Dermal Filler / Biostimulator Consent Form

The purpose of this informed consent form is to provide written information regarding the risks and potential adverse outcomes relating to the procedure named above. This material serves as a supplement to the discussion you have with your doctor. It is important that you fully understand this information, so please read this document thoroughly. If you have any questions regarding the procedure, please address your concerns with your doctor at the time of your consultation.

What is being injected? Dermal Fillers and Biostimulators are utilised improve the appearance of lines, correct volume loss or alter proportions. Dermal Fillers are made up of mainly water, poly-saccharides, anaesthetic, and stabilising molecules. Biostimulators can be made from collagen stimulateng substances and are used either in isolation or in conjunction with dermal fillers to stimulate collagen formation.

Risks of injection: Trauma during the procedure is caused by needles and cannulas passing through tissue, and includes bleeding, bruising, haematoma (a larger collection of blood in the skin, outside of blood vessels), damage to underlying structures including veins, arteries, nerves, salivary glands, lymph nodes, bone, muscle and other soft tissue structures are possible. In rare cases this could cause continuous problems in appearance, sensation or function and may require medical intervention to treat or may be permanent. Most traumatic injuries heal completely on their own.

Infection: Bacterial, viral or fungal infections can occur post procedure. Infections can cause redness and swelling and resolve or progress into abscesses or biofilms which can be slower to recover. Rarely infections occur months later as ‘biofilm reactions’. Symptoms include itching, and a lumpy or “thick” feeling at or just under the skin. Injections into the lip area could trigger a recurrence of cold sores (Herpes simplex infections) which may require treatment. These problems may resolve in time, but medical intervention may be required in some cases, and long-term effects may persist in rare cases.

Reactions: Reactions rarely occur but can include an immediate reaction causing swelling, and very rarely life threatening anaphylaxis. Delayed reactions localised to the skin can cause nodules, lumps or bumps or very rarely sterile abscesses. These may occur soon after the procedure or months later. They may require treatment and may leave permanent effects on the appearance, sensation and function of the areas affected. The chance of delayed reaction increases if you have active autoimmune disease or an active immune system including viral or bacterial infections elsewhere.

Lumps, Bumps, Swellings- Unwanted visual side effects may cause dissatisfaction or distress, and include an increase in asymmetry, swelling, lumps, bumps puffiness or surface irregularities. These non-inflamed filler side effects are temporary and treatable with full resolution likely.

Skin Changes-Injectable procedures are rarely associated with pigment changes, the formation of thread veins or new capillaries, and other blemishes. These may either recover, require further treatment or be permanent.

Blood Vessel Blockage: In rare instances the blood supply can be blocked by filler/biostimulators. This can cause local tissue injury called ‘necrosis’, which can result in permanent scarring. Seeking help immediately if you suspect blood vessel occlusion is vital as your doctor may be able to dissolve the blockage and therefore prevent any long-term issues.  

Blindness/Stroke - There are extremely rare cases in which blood supply to the eye or parts of the brain can be blocked by the injected material causing blindness and stroke.

Dissatisfaction: With all treatments the precise degree of improvement cannot be guaranteed. The outcome’s subjective nature also means dissatisfaction is a possible outcome regardless of effectiveness of treatment. It should be understood that the effect of all treatments may gradually wear off and additional treatments may be necessary to acquire the desired effect, and further charges will apply if more product is required.

Follow-up: I understand adjustments requiring more product incur a charge.



While there are limited side effects from the use of Dermal Fillers and Biostimulators, there are a few post-treatment instructions you should be aware of. 

During the first 24-48 hours after your treatment you may experience redness, swelling bruising and tenderness in the treated areas. This is normal and will pass quickly. 

The following guidelines are recommended during the first 24-48 hours following your treatment. 

  • It is best to keep the area free of cosmetics and avoid using moisturizers with active ingredients such as AHA, BHA or retinoid creams. Mineral make-up is fine to use. 
  • Try to avoid touching the area for 6 hours after treatment. 
  • Try to avoid stretching the muscles in the surrounding area for excess amount of time as this may disturb the filler. 
  • Apply cool compresses, and bruise cream to the treated areas to relieve swelling and possible bruising. 
  • In the case of biostimulators (not dermal fillers) your doctor may recommend regularly massaging the treated area for the first 5 days following treatment. Your doctor will discuss this with you at the time of your treatment
  • Avoid drinking alcohol as it dilates blood vessels and may increase bruising and swelling. 
  • Avoid strenuous exercise and extremes of hot e.g. Spa/sauna. 
  • Drink water regularly throughout the day. 
  • You may take Panadol or similar medication if treated areas are tender. 
  • Avoid Aspirin, ibuprofen or Nurofen or other anti-inflammatories. 
  • Do not have facials, facial waxing, peels or laser treatment 10-14 days after your treatment. 
  • For Non-surgical rhinoplasty, try not to wear glasses for 2 weeks 

If you have any issues or concerns following your procedure, please call the clinic and your treating doctor will get back to you as soon as possible.