The consent has all the pre- and post-care recommendations and the exact text is here for your review
The VI Peel® contains a synergistic blend of powerful ingredients suitable for all skin types. VI Peel® will improve the tone, texture and clarity of the skin; reduce age spots, improve hyperpigmentation (including melasma), soften lines and wrinkles; clear acne skin conditions; reduce or eliminate acne scars; and stimulate the production of collagen, for firmer, more youthful skin.
Contraindications:
- Patients who are pregnant or who are breastfeeding
- Patients who have an aspirin, hydroquinone or phenol allergy
- Patients who have used oral isotretinoin (Accutane) within the past 6 months
- Patients who have active cold sores, warts, open wounds or history of herpes simple
- Patients who are undergoing chemotherapy and or radiation therapy within 6 months
- Patients with a history of an autoimmune (i.e. Lupus) or liver disease/disorder as well as any condition that may weaken their immune system
Agree and Understand:
- Prior to receiving treatment, I have communicated with the Practitioner about any conditions or medications that may contraindicate this procedure.
- I understand that there may be some degree of discomfort such as burning, stinging, redness, heat or tightness during and a week after the procedure.
- I understand that there is no guarantee of the final results of the peel. Occasionally hyperpigmentation may develop which may persist for a week or months after the peel.
- I understand although complications are very rare, sometimes they may occur. In the event of any complications, I will immediately contact the Physician/Clinician who performed the treatment.
- I understand if I have any acne condition in the skin, the peel may bring out oils and bacteria from below the surface and can cause an actual breakout.
- I understand that maintenance of VI Peel® treatments are necessary to maintain results as well as the recommended VI Derm® skin care regimen and SPF 50+.
- I understand the extended direct sun exposure including tanning beds are strictly prohibited before and after receiving the VI Peel®.
- I understand no activities involving excessive sweating can be done for 72-96 hours (exercise, sauna, hot tub steam room and that overheating may cause me to develop blisters or cause hyperpigmentation to worsen.)
- I understand that I must protect my skin with VI Derm® SPF 50+and avoid sun exposure during the 7 days exfoliation process.
- I understand that this is an elective cosmetic procedure.
- I understand that no other chemical peels, facial machine brushes or medical device (laser, IPL, etc) treatments may be performed on my skin until my physician/clinician releases me to do so.
The nature and purpose of the treatment have been explained to me. I have read and understand this agreement in its entirety. All of my questions have been answered to my satisfaction and I consent to the terms of this agreement. Alternative methods of treatment and their risks and benefits have been explained to me and I understand that I have the right to refuse treatment.
Please message me if you have any questions. This is a medical grade peel, and it is not to be taken lightly. Lastly, be ready to be amazed by the feel and look of the treated area. I love the VIPEEL!
Most common areas treated:
- Face
- Neck
- Decolletage (chest) and Neck
- Arms
- Back
- Hands
Common skin concerns:
- Sensitive Skin
- Early Signs of Aging (Ages 20+)
- Rough Texture
- Keratosis Pilaris
Product Benefits:
- Restores a more even skin tone
- Smooths away rough skin
- Reduces the appearance of fine lines and wrinkles
- Reduces the appearance of Keratosis Pilaris
Product Features
- Safe for all skin types
- Medium-depth peel
- Results within 7 days
- Safe to use for all Fitzpatrick types I-VI
VI PEEL PRECISION PLUS
Your Peel for Skin Discoloration
- VI Peel Precision Plus combats pigmentation with our Lighten Booster and fast acting Brightening Booster. This powerhouse formula effectively suppresses melanogenesis and promotes rapid cell turnover for improved skin tone.
For Skin Concerns:
- UV Induced Pigmentation
- Sun Damage
- Melasma
- Post-Inflammatory Hyperpigmentation
Product Benefits:
- Exfoliates and helps diminish pigmentation and textural damage to restore skin to its natural health
- Effectively penetrates damaged areas
- Promotes rapid cell turnover
Product Features:
- Safe for all skin types
- Medium-depth peel
- Results within 7 days
- Safe to use for all Fitzpatrick types I-VI
