Notes

Place of procedure: Office
Indication for Procedure: Improvement of facial lines, scars and enhancement of cheek and lips for cosmetic purposes. Based on the physical examination, it was determined that the patient may benefit from the above procedure. Pending Follow-up from this procedure further recommendations will be made. Frequency, date and dose of last injectables were reviewed. Allergy, pregnancy, lactation and general health status were reviewed.
Written Informed Consent was obtained after careful discussionof the risks and benefitsof the procedure. Consent was signed and attached to chart. No sedation was given.

The area(s) to be injected were examined and cleansed with Hydrogen Peroxide and 70% alcohol. Filler injection was done with a combination of BD needle and blunt tip cannula topical numbing with BLT.
A total of : 1 syringes of Ultra PLus filler each 1ml were injected as per patient chart.
cheeks: left 0.5 ml right 0.5 ml
Others:

Lot#:
Exp Date:
Estimated Blood Loss: Less than 1cc.
Complications: None. Patient tolerated the procedure well and was discharged home in good condition, with written and verbal advise to notify the office with any problems such as excessive swelling,pain,asymmerty, difficulty breathing.
Comments
Instructed not to excercise 24 hours post injection, no rubbing for 24 hours or sleep on that side. No touching the injected areas for 4-5 hours and no rubbing for 24 hours. Follow- up as scheduled in 2-3 weeks .