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Micropigmentation New Client Consent

Please fill out the following form
in order to participate in our activity.

Emergency Contact Information:

Have you had any form of non-invasive cosmetic treatment in the past 2 weeks that would interfere with your treatment?
(Examples: botox, fillers, peels, laser treatments)
Are you currently taking any medication that may interfere with your treatment with Wen Beauty?
Are you currently pregnant or breastfeeding? (Please circle all that apply)
Do you sweat a lot when exercising?
Do you smoke?
Are you Allergic to any of the following? (Please Check all that apply)
Are you Allergic to any medicine, lidocaine, benzocaine, tetracaine, antibiotics, foods, or other substances?
Have you ever had any recent surgery on area being treated by Wen Beauty?
Please indicate if you have ever developed/been treated for any of the following conditions (Please circle all that apply)
Read & Acknowledge-

Micropigmentation always leads to skin injury. Therefore it is extremely important to carefully follow the aftercare instructions allowing your skin to heal without any complications. Inadequate care in the healing phase of the skin will lead to poor results and/or infection.

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  • Despite the application of the most advanced and top-quality pigments, allergic reaction are possible but rare.

  • During/after the treatment, temporary swelling, redness, and or itching may occur.

  • Depending on the skin structure, after the first treatment, small scabs with a loss of color intensity may occur.

  • In the first seven days: eyebrows, lips, and eyeliner, areola, and/ or scars will be 40% darker and 10-15% thicker.

  • The pigment is absorbed differently due to differences in the skin quality, thus there is no warranty for the treatment success.

  • I understand the permanent skin pigmentation procedure carries with it known and unknown complication and consequences associated with this type of cosmetic procedure, including but not limited to: infection, allergic reaction, scarring, inconsistent color, and spreading, fanning or fading of pigments.

  • Depending on the skin structure, it should be noted that change in the color intensity is possible and that one or more additional “TOUCHUP” treatments will be required for satisfactory results. I absolutely understand and accept that such procedure is a process, often requiring multiple applications of color to achieve desirable results and the 100% success cannot be guaranteed.

  • I understand that positioning of my procedures can be affected if I have elected or wish to elect cosmetic surgery, Botox, or Restalyne, and I assume this responsibility.

  • I am aware that if I am to receive an MRI after the procedure, I must tell the Radiologist that I have iron oxide permanent cosmetics.

  • If I am a lens wearer, I realize that I must keep my lenses out the day of an eyeliner procedure.

  • I realize this is an elective cosmetic procedure and is not medically necessary. It has been explained to me that the following possibilities may occur:

  • Minor and temporary bleeding, bruising, redness or other discoloration; swelling; fever blisters on the lip area following lip procedures and/or fading or loss of pigment.

  • I understand that many lasers & IPL’s (Intense Pulse Lights) including those used for hair removal, anti-aging, Photo Facials, removal of lines may or will turn permanent make up dark or even black.

  • I agree to inform my artist or anyone operating such that I have permanent make up.

 

Eyebrow Aftercare

-Keep eyebrows clean for the first 48 hours by applying the following care:

-Minimal water is required for best healed results for the first 48 hours.

-Spritz your desired hydrosol cellular mist to full face including eyebrows am/pm post procedure for cooling relief for 14 days or until finished.

-Apply a thin layer of Beauty Balm on day one AM/PM for 14 days or until flaking is complete. Continue use for ultimate hydration of area.

-Minimize heavy sweating or working out for 3 days-heavy sweating will cause color to fade more than expected.

-Don't pick any flakes/scabs, let them peel naturally.

-Don't apply cosmetic makeup for 7 days post treatment or until full scabbing is complete.

-Don't touch your eyebrows with dirty fingers for the first 72 hours.

 

Lip Aftercare

-Apply the beauty balm or luxe lip treatment with a Q-Tip in the procedure area for the first 24-72 hours every hour on the hour. This will keep the area hydrated and accelerate the healing.

-Do not let the area dry out, keep hydrated all times. Check your lips every thirty (30) minutes, re-apply balm as necessary. Do not press or rub when applying ointment. Apply an extra heavy coat of balm to the treated area before bedtime, bath, washing of adjacent areas, and immediately upon rising in the morning.

-Avoid smoking during the healing process; smoking can alter the color chosen and may result on an undesired healed color 8 weeks after procedure.

-Toothpaste and mouthwash are considered "soap" and will remove lip color, so proceed with caution when using. When brushing teeth for the first three (3) days, coat lips with of beauty balm before brushing and use a minimal amount of toothpaste.

-Avoid smoking during the healing process; smoking can alter the color chosen and may result on an undesired healed color 8 weeks after procedure.

-After one week, you may resume all regular activities.

For the first two (2) days, use a straw when drinking liquids; avoid sandwiches, biting into fruit or foods that might cause friction to the lips.

-Do not use any lipstick or cosmetics on or near the treated area for seven (7) days.

-For at least four (4) weeks, you need to minimize exposure to the sun.

-Special care should be exercised while the treated area is healing. Under no circumstances should you pick, scratch or rub the treated area or attempt to remove the crusty material. Removing of the crusts may result in the removal of the actual pigment and/or infection may occur. It is important that this protective "cover" stay on during the healing process (three to six days).

 

*Note*

Swelling and some redness are normal the next day after the procedure for some clients. Shedding your color and outer epidermal skin is normal during the first 3-4 days following treatment. At the end of six weeks, your procedure should be healed. Please do not wait any longer than 10 weeks after the initial procedure to have your treatment 2 done.

 

Eye Aftercare (Lash Line Enhancement)

DAY 1-3: WILL BE SENSITIVE TO TOUCH -KEEP DRY - CLEAN WITH COTTEN ROUND & MIST  FOR 48 HOURS, SWELLING IS NORMAL. 

DOING COLD EYE COMPRESSES MAY FEEL GOOD.

-Keep eyes clean for the first 48 hours by applying the following care:

DAY 1-7: No makeup on the eye, eyelids, or lashes.

DAY 1-14: Spritz your desired hydrosol cellular mist to full face am/pm post procedure for cooling relief for 14 days or until finished. Apply a thin layer of beauty balm ointment with a Q-Tip in the procedure area after the first 24 hours am/pm.

DAY 1-10: Flaking process will begin.

WEEK 2-6: Lightening process will happen for a total of 30-45 days after each treatment.

-Don't pick any scabs, let them peel naturally.

-Don't apply cosmetic makeup for 7 days post treatment or until full scabbing is complete.

-Don't touch your eyes with dirty fingers for the first 72 hours.

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Extra Information:

Exposure to the sun and tanning beds can cause fading and discoloration of the pigment.

For further sun protection wear hats and sunglasses. Yearly touchups are recommended to maintain your results.

 

I have read and understand the above information

Signature Consent

By signing below, I agree to the following:

-I have answered these questions to the best of my understanding.

-I have been informed in detail by Catherine Wen of Wen Beauty, LLC about the specific risks of the skin treatments being performed.

-Catherine Wen of Wen Beauty, LLC cannot be held liable for any services or service outcomes performed by my chosen artist.

-I certify that I have been given the opportunity to ask questions and that I have read and fully understand the contents of this consent form.

-I agree on photo taking of the services being rendered that will be performed on me.

-I understand that these photos may be used to promote Wen Beauty, LLC for marketing purposes, education and promotion.

Thanks for submitting!

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