• OMBRE POWDER BROWS CONSENT FORM

  • Today’s Date*
     - -
  • DOB*
     - -
  • Format: (000) 000-0000.

  • Aftercare

  • Expect some redness and swelling right after the procedure. You may also experience a white halo surrounding the area and this is related to the topical anesthetic used. These symptoms will disappear in the next hour or so.

      
    INSTRUCTIONS:
    1.    Avoid getting your eyebrows wet until your brows are fully healed (when it is done flaking). Healing time varies from 10-14 days.

    2.   Apply a grain size of A&D/Vaseline/Aquaphor ointment using a Q-tip on each brow. Apply the ointment twice a day, morning and night. 

    It is crucial that during the healing period that you maintain facial hygiene and AVOID:

    Touching or picking the eyebrows (apply ointment with Q-tip). Picking can lead to color loss, scarring and infection (especially if hands are not clean).
    Getting the brows soaked with water. Accidental splash of water is okay as long as you pat dry with a napkin. It is best to wash your face by the sink prior to showering or you can avoid the eyebrow area when showering. 
    Any makeup on the eyebrow area
    Workouts that involve a lot of sweating; sauna, facial massage and steaming
    Sun tanning or salon tanning; swimming; excessive sun exposure (wear a hat when outside for a longer period)
    Drinking alcohol in excess (may lead to slow healing)
    ​ 

    WHAT TO EXPECT DURING THE HEALING PERIOD:
    Your brows will start to darken over the next couple of days and this is normal. Keep in mind that your brows will lighten by 20-30% and continue to fade overtime. 

    At day 3-5, you can expect your brows to itch and flake. Your brows will look like dandruff flakes or dry skin. When the flakes fall off, some areas of the brow may appear too light but with time, the color will resurface. It is crucial that you do not pick/touch your brows to avoid color loss and/or possible scarring.

    Total brow healing time is 10-14 days. You may resume normal activities brow activities such as washing your brows or applying makeup after you are done flaking.

    At 2 weeks, the brows may be light and patchy since the skin is flaking off in different areas. Final result and color will be at 4 weeks. 

    ​

    IN THE NEXT 30 DAYS:
    Avoid sunbathing, solarbrium, light therapies, chemical peelings, fruit acids, microdermabrasion, creams that contain regeneration factors. Use of antibiotics and hormonal therapy can speed pigment fading.

    After 14 days, apply sunscreen to the brows when exposed to sunlight to promote longevity. Other ways to extend the color of your brows: being gentle around the brow area when washing your face or when exfoliating avoid the brow area. 

    Always avoid laser treatments over the treated area (fraxel, laser, IPL) because it can destroy the pigments. 

    TOUCH UP APPOINTMENT: 
    A touchup session is considered a perfection session to fill in any spots that did not take pigment well. Touchups are recommended as everyone heals differently. It can be scheduled anytime after 6 weeks from the initial procedure. New procedures are a two step process and final results are sometimes not guaranteed until a follow visit is completed. 

  • Clinical Outcome of Procedure(s)

    The results of your procedure are determined in part by nature of the pathology of skin type, but not limited to the following:

    Medications you are currently taking; your skin characteristics; personal pH balance of skin, tanning, fruitcaids, AHA’s, and retin A use; alcohol intake, smoking, sun exposure and improper skin care; following pre and post instructions.

  • I understand and accept such procedure is a process, often requiring a follow-up application of color to achieve desirable results and that 100% success is not guaranteed.*
  • I acknowledge that obtaining permanent makeup is my choice alone, The application of permanent makeup will result a change in my appearance and that needles and pigments will go into my skin using only sterile disposable single use needles. No representations have been made to me as my ability to later restore the skin involved in permanent makeup to the original condition and can be costly to remove.*
  • I acknowledge infection is always possible as a result of permanent makeup and I agree to follow all suggested instructions concerning the care of the site while it is healing. Possibilities may include: redness, minor bleeding, swelling, tenderness, allergic reaction, and/or keloid formation.*
  • I understand that position of my procedures can be affected if I elect to have cosmetic surgery and/or cosmetic botox and fillers.*
  • I am aware that if I am to receive an MRI after the procedure, I must tell my healthcare professional that I have iron oxide permanent cosmetics.*
  • I understand that this procedure is permanent in nature, but will fade over time. The fading can alter the original color and that this determines that it is time for touchups. Touchups can be done anytime after 5-6  weeks. Then every two years as maintenance.*
  • I agree to accompany my technician for blood testing in the event of accidental needle stick for their safety and disclose all test results to technician.*
  • I understand that I must comply with recommended pre and post care and following it is crucial for the healing, preventing infection and results of treatment.*
  • I understand that before and after pictures will be taken for purpose of documentation which may or may not be used for educational or advertising purposes.*
  • I am over the age of 18 and not under any influence of drug or alcohol.*
  • I am not pregnant.*
  • I understand that it is my responsibility to book my touchup accordingly to the timeframe and each touch up fee is according to the time frame.*
  • I understand there are NO guarantees and refunds will NOT be given.*

  • Medical History

  • Are you pregnant or nursing?*
  • Do you smoke? Drink alcohol?*
  • Are you on Accutane? Or have you taken in within the last year?*
  • Are you on steroids or anti-inflammatory medications?*
  • Do you suffer from any medical or skin conditions: such as keloids, psoriasis or any open wounds or lesions at procedural site?*
  • Do you bruise, swell or bleed easily?*
  • Have you had botox to raise your eyebrows?*
  • Do you have any allergies to latex?*
  • Do you have a history of cold sores at proposed site?*
  • Should be Empty: