————Информированное согласие на увеличение груди
Информированное согласие на увеличение груди
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Согласие пациента на операцию увеличения молочных желез с помощью эндопротезов.
Цель данного документа – представить пациенту до подтверждения им согласия на операцию полную информацию об особенностях послеоперационного периода и осложнениях, которые могут возникнуть при данном виде лечения.
(Фамилия, имя, отчество пациента)
1. Я уполномочиваю доктора (далее – Врача) и его ассистентов выполнить мне операцию увеличения молочных желез с помощью эндопротезов.
2. Содержание и результаты операции, возможные опасности и осложнения, а так же возможности альтернативных методов лечения мне полностью объяснены Врачом, и я их полностью понял(а). Особенно важными и полностью ясными для меня являются следующие положения об особенностях послеоперационного периода.
А. Операция направлена на увеличение молочных желез, однако ее отдаленные результаты зависят от многих факторов и не могут быть определены на много лет вперед.
Б. Многолетними исследованиями доказано, что материал, помещенный в ткани для увеличения объема молочных желез, не вызывает со временем злокачественного роста тканей или увеличения частоты развития других заболеваний.
В. Форма груди зависит от многих факторов, и операция, как правило, не может привести к созданию идеальной формы.
Г. После операции на месте разрезов остаются постоянные рубцы; их качество не может быть в полной мере предсказано, так как процессы формирования рубцов индивидуальны.
Д. После купания в холодной воде температура молочных желез в течение некоторого времени может быть ниже, чем температура других тканей тела.
Е. Беременность не рекомендуется, по крайней мере, в течение 6 месяцев после операции.
Ж. В редких случаях после операции может наступить снижение чувствительности и даже онемение соска, ареолы и окружающей их кожи молочной железы.
3. После операции возможно развитие общехирургических осложнений (нагноение раны, кровотечение, тромбофлебит, тромбоэмболия, образование келлоидных рубцов и др.), а также следующих осложнений, характерных для данной операции.
А. У некоторых пациентов с тонкой кожей могут ощущаться края протезов; вероятность этого связана и с конструкцией протезов.
Б. В незначительном проценте существует возможность того, что ткани организма не переносят материала импланта, что может потребовать удаления протезов.
В. В 3-5% случае грудь со временем может стать более плотной в результате образования более грубой капсулы (рубцовой оболочки) вокруг протеза и развития капсулярной контрактуры (утолщение и сжатие рубцов вокруг протеза), это состояние может вызвать дискомфорт и даже боль и потребовать проведения повторной операции (рассечения рубцов с установкой того же или нового протеза).
Г. Вокруг протезов могут возникнуть послеоперационные скопления крови или развиваться нагноение; это может потребовать проведения дополнительных операций.
Д. Оболочка имплантата изготовлена из прочного силиконового эластомера, однако, в результате сильного давления или удара, а также по неустановленным причинам в некоторых случаях бывают разрывы оболочки, что требует удаления имплантата. Повторная операция по установке имплантатов возможна через некоторый срок, который индивидуален.
4. Я понимаю, что практическая хирургия – это не точная наука, и что даже авторитетный специалист не может дать 100% гарантию успеха лечения. Поэтому Врач, так же как и любой другой хирург, не может мне гарантировать достижение отличного результата.
5. Я понимаю, что две половины человеческого тела всегда имеют различия в форме и размерах, и эти различия остаются после операции.
6. Мне не известно о моей повышенной чувствительности к медикаментам кроме
Я удостоверяю, что Я ознакомлен(а) с приведенной выше информацией, что полученные мной объяснения меня полностью удовлетворяют, и, что Я полностью понимаю назначение данного документа, и подтверждаю свое согласие на операцию.
Дата «____»_____________200__г. Подпись пациента ______________
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Птозом груди называется опущение молочных желез и потеря их объема, которое сопровождается растяжением кожи.
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[1] => Array
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[2] => Array
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[TEXT] => Информированное согласие на подтяжку груди
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[3] => Array
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[TEXT] => Показания к подтяжке груди
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[ICON] =>
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[PICTURE] => 4902
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[4] => Array
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[TEXT] => Противопоказания к подтяжке груди
[LINK] => /plastika-grudi/podtyazhka-grudi/protivopokazaniya-k-podtyazhke-grudi/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ICON] =>
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[PICTURE] => 4903
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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)
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[3] => Array
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[TEXT] => Уменьшение груди
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[ITEM_TYPE] => D
[ITEM_INDEX] => 26
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
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[PICTURE] => 4904
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
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[TEXT] => Договор на уменьшение груди
[LINK] => /plastika-grudi/umenshenie-grudi/dogovor-na-umenshenie-grudi/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[1] => Array
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[TEXT] => Информированное согласие на уменьшение груди
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[UF_TOP_SEO] =>
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[1] => Array
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[TEXT] => Пластика лица
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ITEM_TYPE] => D
[ITEM_INDEX] => 29
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[DEPTH_LEVEL] => 1
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[DEPTH_LEVEL] => 1
[IS_PARENT] => 1
[CHILD] => Array
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[0] => Array
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[TEXT] => Блефаропластика
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
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[0] => Array
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[TEXT] => Договор на блефаропластику
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[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[1] => Array
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[TEXT] => Информированное согласие на блефаропластику
[LINK] => /plastika-lica/blefaroplastikaplastika/informirovannoe-soglasie-na-blefaroplastiku/
[SELECTED] =>
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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)
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[1] => Array
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[TEXT] => Золотые нити (нитевой лифтинг)
[LINK] => /plastika-lica/zolotie-niti/
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[ADDITIONAL_LINKS] => Array
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[CHILD] => Array
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[0] => Array
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[TEXT] => Договор на нитевой лифтинг
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ITEM_TYPE] => D
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[DEPTH_LEVEL] => 3
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[1] => Array
(
[TEXT] => Информированное согласие на нитевой лифтинг
[LINK] => /plastika-lica/zolotie-niti/informirovannoe-soglasie-na-nitevoy-lifting/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ITEM_TYPE] => D
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[PARAMS] => Array
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[UF_TOP_SEO] =>
[ICON] =>
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[DEPTH_LEVEL] => 3
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[2] => Array
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[TEXT] => Ментопластика
[LINK] => /plastika-lica/mentoplastika/
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ITEM_TYPE] => D
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[UF_TOP_SEO] =>
[ICON] =>
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
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[TEXT] => Договор на отопластику ментопластику
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ITEM_TYPE] => D
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[UF_TOP_SEO] =>
[ICON] =>
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[3] => Array
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[TEXT] => Отопластика
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ICON] =>
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
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[TEXT] => Договор на отопластику
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[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[ICON] =>
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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[1] => Array
(
[TEXT] => Информированное согласие на отопластику
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[SELECTED] =>
[PERMISSION] => R
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[ICON] =>
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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)
)
[4] => Array
(
[TEXT] => Пластика лба
[LINK] => /plastika-lica/plastika-lba/
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[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
)
[ITEM_TYPE] => D
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[PARAMS] => Array
(
[FROM_IBLOCK] => 1
[DEPTH_LEVEL] => 2
[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 1
[PICTURE] => 4918
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
(
[TEXT] => Договор на пластику лба
[LINK] => /plastika-lica/plastika-lba/dogovor-na-plastiku-lba/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[ITEM_TYPE] => D
[ITEM_INDEX] => 42
[PARAMS] => Array
(
[FROM_IBLOCK] => 1
[DEPTH_LEVEL] => 3
[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 0
[PICTURE] => 4919
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
)
[1] => Array
(
[TEXT] => Информированное согласие на пластику лба
[LINK] => /plastika-lica/plastika-lba/informirovannoe-soglasie-na-plastiku-lba/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[PARAMS] => Array
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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)
)
[5] => Array
(
[TEXT] => Ринопластика
[LINK] => /plastika-lica/rinoplastika/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
)
[ITEM_TYPE] => D
[ITEM_INDEX] => 44
[PARAMS] => Array
(
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[DEPTH_LEVEL] => 2
[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 1
[PICTURE] => 4921
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
(
[TEXT] => Договор на ринопластику
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[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[ITEM_TYPE] => D
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[PARAMS] => Array
(
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 0
[PICTURE] => 4922
)
[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
)
[1] => Array
(
[TEXT] => Информированное согласие на ринопластику
[LINK] => /plastika-lica/rinoplastika/informirovannoe-soglasie-na-rinoplastiku/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[PARAMS] => Array
(
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[DEPTH_LEVEL] => 3
[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 0
[PICTURE] => 4923
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
)
)
)
[6] => Array
(
[TEXT] => Фейслифтинг
[LINK] => /plastika-lica/feslifting/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
)
[ITEM_TYPE] => D
[ITEM_INDEX] => 47
[PARAMS] => Array
(
[FROM_IBLOCK] => 1
[DEPTH_LEVEL] => 2
[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 1
[PICTURE] => 4924
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[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
(
[TEXT] => Договор на фейслифтинг
[LINK] => /plastika-lica/feslifting/dogovor-na-feyslifting/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[ITEM_TYPE] => D
[ITEM_INDEX] => 48
[PARAMS] => Array
(
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[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 0
[PICTURE] => 4925
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
)
[1] => Array
(
[TEXT] => Информированное согласие на фейслифтинг
[LINK] => /plastika-lica/feslifting/informirovannoe-soglasie-na-feyslifting/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[ITEM_TYPE] => D
[ITEM_INDEX] => 49
[PARAMS] => Array
(
[FROM_IBLOCK] => 1
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
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[PICTURE] => 4926
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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)
)
)
)
[2] => Array
(
[TEXT] => Пластика тела
[LINK] => /plastika-tela/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
)
[ITEM_TYPE] => D
[ITEM_INDEX] => 50
[PARAMS] => Array
(
[FROM_IBLOCK] => 1
[DEPTH_LEVEL] => 1
[SORT] => 500
[UF_TOP_SEO] => С годами наше тело теряет былую привлекательность: контуры теряют четкость, животик обвисает, кожа растягивается, становится более дряблой. Кроме возрастных изменений большое влияние на женскую фигуру оказывают роды и гормональные нарушения.
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 1
[PICTURE] => 4927
)
[DEPTH_LEVEL] => 1
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
(
[TEXT] => Абдоминопластика
[LINK] => /plastika-tela/abdominoplastika/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
)
[ITEM_TYPE] => D
[ITEM_INDEX] => 51
[PARAMS] => Array
(
[FROM_IBLOCK] => 1
[DEPTH_LEVEL] => 2
[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 1
[PICTURE] => 4928
)
[DEPTH_LEVEL] => 2
[IS_PARENT] => 1
[CHILD] => Array
(
[0] => Array
(
[TEXT] => Договор на абдоминопластику
[LINK] => /plastika-tela/abdominoplastika/dogovor-na-abdominoplastiku/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
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[ITEM_TYPE] => D
[ITEM_INDEX] => 52
[PARAMS] => Array
(
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 0
[PICTURE] => 4929
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
)
[1] => Array
(
[TEXT] => Информированное согласие на абдоминопластику
[LINK] => /plastika-tela/abdominoplastika/informirovannoe-soglasie-na-abdominoplastiku/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
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[PARAMS] => Array
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
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[IS_PARENT] => 0
[PICTURE] => 4930
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[DEPTH_LEVEL] => 3
[IS_PARENT] => 0
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)
)
[1] => Array
(
[TEXT] => Глютеопластика
[LINK] => /plastika-tela/gluteoplastika/
[SELECTED] =>
[PERMISSION] => R
[ADDITIONAL_LINKS] => Array
(
)
[ITEM_TYPE] => D
[ITEM_INDEX] => 54
[PARAMS] => Array
(
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[SORT] => 500
[UF_TOP_SEO] =>
[ICON] =>
[TRANSPARENT_PICTURE] =>
[IS_PARENT] => 1
[PICTURE] => 4931
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[IS_PARENT] => 1
[CHILD] => Array
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[TEXT] => Возможные осложнения после круропластики
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[TEXT] => Асимметрия после круропластики
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[1] => Array
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[TEXT] => Гематома после круропластики
[LINK] => /plastika-tela/kruroplastika/vozmozhnye-oslozhneniya-posle-kruroplastiki/gematoma-posle-kruroplastiki/
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[2] => Array
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[TEXT] => Грубые рубцы после круропластики
[LINK] => /plastika-tela/kruroplastika/vozmozhnye-oslozhneniya-posle-kruroplastiki/grubye-rubcy-posle-kruroplastiki/
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[3] => Array
(
[TEXT] => Дистопия имплантатов после круропластики
[LINK] => /plastika-tela/kruroplastika/vozmozhnye-oslozhneniya-posle-kruroplastiki/distopiya-implantatov-posle-kruroplastiki/
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[4] => Array
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[TEXT] => Капсулярная контрактура после круропластики
[LINK] => /plastika-tela/kruroplastika/vozmozhnye-oslozhneniya-posle-kruroplastiki/kapsulyarnaya-kontraktura-posle-kruroplastiki/
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[5] => Array
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[TEXT] => Нагноение после круропластики
[LINK] => /plastika-tela/kruroplastika/vozmozhnye-oslozhneniya-posle-kruroplastiki/nagnoenie-posle-kruroplastiki/
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[TEXT] => Серома после круропластики
[LINK] => /plastika-tela/kruroplastika/vozmozhnye-oslozhneniya-posle-kruroplastiki/seroma-posle-kruroplastiki/
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[TEXT] => Договор на круропластику
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[TEXT] => Информированное согласие на круропластику
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[TEXT] => Подготовка к круропластике
[LINK] => /plastika-tela/kruroplastika/podgotovka-k-kruroplastike/
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[TEXT] => Информированное согласие на липосакцию
[LINK] => /plastika-tela/liposakciya/informirovannoe-soglasie-na-liposakciyu/
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[TEXT] => Липофилинг
[LINK] => /plastika-tela/lipofiling/
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[TEXT] => Подтяжка бедер
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[TEXT] => Договор на подтяжку бедер
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[LINK] => /plastika-tela/podtyazhka-beder/informirovannoe-soglasie-na-podtyazhku-beder/
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[TEXT] => Информированное согласие на удаление рубцов
[LINK] => /plastika-tela/udalenie-rubcov/informirovannoe-soglasie-na-udalenie-rubcov/
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О докторе
За 10 лет в пластической хирургии я выполнил сотни различных операций и выработал собственный подход и техники их исполнения.