top of page

Consent form
for injectable treatments

Logo
1. What treatments will you receive? Required
2. Are you over the age of 18?
3. Are you currently pregnant or breastfeeding?
4. Have you had any side effects from cosmetic injections in the past?
5. Do you have a history of anaphylaxis or severe allergies?
6. Do you have any medical conditions that could interfere with getting cosmetic injectables?
7. Are you currently taking any medications?
8. Have you been diagnosed with HIV, Hep, or infectious diseases?
9. Do you agree to pictures being taken before/during/after the procedure for online portfolio?
10. Do you understand the treatment and do you give your consent to proceed?
SEND

Please remove any piercings or make-up from the treatment area before your arrival. 

1. WHAT'S INJECTED

DERMAL FILLERS: A hyaluronic acid (HA) filler in gel form is injected gently into specific facial areas, such as the lips, chin, and cheeks, to enhance volume and create a natural-looking appearance. A mild topical aenesthetic, such as lidocaine cream, is applied before the procedure to help reduce discomfort caused by needle. Read more on the producer's websites: Revolax, Juvederm

ANTI-WRINKLE:  Botox® Cosmetic is carefully injected into targeted facial muscles and used to temporarily soften the look of moderate to severe wrinkles (forehead. eye corners, frown lines). Read more on the producer's website: Botox

HYALURONIDASE (Filler dissolver):  Hyaluronidase is an injectable enzyme used to gently dissolve hyaluronic acid-based dermal fillers. It may be administered to correct complications, adjust aesthetic outcomes, or manage vascular occlusion. While hyaluronidase is generally considered safe and effective when administered appropriately, there is a risk of adverse reactions including severe anaphylactic events (extremely rare). Individuals with a known allergy to insect venom (wasps, bees, etc.) have an increased risk of severe allergic reactions, including anaphylaxis, due to potential cross-reactivity with hyaluronidase. A skin test is performed prior to treatment to assess for possible sensitisation.

2. RESTRICTIONS

You cannot receive injectable treatments if you find yourself in one of these situations:

2.1 Under the age of 18

2.2 Pregnant or breastfeeding

2.3 Had severe side effects to cosmetic injections before.

2.4 You have a history of anaphylaxis or multiple severe allergies.

2.5 You have an active infection at the treatment site.

2.6 You are currently taking psychiatric medication.

2.7 You are unable to make informed decisions for yourself.

2.8 You have a medical condition that makes cosmetic injections a health risk.

2.9 You are allergic to insect venom (wasp, bees) 

3. THE RISKS​​​

Cosmetic injections are generally safe when performed by a licensed and skilled injector but it can still cause unwanted results and side effects. Please approach this treatments with caution and be aware of your symptoms and their evolution over time. 
3.1 The treatment may not give the exact result you expect. Even if a treatment is technically successful by clinical standards, a person may still feel disappointed if the result doesn’t align with their vision.
3.2 Mild pain, bruising, or bleeding may occur. Needles can cause all of these and damage to veins, arteries, nerves or muscles. Some of these can require medical help. 
3.3 Bacterial infections may develop post-procedure, particularly due to inadequate aftercare. Infections can cause redness, swelling and pain and can require specialised medical treatment. Please follow the aftercare to help avoid this situation.

3.4 Vascular occlusion, a rare but serious complication caused by filler entering a blood vessel at the site of injection, restricting normal blood flow. Immediate injection treatment is necessary to dissolve the filler and restore circulation.

3.5 Herpes/cold sores recurrence can be triggered by injections to lips area.

3.6 Botox® Cosmetic can cause mild to severe side effects, including muscle weakness, vision problems, dizziness, severe allergic reactions and anaphylaxis. Reversible eyelid ptosis and facial paresis can also occur if Botox spreads into unintended facial muscles. This may happen even if the procedure was performed correctly but the post-injection aftercare is ignored. Although extremely rare, any of these can occur hours, days, or even weeks after treatment. If these symptoms arise, avoid driving or engaging in activities that require focus and responsibility and contact the injector immediately (see article 5).

3.7 Tell your injector about all your muscle or nerve conditions, such as ALS or Lou Gehrig’s disease, myasthenia gravis, or Lambert-Eaton syndrome, as you may be at increased risk of serious side effects, including difficulty swallowing and difficulty breathing, from standard doses of Botox® Cosmetic.

3.8 Severe allergic reactions and anaphylaxis. Even when performed correctly by trained professionals, injectables can still trrigger severe allergic reactions, which can develop quickly and become life-threatening (anaphylaxis). If you're on your own if this happens, seek immediate help or call an ambulance (999) without hesitation. Most common signs are: severe swelling of throat and tongue and difficulties breathing, difficulties speaking increased heart rate. Read more: nhs.uk

 

4. POTENTIAL SIDE EFFECTS

4.1 Swelling and light bruising. Mild swelling and bruising are common and resolve in a few days.
4.2 Redness. The treated area may feel sore and appear red for up to 48h.

4.3 Numbness or tingling in the treated area.

4.4 Botox® Cosmetic is known to cause light headaches within first 24h after treatment.
4.5 Lumps or Irregularities: Although the procedure may be perfectly successful immediately after the treatment, the soft and malleable nature of hyaluronic gel can lead to irregularities in time, especially if aftercare instructions are not followed. Some people may experience lumps or unevenness in the lips after the healing process is complete (typically around 30 days after the procedure). These issues can often be massaged out but may sometimes require further adjustment.​​​

​​

5. EMERGENCY ACTION PLAN

5.1 In the event of LIFE-THREATENING SITUATIONS: call an ambulance immediately (999) if you experience sudden swollen tongue or throat and difficulties breathing, swallowing or speaking.

5.2 in the event of NON-LIFE-THREATENING SITUATIONS: Please contact Honey Lips® immediately  - 07841777601 - if you experience rashes, bruises, local infection, intense pain, changes in skin colour around the puncture or any unmentioned side-effect that might worry you. 

6. DISSATISFACTION 

As with any treatment, the results cannot be fully predicted or cannot be guaranteed. The procedure may not provide the desired outcome or solve the problem as expected. Since results are subjective, dissatisfaction is possible, even if the treatment is effective. Treatments will gradually wear off over time, and additional sessions may be needed to maintain results. It's important to follow the aftercare instructions in the leaflet, as ignoring them can affect the outcome.

Refunds are not given for dissatisfaction with the appearance of the results.

For Hyaluronidase (filler dissolving), there’s no guarantee it will work 100%. Lumps, bumps, or asymmetries may not only be caused by fillers but could also result from other treatments, lifestyle, or medications.

7. CONFIDENTIALITY / DATA PRIVACY

We ask for information about your general health to allow us to treat you safely and to protect our staff. Please answer sincerely to all questions. All information will be kept strictly confidential. You will be required to fill this form each time you visit us, so we can be up-to-date with your general health.

Frequently asked questions about fillers and cosmetic injections

  • Is 0.5 filler noticeable?
    If you're considering a subtle enhancement, 0.5ml of lip filler is noticeable but in a very natural way. 0.5ml is ideal for first timers or those wanting just a slight boost in volume, symmetry, or definition without a dramatic change. It enhances your lips while keeping your overall look soft and balanced.
  • What's the minimum age?
    In the UK, you must be 18 or older to get injectables. This prohibition is enforced by the Botulinum Toxin and Cosmetic Fillers (Children) Act 2021, which came into effect on 1 October 2021. The law applies regardless of parental consent or whether the individual is a resident or visitor in England.
  • How long does lip fillers take to settle
    Revolax fillers typically begin to settle within 3 to 7 days, with full results visible after about 2 weeks. During this time, any minor swelling or unevenness will naturally improve as the product integrates with your tissue. For best results, follow all aftercare advice and avoid intense heat, exercise, or pressure on the treated area during the first 48 hours.
  • Are injectables painful?
    Pain perception varies from person to person; however, the majority of patients report only mild discomfort during the procedure, while others find it completely painless. A topical anaesthetic containing lidocaine is applied prior to treatment to minimise any potential discomfort and enhance patient comfort. Among chin, cheek, and lip fillers, lip filler is generally considered the most uncomfortable.
  • How long does it last?
    Fillers results typically last between 6 to 12 months while ant-wrinkle treatments around 4 months, depending on many contributing factors like the brand of filler, your metabolism, and lifestyle. Regular maintenance appointments can help sustain your results.
  • Is there a downtime?
    There may be some mild swelling or bruising for a few days after your appointment. Most clients return to their usual routine straight away. Advice: If you're preparing for an important event such as a wedding, party, or photoshoot, we recommend scheduling your treatments at least 3–4 weeks in advance. This allows time for any swelling or bruising to fully settle and ensures your final results look their best.
  • How to book appointments?
    Please use the "book" button and follow the easy steps to schedule an appointment. Alternatively, you can use the live-chat function or contact Roxana on 07841 777601 (WhatsApp) for any additional information.
  • Where's the location?
    114 New Cavendish, W1W 6XT, London 5 min walk from Harley Street 5 min walk from Great Portland Station 9 min walk from Oxford Circus Station Paid street parking is generally available. ULEZ

IMPORTANT: Appointments and treatments will not be provided to under 18!

Honey Lips® is fully committed to upholding high industry standards and UK legal requirements for filler injections. Cosmetic Injector certified by the Centre for Medical Sciences and Research UK, with multiple professional accreditations in injectable fillers and related.

Honey Lips® is a registered trademark. London, 114 New Cavendish, W1W 6XT,  2C, Mon-Sat: 11am-6pm.
Privacy policy · Terms & Conditions · Cookies policy · Treatments risksConsent form
Gift cardBe a modelAftercare · Lip balmBlogContactMasterclass · Review · Newsletter
bottom of page