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Maxim, March 1999
Mark Berman
Think we’re being alarmist assholes? Wait till you see
the surgical consent form.
The following is excerpted from an actual consent form for penis
enhancement surgery we found at http://www.psurg.com/PENISL.htm
(Yes, the doctor’s name really is Stubbs.)
Special Consent to Penis Lengthening Surgery
1. I hereby request Dr. Robert H. Stubbs to perform
“penis lengthening” surgery on:
______________________ (Name of patient) or (Myself)
2. The procedure listed in Paragraph 1 has been explained
to me by the doctor and/or his staff and I completely understand
the nature and consequences of the surgery. The following points
have been specifically made clear:
a) That medicine is not an exact science and complications
such as death, although extremely rare, may occur.
b) That swelling, bruising and mild discomfort usually
occur.
c) That no guarantees with respect to the final outcome
can be offered.
d) That infection is possible.
e) That sensation may be altered or completely lost.
f) That function may be altered.
g) That delayed wound healing and/or poor scarring may
occur.
h) That revisions may be necessary.
i) That the healing process takes time and the final result
will not be readily visible for many months.
j) That bleeding may occur and should blood collect (a
hematoma), this may require further surgical treatment.
k) That skin loss may occur and that smoking may cause
this problem.
l) That chronic or persistent problems may occur which
require treatment.
3. I…authorize and request that the above-named surgeon,
his assistants or his designees perform such procedures as are,
in his professional judgment, necessary and desirable, including,
but not limited to, procedures involving pathology and radiology…
4. I consent to the administration of anesthesia, and/or
deep sedation…
5. I am aware that the practice of medicine and surgery
is not an exact science, and I acknowledge that no guarantees
have been made to me as to the results of the operation or procedure.
6. I consent to be photographed before, during and after
treatment; that these photographs shall be the property of Dr.
Robert H. Stubbs and may be published in scientific journals and/or
shown for scientific or educational reasons.