BB Glow Consent Form
BB Glow treatment is an anti-aging and skin brightening procedure based on the MTS Microneedle Therapy System, which is based on the skin's natural ability to repair itself when it suffers physical damage. Immediately after an injury to the skin, the body begins a healing process, triggering new collagen synthesis.
The procedure is safely done using a Microneedling Pen with a single-use sterile needle head. The device offers adjustable depth, speed, and needle size control. A session usually takes 2 hours, in which serums and/or pigments will be applied to stimulate the rejuvenation process along with a facial hydrating mask at the end.
Skin will be red with a mild swelling and/or bruising, skin might feel tight and sensitive to the touch. Although these symptoms may take 1 to 2 days to resolve completely, they will diminish significantly within a few hours after the treatment.
You might experience scarring, pain, persistent redness, itching and/or swelling, allergic reaction. Although Microneedling is a minimally invasive procedure, there is a risk of infection. It is your responsibility to fully and accurately disclose all medical history prior to any treatment. If you have any condition listed above, if you are taking any medication, and/or if you are allergic to anything, please bring it to the attention of your esthetician prior to signing this consent form.
Microneedling will not completely or permanently improve skin texture, tone, elasticity, hyperpigmentation, scars, fine lines and wrinkles. It is important that your expectations be realistic, and you understand that the procedure has its limitations. Additional procedures may be necessary to achieve your desired effects.
Although rare, there is a possibility Microneedling may induce undesirable results, including but not limited to skin sloughing, scarring, permanent pigment change, and/or other undesirable skin changes. Pigment/color change (hyperpigmentation) is very rare, but could happen due to failure to follow post treatment instructions such as avoid sun exposure for 1 to 2 weeks after treatment, apply daily SPF facial moisturizer, and avoid picking or peeling skin during the healing period.
I have been advised of the relevant information associated with this treatment and I confirm that I fully understand this advice. This includes advice about:
the aims/motivations for having the procedure and the desired outcome
the risks inherent in the procedure
the risks inherent in refusing the procedure
the risks specific to me
the expected benefits of the treatment
the potential disadvantages of the treatment
alternative procedures and their pros and cons - including the option of no treatment at all
any uncertainties about and the likelihood of success of the procedure
any follow-up treatment that may be required
CLINICAL PHOTOS AND VIDEOS: I agree to and authorise the taking of clinical photographs and videos. I understand that these clinical photographs and videos will form part of and will be kept with my confidential medical records.
I have been asked what information I want and would need in order to make an informed decision. I have been given the opportunity to discuss my desired outcome fully in order for me to make an informed decision.
I certify that I have read the above consent and that I fully understand it. I have been given ample opportunity for discussion and all my questions have been answered to my satisfaction. No new information has become available that affects my decision to have the treatment or my decision to consent. I hereby consent to this procedure. This constitutes the full disclosure and supersedes any previous verbal or written disclosures.
