Laser Pigment Lesion Removal Consent

The procedure planned is treatment of Pigmented Lesion with a Laser using topical, or no anaesthesia. The purpose of this procedure is to: a. Removal of the pigmented lesion or lightening of the pigmented lesion

I understand that normal clinical responses include: discomfort, erythema (redness), edema (swelling), crusting, darkening of the pigmented lesion, pin point bleeding and sometimes bruising and blistering. These will heal within the treatment time interval, topical antiseptic or Aloe Vera can be applied for the following days post treatment.

I understand that the unwanted risk of the procedure includes possible pain, bleeding, blistering, infection, scarring, drug reactions and unforeseen complications. Eye injury is possible but highly unlikely, since complete eye protection is provided throughout laser treatment sessions. There is also a risk of persistence of residual pigment, hyperpigmentation, hypopigmentation (permanent lightening of the skin colour), change in skin texture, and hair loss or hair thinning. The risk of scarring, including keloid formation, despite proper treatment, exists in all cases and can be greatly minimized by proper pre care and aftercare. Previous treatment by any method may increase any or all of these risks.

I understand that there may not be complete removal of any pigmented lesion caused by a pigmentation condition.

I understand my responsibility for properly fulfilling the appropriate aftercare instructions as explained by The Practice Beauty Clinic employee, and/or written instructions provided. I agree that pre & post-operative clinical photographs and videos may be taken to monitor my treatment progress and for patient educational purposes. I understand that my identity will be protected.

I certify that I have read and understand the contents of this consent form. I have been given the opportunity to ask any questions that I have about the procedure, and all of my questions have been answered. My laser practitioner has explained the procedure and its alternatives to me, and I both understand and accept the risks involved in this procedure.