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Vivace® Direct – November 16th, 2023

Safety and Side-Effects: How to Minimize Risks and Prevent Complications with Radiofrequency Microneedling

Vivace® Microneedle RF and Vivace Ultra™ are aesthetic treatments that can deliver impressive skin rejuvenation results when performed correctly. However, like any medical treatment, while minimal, there is the potential of side effects associated with the treatment. Safety considerations and strategies to minimize risks and prevent complications when offering RF microneedling are important for any health professional to provide the best patient experience. Here are nine (9) items you should consider:

1.  Proper Training and Certification: Before performing Vivace® Microneedle RF or Vivace Ultra™, ensure that you have received proper training and certification. Sometimes, this may include setting up a virtual Q&A with one of Aesthetics Biomedical’s Clinical Nurse Trainers. Other times, collaborating with internal practitioners practice or during round-table digital webinars may enhance device usage knowledge. Understand the device settings and the “why’s” behind every setting suggestion (ex: when to decrease RF power vs. RF time, etc.) and the recommended techniques (ex: keeping the skin taut and completing two passes within a section before moving to another treatment part, etc.). Continuous education and staying updated on best practices are essential as techniques, the way we view the device, and what we deem a great clinical outcome based on the target treatment concerns are constantly evolving.

2. Patient Assessment: Conduct a thorough patient assessment before recommending the procedure. Assess the patient’s medical history, skin type (ethnicity), and any contraindications, such as pregnancy, active skin infections, or a history of keloid scarring. Also, assess whether the patient has certain extrinsic or intrinsic factors that would contribute to a patient’s epidermal/dermal skin thickness and optimized skin integrity. This step helps in selecting suitable candidates or mitigating potential unwanted results (post-inflammatory hyperpigmentation or hypopigmentation, etc.) and minimizing potential complications.

3. Informed Consent: Obtain informed consent from your patients. Clearly explain the procedure, potential side effects, and risks. Make sure they understand the expected outcomes and that they have realistic expectations. Also, clearly explain why certain potential side effects can occur and allow a non-judgmental space for a patient to be able to express his/her habits that could affect an optimized treatment outcome (ex: not wearing sunscreen or using medical-grade skincare, constantly being out in the sun, allowing pets to get close-and-personal and lick the patient’s face, tobacco use, etc.).

4. Skin Preparation: Prepare the patient’s skin adequately before the procedure. If a patient is a higher Fitzpatrick Skin Type, consider pre-treatment with a topical cream that will decrease melanocyte activity. Immediately prior to treatment, cleansing and disinfection with two passes of at least 70% isopropyl alcohol and changing to clean gloves after touching something that is not clean (such as an iPad or drawer handles) are essential to minimize the risk of infection. Avoid performing Vivace® Microneedle RF or Vivace Ultra™ on skin with sunburns or open wounds and active acne should be treated last after all other non-acne treatment areas area completely treated (1-3 or more suggested passes depending on type of needle array and treatment concern).

5. Depth and Energy Settings: If available, the Vision Ultrasound Handpiece will appropriately determine epidermal and dermal thickness for each patient, so selection of needle depth is precise to each patient and treatment. If you haven’t yet upgraded to include the Vision Ultrasound Handpiece, selecting appropriate needle depth is based on many factors that determine a patient’s skin integrity and can affect epidermal/dermal thickness. Also, feeling “kickback” on the Precision RF Handpiece or seeing consistent pinpoint bleeding can indicate that depth settings are inappropriate for that patient if working toward collagen induction. Energy settings are based on the patient’s clinical endpoint of moderate erythema and edema and patient tolerance. Being precise with depth and understanding the target concern (ex: treating in reticular layer of the dermis for collagen induction or subcutaneous tissue to target adipose tissue) as well as understanding that the clinical endpoint and patient tolerance will guide you toward appropriate inflammation will help prevent too aggressive of settings that may cause superficial burns or PIH.

6. Hygiene and Sterilization: Maintain strict hygiene and sterilization protocols for both the treatment area and the equipment used. Safely dispose of needle arrays immediately after each procedure.

7. Cooling and Anesthesia: Consider using cooling methods and topical or local anesthesia to minimize discomfort during the procedure. Cleaning with a pass of acetone to decrease the stratum corneum prior to applying topical anesthetic for maximum absorption, waiting the appropriate time frame of at least 30 minutes, or using plastic wrap on top of the topical anesthetic are some examples that help lessen patient discomfort. This can also reduce the risk of adverse reactions as the patient is more tolerant of the procedure and you are able to deliver the treatment pulse in its optimal format.

8. Post-Treatment Care: Provide clear post-treatment instructions to your patients. Advise them on proper skincare, sunscreen use, and avoiding activities that could irritate the treated area or cause adverse effects such as keeping the treatment area from direct sunlight when driving home after the procedure or using car air conditioning to alleviate any post treatment discomfort. Incorporating the Soothe Mask and Boost Serum immediately post treatment will decrease the initial social downtime. Follow-up appointments allow you to monitor progress and address any concerns promptly.

9. Monitor for Complications: Be vigilant in monitoring patients for any signs of complications, such as infection, excessive redness, or unusual swelling. Usually this occurs with improper hygiene such as touching a public door handle and then touching one’s face, allowing pets to lick the face, not changing bedsheets and pillowcases frequently, etc. Promptly address any issues that arise and, if necessary, collaborate with other healthcare professionals for optimal care.

By prioritizing safety, proper training, patient assessment, and open communication, you can minimize risks and complications, ensuring a positive experience for your patients when Vivace® Microneedle RF and Vivace Ultra™ treatments are performed with diligence and care. Always remember that patient safety is paramount in aesthetic medicine, and a well-informed and prepared practitioner can help achieve optimal results while minimizing risks.

Disclaimer: Medical treatment of any adverse events is at the discretion and medical judgement of the treating practitioner and/or medical director. The suggestions or guidelines are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, medical director, or qualified health provider with any questions you may have regarding a medical condition. All suggested treatment settings are for suggested use only.

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