I certify I am over the age of 18 & understand Mesotherapy is a non-invasive non-surgical technique that uses micro-injections of pharmaceutical and homeopathic preparations, plant extracts, vitamins, and other ingredients into subcutaneous fat.

 

Fat Dissolve Solution is the first addition of highly concentrated Vitamin B12 and other active ingredients for rapid fat decomposition, promoting rapid fat decomposition and quickly excluding it from the body. It has been certified for its high safety, quick effect and little side effects. It can be used for facial obesity, double chin and excessive body fat. It efficiently eliminates fat deposits and cellulite in different parts of body, improves skin clarity, natural beauty balance, face and body contouring.

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I understand and acknowledge that there are risks involved such as swelling, burning & itchiness with the treatment that will subside within a few days. I will follow the aftercare as directed. Although it is impossible to list every potential risk and complication, I have been informed of possible benefits, risks, and complications, and I have had the opportunity to ask questions regarding these risks and other possible complications.

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I also recognise there are no guaranteed results and that independent results are dependent upon age, skin condition, and lifestyle and that there is a possibility I may require further treatments of the treated areas to obtain the expected results at an additional cost.

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I understand there are contraindications to this treatment, including but not limited to, pregnancy, breastfeeding, sensitivity to PPC (Phosphatidylcholine & Sodium deoxycholate), and severe allergies.

I certify that I am not experiencing any of the above conditions.

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I acknowledge that my technician has received training & certification in appropriate sanitation and hygiene techniques prior to performing any procedures. While the risk of infection from the procedure is extremely small, the possibility of such an occurrence cannot be totally prevented. Accordingly, I understand and accept the risk and release Mills Aesthetics from any and all liability related to the subject procedure, except instances involving gross negligence.

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I grant Permission to Mills Aesthetics:

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• to take and use: photographs and/or digital images of me for use in news releases, educational materials and/or social media platforms including but not limited to Instagram, Facebook, Twitter, TikToK and Pinterest.

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I have also, to the best of my knowledge, given an accurate account of my medical history, including all known allergies or prescription drugs or products I am currently ingesting or using topically.

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By signing below, I agree to the following:

I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree I will assume the risk and full responsibility for any and all injuries, losses, side effects, or damages which might occur to me while I am undergoing this procedure. I do not hold Mills Aesthetics responsible for any of my conditions that were present, but not disclosed at the time of this skin care procedure, which may be affected by the treatment performed.