Consent Form for Thread Lift with Spring Thread

Informed Consent

Introduction

The procedure involves the placement of permanent and specially designed threads in order to improve visible signs of aging on the face and neck; they act in such a way as to imitate and replace loose connective tissue. The threads are made from 2 components. They have a polyester core and a silicone coating which makes them permanent so they will not dissolve like other threads and therefore will remain in the tissue permanently. However, if they need to be removed because of infection, for example, this is usually although not always possible. New threads can be placed in due course if required. Another specific feature of these threads is that they have barbs, cogs placed along the length which are orientated at an angle. When placed in a specific way those cogs engage into the soft tissue just like a fishing hook and when they are pulled, they elevate the tissues without slipping which is how we manage to achieve an effective and long-lasting lift. As individuals age, the skin and muscles of the face region begin to lose tone. The procedure cannot stop the process of aging. It can improve the most visible signs of aging by lifting the skin and indirectly some deeper structures which are attached to the skin.

The Spring Thread lift is individualized for each person and your Practitioner will discuss the exact plan for you prior to the procedure. The best candidates for Thread Lifting will have a face and neckline that has begun to sag and lose definition.

Alternative Treatment

Alternative forms of management consist of not treating at all, an open surgical procedure or a more invasive type of thread lift called thread lift with skin excision. Thread lift with Spring Thread falls in the category between injectables (Botox and Fillers) and open surgery. Most patients have had good results from Botox and Fillers for many years, but then they reach a stage when Botox and Fillers do not have the same effect anymore because the aging process has advanced further. However, there is this transitional period when patients are not ready for open surgery like face and neck lift yet, but they still want and need something more than Botox and Fillers.

Explanation of the Procedure

The procedure involves optional oral sedation which will make you comfortable and relieve any anxiety that you may have. If you would like oral sedation you must arrange for somebody to pick you up as you will not be allowed to drive for 24 hours after the procedure. If there is no one to pick you up, you can arrange a taxi otherwise we cannot offer you an oral sedation.

You will have completed your paperwork previously and been given the opportunity to ask questions and discuss alternative treatment options along with the individual plan that the Practitioner has detailed explaining where (if any) the scars will be positioned and where the Threads will be placed and the anticipated results. You will have also been given pre and post treatment instructions and this will enable you to prepare effectively prior to the procedure. An example of how you may wish to prepare may be that you need to ensure you have a supply of pain relief like paracetamol. Also, you will be asked to eat soft foods for several days following the procedure so again this gives you the opportunity to plan. Patients may like to cover their bandages with a head scarf when they leave the clinic and again if you are prepared for this it will make your procedure all the more comfortable.

On the day of the procedure, photographs will be taken and you will be prepared for the procedure. You can have a friend stay whilst we do this. Once the oral sedation has been administered it will take between 30-45 minutes for you to feel relaxed and comfortable. You will then be taken into the treatment room and your face will be cleaned and sterile drapes will be positioned around you. We may position a blood pressure monitor on your arm in order to monitor you throughout the procedure along with a pulse oximeter which will be positioned on one of your nails and it is vital that all nail varnish and false nails are removed on at least one fingernail. The skin will then be prepared with a surgical cleanser and markings will be drawn onto the face which can be removed following the procedure, however, sometimes these markings are still visible for up to 2-3 days following the procedure. A local anesthetic will be administered in the treatment area. This may feel a little uncomfortable to start with, but after a while the area should be fully numb and all you will feel is pressure pushing and pulling but no sharp pain. Throughout the procedure you will be able to communicate to your Practitioner if you feel any pain and this can be easily controlled.

A few small punctures (cuts) will be made usually in the hairy area in front of your temples, or behind the ears, and there may be a few more on the top of your head in the hairy area depending on the design your Practitioner has selected for placing your threads. We may have to cut a tiny amount of hair but that usually is not noticeable.

Once this has been completed the Spring Thread are then positioned with their barbs orientated in such a way as to provide a pull. A dressing will be applied, and we recommend you wear a bandage 2-3 days after the procedure although this is not always necessary.

You may have some leakage and discharge from the cuts. Please remember there will be a few very small scars following the procedure, usually in the hairy area and usually unnoticeable, and in the majority of cases, these fade completely within a couple of weeks.

Please bear in mind the longevity of the procedure depends on your lifestyle, e.g. smoking, over exercise and the amount of weight fluctuation. It can last from 2 - 5 years depending on the above or longer. With every thread procedure there is always a possibility of damaging the nerves and blood vessels causing temporary or permanent nerve damage, though we have had no incidences of this.

You may experience prolonged numbness, eventually the sensitivity returns, but it may not return fully, but again, we have had no incidence of this. Please note, bruising (hematoma) can occur.

Infection is extremely uncommon in the face, the incidence being approximately 5 to 10 per cent.

In the case of patients that have a compromised immune system such as those that are on immunosuppressant treatment or HIV positive patients there is an increased risk of infection post operatively.

Statement

If I am not satisfied completely with the results from my thread lift, I will contact the Clinic to address my concerns. I confirm that the Clinic will not be responsible if I decide to see someone else for revision of my procedure performed by the Clinic, before firstly returning to the Clinic to discuss this.

Individual Treatment Plan

Risks and Complications of Thread Lift

As with all thread lift procedures there are risks to be considered. Consent forms should be read carefully to ensure the procedure and its limitations are fully understood. Whilst we have prepared this document with the most up-to-date information we have on this procedure, we strongly advise that you do additional research of your own to support your decision to go forward and have treatment. By signing this form, you have acknowledged that you have read and understood the potential risk and have been given the opportunity to discuss it with your Practitioner. The risks and complications include but are not limited to:

• Bleeding, bruising, and swelling. This will depend on the individual reaction to the procedure. A collection of blood called a hematoma is extremely rare but can occur.
• Irritation. Hair or skin can grow into the incision line or puncture holes and cause irritation. This can be treated by the removal of the hair.
• Irregularities. Puckering or depressions around the treatment site. Your Practitioner will explain this to you before the procedure. These irregularities can settle following the procedure but can take up to 3 months and in very rare cases be permanent.
• Bunching and pleating. An excessive amount of loose skin can cause pleating. Most of the time this will disappear within two weeks.
• Palpable bumps or lumps under the skin. The thread can rarely be felt under the skin. If this is a problem, it may need to be removed in which case sometimes the result may be affected.
• Tightness. It is common for the skin to feel tight after surgery. This usually improves but in rare