PhilArt Injectable Polynucleotides Consent Form

PhilArt Injectable Polynucleotides Consent Form (#27)

 

 

PhilArt Treatment Information and Consent

Introduction

PhilArt is made from Polynucleotides using High Purification Technology (HPT) to promote cell regeneration. PhilArt PN-HPT has both hydrating and viscoelastic properties that are similar to those of Hyaluronic Acid. PhilArt PN-HPT will improve the production of new collagen and elastin fibres generating new dermal matrix glycosaminoglycans.

Overall, PhilArt PN-HPT promotes fibroblast proliferation and viability and increases collagen production. PhilArt has been used to treat both body and face, including necks, décolletage, the delicate eye area, back of hands, abdomen, thighs, knees, arms, stretch marks across the body, and fibrous tissues such as scars.

PhilArt has moisturising and antioxidant properties which create an optimal environment within your skin to promote the natural growth of fibroblasts, which produce collagen and elastin. PhilArt enhances hydration, tissue elasticity and tightening, and helps create a natural healthy glow to your skin.

Recommendations and Treatment Protocol

PhilArt is a temporary rejuvenation treatment. The course usually consists of 3 treatments, 2-3 weeks apart. However, your practitioner will be able to advise you of your personal individualised treatment plan. A review of the treatment may be offered from 4 - 6 weeks. A course of treatments may last up to 6 -12 months; however, this is different for every patient.

Side Effects and Complications

Side effects and complications include but are not limited to:

  • Pain or stinging whilst the injection is performed.
  • Injections into the lip area could trigger a recurrence of facial cold sores (herpes simplex infections) for patients with a history of prior cold sores.
  • Localised swelling, redness and/or tenderness.
  • Bleeding at the sites of injection.
  • Bruising - maybe severe in rare cases and may persist for several days.

 

Rare Side Effects

  • Persistent or prolonged pain, swelling, or inflammation.
  • Infection (can occur within days or as long as months).
  • Allergic reaction or delayed sensitivity reaction - not recommended for people with fish allergies.
  • Compression / Vascular Compromise - the blood supply to the skin may be interrupted by swelling or inadvertent injection into a vessel, causing pain and/or discolouration. This can lead to necrosis of the skin if not dealt with, skin damage and possible scarring. (Very rare).

 

Precautions and Contraindications

  • Only PhilArt Eye can be used in the peri-orbital region.
  • PhilArt should not be used in patients under the age of 18.
  • PhilArt must not be administered to patients with the following:
    • Ongoing herpes infection
    • Infection
    • Previous or ongoing auto-immune disease, or patients currently undergoing immunotherapy
    • Serious allergies
    • Allergies to any of the product components
  • The risk of bruising or bleeding may be increased by medications with anticoagulant effects, such as aspirin and non-steroidal anti-inflammatory drugs (e.g., Ibuprofen, Aleve, Motrin, Celebrex), high doses of vitamin E, and certain herbs (ginkgo biloba, St. John’s wort).
  • A history of autoimmune disease or diseases affecting the immune system.
  • PhilArt must not be used in pregnant or breastfeeding women.

 

Statement of Consent

I understand that the actual degree of improvement cannot be predicted or guaranteed. Furthermore, I understand that the effect will gradually wear off and additional treatments may be necessary to maintain the desired effect. Topical anaesthetic cream may be offered to me by my practitioner. To the best of my knowledge, I am not pregnant, and I am not breastfeeding. I give my informed consent for PhilArt HPT to be used today as well as future treatments as needed. I understand this is an injectable PN treatment and that the treatment will be individual to my needs as agreed between me and my practitioner.

I understand that whilst I have been advised as to a probable result, this should not be interpreted as a guarantee. I have been informed of the possible side effects and complications that are associated with this procedure. It is possible that side effects not described may occur, and that should this happen I must inform my practitioner immediately.

I confirm that I have been provided with verbal and written information about this treatment, which includes aftercare and follow-up advice, and that the decision to be treated is my own and totally voluntary. I agree to follow the aftercare advice and understand this reduces the risk of adverse reactions and helps ensure optimum results. I understand information about me will be treated as confidential and access to it restricted in accordance with the Data Protection Act, unless specific permissions given.

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