIONS, DO NOT HESITATE TO CALL THE OFFICE DURING BUSINESS HOURS (949-888-9700) OR AFTER HOURS, CALL YOUR SURGEON  - DR BUNKIS CELL PHONE NUMBER IS  (949) 500-8856, OR REGISTERED NURSE, TRACEY PRESCOTT’S NUMBER IS (949) 338-6072. 

WITH AN EMERGENCY THAT REQUIRES IMMEDIATE ATTENTION, CALL 911 BUT PLEASE HAVE YOUR FAMILY NOTIFY DR. BUNKIS OF ANY PROBLEMS YOU MAY HAVE!

I, ________________________________________________certify that I have read and understand the “Cosmetic Injections" information sheets dated March 2008, that my surgeon or nurse have answered all of my questions to my satisfaction, and that I give my informed consent for this/these procedure(s):

_____________________________________________________________

Witness_______________________________ Date____________________

Copyright, 10/05, Last revised 03/08
Juris Bunkis, M.D., F.A.C.S.