Surgical Consent Form

Surgical Consent Form

    Patient Name*:

    Date*:

    Surgery*:

    Email*:

    1. All human beings heal by permanent scar formation.

    2. Scar tissue remains pink for 3-6 months, and then usually fades to white. Sunlight exposure may cause a scar to darken.

    3. The appearance of a surgical scar usually continues to improve for 6-12 months, as the scar "matures". The tissue around a surgical site often remains "puffy" for about 1 month. The surgical scar is usually strong by 4 weeks after the procedure.

    4. Scars overlying active muscle areas tend to widen (stretch) with time. This cannot always be prevented.

    5. Scars can heal thick and raised (keloid or hypertrophic scar) or can heal thin (atrophic scar). How they heal depends in part upon their location on the body and the healing process of the individual patient.

    6. The final appearance of a scar depends upon many factors. Chances of a good result can be estimated for a given procedure, but can never be guaranteed.

    7. If a surgical site is injured before healing is complete, the scar may gape open, the wound may bleed, and the scar may become more obvious.

    8. A chance of feeling or sensation often occurs around a scar. In some areas of the body there is a risk of motor nerve damage.

    9. Infection or bleeding can occur after surgery.

    10. Insignificant, serious, or life threatening reactions may occur to any medication.

    11. Sometimes more than one surgical procedure is necessary to remove a lesion completely or to obtain the best possible cosmetic result.

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