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Kybella® (Deoxycholic Acid Injection) Informed Consent

I voluntarily consent to treatment with Kybella performed by Nurtured by Nurses® and its providers. I understand that Kybella® is an injectable medication used to improve the appearance of moderate to severe submental fullness (“double chin”) by dissolving fat cells beneath the chin.

Treatment Overview

Kybella® contains synthetic deoxycholic acid, a naturally occurring molecule that assists in the breakdown and absorption of dietary fat. Once injected, the treated fat cells are permanently destroyed and can no longer store fat. Multiple treatments may be required to achieve desired results.

Expected Results

  • Results vary by individual.

  • Improvement develops gradually over several weeks following treatment.

  • Most patients require a series of treatments spaced approximately 4–8 weeks apart.

  • No guarantees have been made regarding the outcome of treatment.

Alternative Treatments

I understand alternatives may include:

  • No treatment

  • Diet and exercise

  • Liposuction

  • Surgical neck contouring

  • Other injectable or energy-based procedures

Common Side Effects and Risks

I understand the following are common and expected:

  • Swelling

  • Redness

  • Bruising

  • Tenderness or discomfort

  • Warmth

  • Firmness or nodules

  • Numbness or altered sensation

  • Itching

  • Temporary difficulty swallowing

  • Temporary uneven appearance or fullness during healing

I understand swelling may be significant and may last several days to several weeks.

Potential Complications

Although uncommon, risks may include:

  • Infection

  • Allergic reaction

  • Skin ulceration or tissue injury

  • Hair loss at the injection site

  • Nerve injury, including temporary facial muscle weakness or uneven smile

  • Difficulty swallowing

  • Prolonged swelling, firmness, or numbness

  • Asymmetry

  • Unsatisfactory cosmetic result

  • Need for additional treatment or corrective procedures

Contraindications

I have informed my provider if I:

  • Am pregnant or breastfeeding

  • Have difficulty swallowing

  • Have a bleeding disorder

  • Take blood thinners or medications that increase bleeding/bruising

  • Have an active infection in the treatment area

  • Have had prior surgery or cosmetic procedures to the neck/chin area

  • Have significant loose skin or medical conditions affecting the neck

Results

There is the possibility of a poor or inadequate response from any treatment. Each individual responds differently. Full results may take several weeks to appear. No guarantees about results have been made. Failure to follow aftercare instructions may lead to suboptimal outcomes or unintended aesthetic effects. There are no refunds available for unsatisfactory results.

Dodge City KS

Currently offering in-home services only

By Appointment Only:

Mon: 10am - 2pm

Tues: 10am - 2pm

Wed: 1pm - 7pm

Thur: 10am - 2pm

Fri: 10am - 2pm

Please call for appointments outside of scheduled hours.

316-205-0075

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©2024 by Nurtured by Nurses

El Dorado KS

120 N Main St. Suite 1

El Dorado, KS

Offering appointments in the office or in-home

Mon: 10am - 6pm

Tues: 10am - 6pm

Wed: CLOSED

Thur: 12pm - 7pm

Fri: 10am - 430pm

Sat: 10am - 5pm

Please call for appointments outside of scheduled hours.

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