MICRONEEDLING WITH OR WITHOUT RADIOFREQUENCY CONSENT FOR TREATMENT
Description of Microneedling with or without Radiofrequency Procedure
Microneedling with or without radiofrequency (hereinafter referred to as the “Procedure” or
“Treatment”) is an elective procedure that is intended to allow for controlled induction of the skin’s selfrepair mechanism by creating micro-injuries and optionally applying radiofrequency energy. This stimulates new collagen synthesis and strengthens the fibro septal network. The intended result is smoother, firmer, and younger-looking skin.
This treatment can fractionally remodel and contour the face and body. By penetrating deep into the skin and optionally into the fat layer, the treatment helps reshape the aging face or body for a more sleek and rejuvenated appearance, and is suitable for all skin tones. The procedure is normally completed within 30–60 minutes depending on the treatment area.
Effects of Microneedling with or without Radiofrequency
After treatment, the skin may appear red and flushed, similar to a moderate sunburn. You may also experience skin tightness and mild tenderness in the treated area. Redness typically subsides within 24– 72 hours. Mild swelling and skin peeling may also occur. A sandpaper-like texture, pinkness, or microbruising, pattern like temporary scars in the same pattern as the device handpiece, is normal and usually lasts 2–7 days but may persist longer for weeks to months in some cases.
Precautions and Warnings
Precautions must be taken in the following situations:
Discontinue retinoids, autoimmune therapies, or other skin treatments at least 24 hours before treatment, as directed by your physician.
Avoid treatment on areas with active acne, rosacea, inflammatory skin conditions, open wounds, or herpes simplex outbreaks (requires medication per doctor’s orders).
Avoid if you have a history of metal or skin allergies, recent cosmetic procedures (surgical or injectable), or sunburn/tanning in the past two weeks.
Fitzpatrick skin types V–VI may be at higher risk for pigmentation issues.
Topical lidocaine and tetracaine are used during treatment and are contraindicated if you have known allergies. Undetected allergies may result in itching, swelling, shortness of breath, or other reactions.
Contraindications
This treatment is not advised for patients with:
Keloid scarring
Chronic skin conditions (eczema, psoriasis)
Actinic keratosis
Herpes simplex history
Hemophilia or diabetes
Raised moles, warts in the treatment area
Absolute contraindications include:
Scleroderma, collagen vascular diseases, cardiac abnormalities
Accutane use in the past 6 months
Blood clotting disorders, active infections, facial melanosis, malignant tumors
Immunosuppression, pregnancy or nursing
Use of blood thinners, corticosteroids (within two weeks), or with chronic liver disease or porphyria
Risks of Microneedling with or without Radiofrequency
General Risks:
Bleeding: Rare, minimal pinpoint bleeding may occur
Infection: Uncommon, but may require antibiotics if it develops
Scarring: Rare but possible
Damage to deeper structures: Extremely rare, may involve temporary or permanent effects
Other Potential Side Effects:
Bruising, puffiness, pain, warmth, or itching at the treatment site
Hyperpigmentation or hypopigmentation
Nerve injury (temporary or permanent numbness, motor/sensory changes—rare)
Needle shock (e.g., nausea, fainting—rare)
Allergic reactions to anesthesia
Delayed healing or collagen response, especially in older individuals or those with lifestyle factors (e.g., sun exposure, smoking, poor diet)
Mental Health Considerations:
Patients should have realistic expectations.
Emotional stress from complications or unsatisfactory results is possible.
Results vary, and multiple sessions may be required.
Long-Term Considerations
Treatment does not stop the aging process or guarantee permanent results. Future procedures may be necessary to maintain benefits. Results can be influenced by aging, weight changes, sun exposure, and other external factors.
Use of Anesthesia
A topical numbing cream containing lidocaine and tetracaine is applied 30–45 minutes prior to treatment. This may cause temporary numbness. While uncommon, allergic reactions to the anesthetic may include itching, redness, swelling, respiratory distress, or seizures.
Informed Consent
I have reviewed this Informed Consent Form and understand the risks and benefits of microneedling with or without radiofrequency. I have had the opportunity to ask questions, and they have been answered to my satisfaction.
I understand:
I may not see immediate results.
Additional treatments may be necessary.
Positive results are not guaranteed.
There are risks of complications and side effects.
This is an elective, non-insurance-covered procedure.
I have disclosed all relevant medical history, medications, allergies, and skin products I am using. I voluntarily elect to undergo this procedure and give permission to Dr. Boonipat and the staff at FacePlus+ Plastic Surgery Institute to perform the treatment.
THIS CONSENT FORM IS VALID UNTIL ALL OR PART IS REVOKED BY ME IN WRITING.
My Signature below evidences and confirms that:
I have read and fully understand the above paragraphs.
The procedure has been adequately explained to me.
All my questions have been answered.
I voluntarily authorize and consent to the procedure.
I am a competent adult (18 years or older) and sign this consent of my own free will.