I was explained, and I understand the expected results, the chances of success and the course of the treatment that is required.
I confirm that I do not suffer from any of the above described conditions.
I have had the opportunity to consider the following information, ask questions and have had these answered satisfactorily by the Physician/Therapist/Practitioner.
The VoluDermTM (VO) applicator is intended for dermatological procedures requiringresurfacing of the skin for texture improvement.
- It treats the skin in a fractional manner, leaving areas of untreated skin betweenthe affected zones, for improving the healing process- The VO technology uses a disposable sterile micro needle treatment tip, attachedto the distal end of the VO applicator- The tip is placed on the skin for treatment- The micro needles ablate the skin using Radio Frequency (RF) energy, inducingcontrolled tissue heating- During the treatment you might feel some pain, vibration, a stinging sensation andheat- The TriPollar RF-based applicators are indicated for the non-invasive treatment ofmild-to-moderate facial wrinkles- The system has a biofeedback control switch. In case of excessive discomfort, youmay press the button to terminate the treatment immediately
I understand that receiving the course of treatment is my choice.
- I was told that post VO treatment, tiny scabs in the form of the electrodes or microneedle matrix configuration will usually form within 24 hours to 3 days posttreatment and last for a few days- I was instructed to avoid scratching off the scabs and to apply sunscreen daily- I was told about the possible side effects of those treatments including: local pain,excessive skin redness (erythema), excessive swelling (edema), damage to thenatural skin texture (crust, blister, and burn), fragile skin, change of pigmentation(hyper-pigmentation or hypo-pigmentation), bruising, scarring or transient skinbreakouts such as acne and pimples. Although these effects are rare and expectedto be temporary, any adverse reaction should be reported immediately- I was told to avoid heat, exposure to sun and UV and to apply high SPF sun screenseveral times a day- I was told that in case of excessive swelling, redness or heat, I may apply a coldpack (not ice) to the area and contact my treating physician
I confirm that I have read and understand the above information and agree to undergo the treatment out of my own free will.
Permission for use of photographs (optional)
I First Name Last Name grant permission to (Clinic) Type a label and toLumenis® Ltd to use photos and digital images of my treated areas for the purposes ofprofessional publications, training and education, marketing or sales.