Anti Wrinkle Injections Consent


Anti Wrinkle injections involve a series of small injections in order to weaken/relax the chosen muscles. 

Weakening of the injected muscles begins to be apparent after 3-5 days with the peak effect being reached after 14 days. This is when you will be due to come back for a review. 

If you have Dynamic Wrinkles which are wrinkles that appear in motion like when Frowning but are not visible when resting then these will be completely gone after your review / top up and you will no longer be able to Frown therefore will not be able to create those wrinkles.

If you have Static Wrinkles which means your wrinkles are present at rest it is extremely important to understand that these wrinkles will not disappear. Anti Wrinkle Injections are a muscle relaxant and preventative. They do not fill the wrinkles or cause them to disappear if they are already present without movement. That being said over time with regular treatments they will soften. 

Results can last 3-6 months depending on dosage, the area treated and lifestyle factors such as sun exposure, smoking and excessive exercise.  The procedure can / should be repeated after 3 months.

Bruising at the Injection Point:
It is important to know bruising at the injection point can happen.
It is rare that you will bruise at each and every injection point but it is important to know i can happen. 

This doesn't mean anything has gone wrong or it has been administered incorrectly, it just means the end of the needle has nicked a blood vessel below the surface lower than the eye can see, which has caused the blood to come up to the surface and form a small bruise.

-Apply a cold compress to the bruise, but be sure to not press down hard
-Apply Arnica Gel
-Be Patient, the bruise will go

-Massage the area, this will cause the bruise to spread


I am aware of the following risks/complications that may occur:

  1. Mild to moderate discomfort or pain
  2. Slight redness or swelling
  3. Headaches
  4. Muscle Activity Disorder
  5. Drooping Eyelids
  6. Inflammation
  7. Blurred Vision
  8. Fainting
  9. Muscle Twitching
  10. Bleeding
  11. Bruising/Swelling
  12. Risk of Infection
  13. Unsatisfactory Outcome/Temporary loss of function of nearby muscles.

In the event of an adverse reaction medical help should be sought immediately.

I confirm I do not suffer with any of the Contra-indications associated with Botox Anti Wrinkle Injections:

  • Coldsores (herpes virus)
  • Granulomas
  • Spots/acne at the injection sites (mainly lips)
  • Active Infections (skin)
  • Allergy/Hypersensitivity to Botulinum Toxin or its constituents (Lactose, Sodium succinate, Human Albumin).
  • Scar tissue
  • Pregnancy
  • Breastfeeding mothers
  • Body Dysmorphia
  • Unrealistic Expectations
  • Blood thinning medication
  • Blepharoptosis (Droopy Eyelid)
  • Eyebrow Ptsosis (Droopy Eyebrow)
  • Epiphora (Excessive Tearing)
  • Xerophthalmia (Dry Eyes)
  • Lagophthalmos (Incomplete Eye Closure)
  • Ectropion of Lower Eyelid (Eyelid Margin Eversion)
  • Diplopia (Double Vision)
  • Impaired Blink Relfex
  • Globe Trauma (Orbital Trauma/Blunt Trauma To Eye)
  • Photophobia (Sensitivity to Light)
  • Infraorbital Festooning (Worsening of Eyebags)
  • Cheek Flaccidity
  • Dysphagia (Difficulty Swalling)

I understand that the treatment may involve risks of complication or injury from both known and unknown causes, and I freely assume those risks. Prior to receiving treatment, I have been candid in revealing any condition that may have a bearing on this procedure.

I consent and authorise Paige Edmonds to perform one or more Botox Anti Wrinkle treatments on me. I certify that I have read this entire informed consent and I understand and agree to the information provided in the form. My questions regarding the procedure have been answered satisfactorily.

I hereby release Paige Edmonds from all liabilities associated with this procedure. This consent is valid for all of my Botox Anti Wrinkle treatments in the future as well.