I hereby authorize MedSpa Villlagio to perform Skin Lesion (Mole) removal procedures on me. There are various benefits to this procedure, including:

  • Removing protruding Skin Lesions that get in the way of shaving
  • Reducing skin irritation and infection that can occur when certain Skin Lesions rub against clothing and/or jewelry.
  • Achieving smoother, clearer skin.
  • Enhancing appearance and improving self-esteem.
  • This Skin Lesion removal procedure maybe viewed as cosmetic.


The following points have been discussed with me:

  • The potential benefits of the proposed procedure.
  • The possible alternative procedures.
  • The probability of success.
  • The reasonably anticipated consequences if the procedure is not performed.
  • The most likely possible complications/risks involved with the proposed procedure and subsequent healing period, including infection, scarring and skin discoloration.


I am aware of the following possible experience/risks with Skin Lesions being removed:

  • DISCOMFORT – Some discomfort may be experienced during and after the procedure.
  • INFECTION – Skin infection is a possibility although rare, whenever a skin procedure is performed.
  • PIGMENT CHANGES (Skin Color) – During the healing process, there is a possibility that the treated area can become either lighter or darker in color compared to the surrounding skin. This is usually temporary, but on rare occasion, it may be permanent.
  • SCARRING – Scarring is a rare occurrence, but is a possibility when the skin’s surface is disrupted. To minimize the chances of scarring, it is IMPORTANT that you follow all posttreatment instructions carefully.