DERMAPLANING AND RESURFACING CONSENT FORM
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What is Dermaplaning? Dermaplaning is a form of manual exfoliation similar in theory to microdermabrasion but without the use of suction or abrasive crystals. An esthetician grade, sterile blade is stroked along the skin at an angle to gently “shave off” dead skin cells from the epidermis. Dermaplaning also temporarily removes most of, but not all of the fine vellus hair on the face, leaving a very smooth surface. As with any type of exfoliation, the removal of dead skin cells allows home care products to be more effective, reduces the appearance of fine lines, evens skin tone and assists in reducing milia, closed and open comedones, and minor breakouts associated with congested pores. Dermaplaning can be an effective exfoliation method for clients that have coupe rose (tiny blood vessels near the surfaceof the skin), sensitive skin or allergies that prevent the use of microdermabrasion or chemical peels. Due to the contours of the face,certain areas of the face (such as the eyelids and nose) are not treatable using this method.
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I understand
What should you expect during your treatment? As your esthetician, I will perform a thorough skin analysis prior to your first dermaplaning. If dermaplaning is not appropriate, you will be informed during this session and an alternative treatment may be recommended instead. If dermaplaning is not contraindicated, maximum results are obtained by participating in a series of treatments plus following a home care regimen. I will review your current daily regimen and skin care products, advise you on which products you should continue to use, and recommend any additional products or changes to your regimen to enhance your desired outcome
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I understand
By clicking the boxes I am acknowledging and consenting that I fully and completely understand and accept all risks
I understand that dermaplaning is the process of removing superficial layers of dead skin cells on the skin’s surface by the use of a sterile blade while removing most of but not all the vellus hair I have been explained the process of dermaplaning by my Esthetician and have had the opportunity to ask any questions. I understand that results may not be seen in a single treatment. The ideal plan of treatment is to have at least one dermaplaning treatment as directed by my Esthetician to enhance any skin conditions and follow up with maintenance treatments as needed I understand for optimum results, the importance of following the post-home care system recommended to me by my Esthetician. I understand that there may be unforeseen risk with dermaplaning such as cutting, scraping, or abrading the skin with the blade.
I understand there are contraindications to this treatment, including but not limited to, diabetes (not controlled by diet or medication),cancer, active acne, bleeding disorders, the inability for blood to coagulate or the development keloids following injury. Certainmedications including blood thinners, high doses of aspirin, andaccutane are contraindicated for this treatment due to thepossibility of delayed clotting from a nick or cut. I certify that I am not taking any of the above medications orexperiencing any of the above conditions.
While every precaution to avoid nicks, cuts and scratches, I understand the risk and consent to this treatment today. I hereby give my consent and authorization voluntarily and release VB Aesthetics and my Esthetician, Tricia Kenny, from any claims, implied or stated that, I have or may have in the future with this treatment, regardless of the results. I am stating that the treatment and precautions have been explained to me in detail and that I fully understand
Resurfacing treatments
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I understand that chemical peel is a controlled superficial burn. I may experience some reddens or irritation with light to heavy peeling depending on the type of peel.
I understand that micro dermabrasion can cause irritation, redness, or small abrasion on the surface of the skin
I understand that waxing can cause temporary redness. I understand that I must stop any retinol 7 days prior to waxing. I understand that if I fail to discontinue retinol it can cause lifting of the skin and will take 7-10 days to heal;
I agree to follow all after post procedure instruction provided by my provider.
I agree to avoid sun, to wear mineral SPF, avoid excessive sweating or exercise.
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