This is an informed-consent document
that has been prepared to help your plastic surgeon inform
you of abdominoplasty surgery, its risks, as well as
alternative treatments.
It is important that you read this information carefully and
completely. Please initial each page, indicating that you
have read the page and sign the consent for surgery as
proposed by your plastic surgeon.
INTRODUCTION
Abdominoplasty is a surgical procedure to remove excess skin
and fatty tissue from the middle and lower abdomen and to
tighten muscles of the abdominal wall. Abdominoplasty is not
a surgical treatment for being overweight. Obese individuals
who intend to lose weight should postpone all forms of body
contouring surgery until they have been able to maintain
their weight loss.
There are a variety of different techniques used by plastic
surgeons for abdominoplasty. Abdominoplasty can be combined
with other forms of body-contouring surgery, including
suction-assisted lipectomy, or performed at the same time
with other elective surgeries.
ALTERNATIVE TREATMENTS
Alternative forms of management consist of not treating the
areas of loose skin and fatty deposits. Suction assisted
lipectomy surgery may be a surgical alternative to
abdominoplasty if there is good skin tone and localized
abdominal fatty deposits in an individual of normal weight.
Diet and exercise programs may be of benefit in the overall
reduction of excess body fat.
Risks and potential complications are associated with
alternative forms of treatment that involve surgery.
RISKS of ABDOMINOPLASTY SURGERY
Every surgical procedure involves a certain amount of risk
and it is important that you understand the risks involved
with abdominoplasty. An individualAs choice to undergo a
surgical procedure is based on the comparison of the risk to
potential benefit. Although the majority of patients do not
experience the following complications, you should discuss
each of them with your plastic surgeon to make sure you
understand all possible consequences of abdominoplasty.
Bleeding- It is possible, though unusual, to experience a
bleeding episode during or after surgery. Should
post-operative bleeding occur, it may require emergency
treatment to drain accumulated blood or blood transfusion.
Do not take any aspirin or anti-inflammatory medications for
ten days before surgery, as this may increase the risk of
bleeding. Non-prescription "herbs" and dietary supplements
can increase the risk of surgical bleeding.
Infection - Infection is unusual after this type of surgery.
Should an infection occur, treatment including antibiotics
or additional surgery may be necessary. There is a greater
risk of infection when body contouring procedures are
performed in conjunction with abdominal surgical procedures.
Change in skin sensation- Diminished (or loss of) skin
sensation in the lower abdominal area may not totally
resolve after abdominoplasty.
Skin contour irregularities- Contour irregularities and
depressions may occur after abdominoplasty. Visible and
palpable wrinkling of skin can occur.
Skin scarring - Excessive scarring is uncommon. In rare
cases, abnormal scars may result. Scars may be unattractive
and of different color than surrounding skin. Additional
treatments including surgery may be necessary to treat
abnormal scarring.
Surgical anesthesia- Both local and general anesthesia
involve risk. There is the possibility of complications,
injury, and even death from all forms of surgical anesthesia
or sedation.
Asymmetry- Symmetrical body appearance may not result from
abdominoplasty. Factors such as skin tone, fatty deposits,
bony prominence, and muscle tone may contribute to normal
asymmetry in body features.
Delayed healing- Wound disruption or delayed wound healing
is possible. Some areas of the abdomen may not heal normally
and may take a long time to heal. Some areas of skin may
die. This may require frequent dressing changes or further
surgery to remove the non-healed tissue.
Smokers have a greater risk of skin loss and wound healing
complications.
Allergic reactions- In rare cases, local allergies to tape,
suture material, or topical preparations have been reported.
Systemic reactions which are more serious may occur to drugs
used during surgery and prescription medicines. Allergic
reactions may require additional treatment.
Pulmonary complications- Pulmonary complications may occur
secondarily to both blood clots (pulmonary emboli) or
partial collapse of the lungs after general anesthesia.
Should either of these complications occur, you may require
hospitalization and additional treatment. Pulmonary emboli
can be life-threatening or fatal in some circumstances.
Seroma- Fluid accumulations infrequently occur in between
the skin and the abdominal wall. Should this problem occur,
it may require additional procedures for drainage of fluid.
Umbilicus- Malposition, scarring, unacceptable appearance or
loss of the umbilicus (navel) may occur.
Long term effects- Subsequent alterations in body contour
may occur as the result of aging, weight loss or gain,
pregnancy, or other circumstances not related to
abdominoplasty.
Pain- Chronic pain may occur very infrequently from nerves
becoming trapped in scar tissue after abdominoplasty.
Other- You may be disappointed with the results of surgery.
Infrequently, it is necessary to perform additional surgery
to improve your results.
Deeper sutures- Some surgical techniques use deep sutures.
These items may be noticed by the patient following surgery.
Sutures may spontaneously poke through the skin, be visible,
or produce irritation that requires removal.
ADDITIONAL SURGERY NECESSARY
Should complications occur, additional surgery or other
treatments may be necessary. Even though risks and
complications occur infrequently, the risks cited are
particularly associated with abdominoplasty. Other
complications and risks can occur but are even more
uncommon. The practice of medicine and surgery is not an
exact science. Although good results are expected, there is
no guarantee or warranty expressed or implied, on the
results that may be obtained.
HEALTH INSURANCE
Most health insurance companies exclude coverage for
cosmetic surgical operations such as abdominoplasty or any
complications that might occur from surgery. Please
carefully review your health insurance
subscriber-information pamphlet.
FINANCIAL RESPONSIBILITIES
The cost of surgery involves several charges for the
services provided. The total includes fees charged by your
doctor, the cost of surgical supplies, anesthesia,
laboratory tests, and possible outpatient hospital charges,
depending on where the surgery is performed. Depending on
whether the cost of surgery is covered by an insurance plan,
you will be responsible for necessary co-payments,
deductibles, and charges not covered. Additional costs may
occur should complications develop from the surgery.
Secondary surgery or hospital day-surgery charges involved
with revisionary surgery would also be your responsibility.
DISCLAIMER
Informed-consent documents are used to communicate
information about the proposed surgical treatment of a
disease or condition along with disclosure of risks and
alternative forms of treatment(s). The informed-consent
process attempts to define principles of risk disclosure
that should generally meet the needs of most patients in
most circumstances.
However, informed consent documents should not be considered
all inclusive in defining other methods of care and risks
encountered. Your plastic surgeon may provide you with
additional or different information which is based on all
the facts in your particular case and the state of medical
knowledge.
Informed-consent documents are not intended to define or
serve as the standard of medical care. Standards of medical
care are determined on the basis of all of the facts
involved in an individual case and are subject to change as
scientific knowledge and technology advance and as practice
patterns evolve.
GoSculptura reminds you that all cosmetic surgery carries a
risk, has limitations which could include disappointment
with the results.
You should agree about the anticipated outcome of your
surgery and concur about your expectations of the results.
You should discuss alternative treatments and thoroughly
understand the risk of the procedures
If any dispute may arise the surgeon is only liable if
litigation takes place in Argentina, under Argentinean Law.
It is important that you read the above information
carefully and have all of your questions answered before
signing the consent.
________________________________________
CONSENT FOR SURGERY/ PROCEDURE or TREATMENT
1. I hereby authorize Dr. _____________________ and such
assistants as may be selected to perform the following
procedure or treatment:
I have received the following information sheet:
INFORMED-CONSENT ABDOMINOPLASTY SURGERY
2. I recognize that during the course of the operation and
medical treatment or anesthesia, unforeseen conditions may
necessitate different procedures than those above. I
therefore authorize the above physician and assistants or
designees to perform such other procedures that are in the
exercise of his or her professional judgment necessary and
desirable. The authority granted under this paragraph shall
include all conditions that require treatment and are not
known to my physician at the time the procedure is begun.
3. I consent to the administration of such anesthetics
considered necessary or advisable. I understand that all
forms of anesthesia involve risk and the possibility of
complications, injury, and sometimes death.
4. I acknowledge that no guarantee has been given by anyone
including GoSculptura or any of the staff employed by
GoSculptura as to the results that may be obtained.
If any litigation may arise as result of the surgery it can
only be done in Argentina under Argentinean Law and that
GoSculptura, its management or staff can not be held liable
in any way what so ever.
5. I consent to the disposal of any tissue, medical devices
or body parts which may be removed.
6. IT HAS BEEN EXPLAINED TO ME IN A WAY THAT I UNDERSTAND:
a. THE ABOVE TREATMENT OR PROCEDURE TO BE UNDERTAKEN
b. THERE MAY BE ALTERNATIVE PROCEDURES OR METHODS OF
TREATMENT
c. THERE ARE RISKS TO THE PROCEDURE OR TREATMENT PROPOSED
________________________________________
I CONSENT TO THE TREATMENT OR PROCEDURE AND THE ABOVE LISTED
ITEMS (1-6). I AM SATISFIED WITH THE EXPLANATION.
___________________________________________________________
Patient or Person Authorized to Sign for Patient
Date ______________________ Witness
_________________________
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