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- PLEASE REVIEW EACH LESSON IN ORDER & COMPLETE CHAPTER QUIZ WHEN COMPLETE -

Post Procedure Warnings

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Minor Bleeding: 

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Minor bleeding is a rare occurrence when using plasma arcing devices for this type of application. Additionally, minor bleeding also occurs after the use of lasers for similar skin tightening applications including laser tattoo removal. 

Bleeding occurrence is particularly rare especially if the intensity of the treatment is very mild. The likelihood of minor bleeding increases as the arc duration increases, the power setting of the device increases or both. Please note that minor bleeding is not an indication that the treatment has not been carried out correctly as this can occur despite the type of device used, technique or intensity of the treatment itself. 

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Some degree of minor bleeding can occur even at very low-intensity treatments in those cases where fine vessels are present on the treated area especially on the upper eyelids. 

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The Carbon Residue: 

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As we have seen in mole removal or brown spot removal the carbon residues need to be purposely removed in order to accomplish the desired result. This is done by using a cotton pad wet with non-flammable antiseptic, such as Chlorhexidine Gluconate. 

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In the case of skin tightening and especially eyelid tightening, the carbon residues should not be purposely removed.  This is because throughout our extensive experience, we have seen that the best and fastest recovery is achieved when the carbon residues are not intentionally removed. This is due to the micro traumas caused by rubbing the cotton pad while trying to remove the carbon residues. Therefore, while performing skin tightening and especially eyelid tightening, do not intentionally rub the area treated with the cotton pad as done in other aesthetic applications. 

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If applying an appropriate sterile topical product soon after the treatment, including antiseptic, make sure you do not rub it on the area treated. Just apply the product very gently, including any use of sterile cream. 

No effort is made to remove the carbon residues. This is deliberate. 

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In case you have applied a sterile cream (most commonly a sterile soothing topical product), the carbon residue will mix with the cream making the cream brownish, this is normal. The carbon residues are sterile anyway, as you have cleaned and disinfected the area before applying the numbing product. 

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Immediate apparent skin retraction: 

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The immediate noticeable effect of plasma tightening is an apparent skin contraction. Please note that this is not permanent and not representative of the end results of the particular treatment session you are carrying out. The results will become apparent only once the area has fully recovered after the swelling has subsided and the scabs have fallen off or the peeling process is over. This immediate skin contraction can result in the fine lines to appear as though they have disappeared completely; however, this is not a permanent effect because this is simply due to the superficial dehydration effects of the plasma arcing. 

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Sometimes (in 40%) of the cases as the arc is applied the area around the skin reddens noticeably. This means that the skin reaction to the treatment can be quite significant and the swelling following the treatment can be quite intense. 

Swelling usually starts the day following the treatment and lasts up to 5 days. 

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Swelling and downtime: 

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Swelling is characteristic to eyelid tightening using plasma (or lasers) and it should always be expected after this type of aesthetic procedure. Swelling can be minimized using certain techniques but never completely avoided, because in order to produce the desired localized skin tightening a deliberate controlled burn has to be caused to the eyelids. Please note that the swelling should not be cured, because it is not a disease, and it is a direct transient consequence of the controlled burn caused by the aesthetic treatment. A common mistake made as aftercare treatment is the use of antihistamines to try and alleviate the swelling. However, this type of swelling does not respond to antihistamines. We recommend the patients take Bromelain on an empty stomach before having the procedure done. Bromelain is a homeopathic pineapple enzyme derivative used to help reduce swelling. 

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During the downtime some clients can experience a certain degree of discomfort. The degree of discomfort depends on the sensitivity of the skin to the treatment as well as the overall treatment intensity. The higher the treatment intensity the more the swelling and the discomfort which can be experienced by the client during the period of time in which the swelling is most pronounced. As the swelling start to subside so will the discomfort levels. 

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Swelling starts on the following day and usually peaks on the second day. The third or fourth day after the treatment the swelling usually starts to subside slightly and in most cases the swelling will have subsided completely on the fifth day.  The scabs will normally have fallen off by themselves on the sixth or seventh day after the treatment. The swelling intensity and discomfort levels are not only dependent on the intensity of the treatment but also the individual skin reaction. 

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In case of high-intensity treatments blistering can also develop. The fluid inside blister can also be transferred to the under eyelids (eye-bags). Sometimes the blistered eyelid can give up some fluid during the recovery period. This is when the aftercare is very important and it has to focus on avoiding possible causes of infections. This is simply done by keeping the area clean, avoid possible causes of infections, and applying the appropriate antiseptic twice a day. One again, swelling is a normal reaction to be expected after high-intensity treatment and it normally starts to subside three to four days after the treatment, by itself. We do not recommend high-intensity treatments because the risk versus the reward is minimal. 

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Plasma Device Mistakes

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Mistakes using plasma devices are rare, however, it is worth discussing the most common ones, so knowing them makes them recognizable and avoidable, altogether.  Generally taking proper training for each type of treatment is sufficient to have all the necessary knowledge in order to perform these aesthetic treatments correctly. The best way to avoid making mistakes using plasma devices is to: 

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→ Engage in appropriate training. The easiest way to avoid mistakes using plasma is studying the training manual and the instruction manual of the respective device you will utilize.  This may sound obvious; however, most mistakes are made by those who fail to read the manuals and do not study the training material regarding the relevant procedure before carrying them out.  

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→ Patch test. Patch testing an area is very important to prove that the area will not have an adverse reaction to the specific treatment. 

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→ Practice on the test product (orange) before carrying out any aesthetic treatments.

 

→ Always start using very low-intensity treatments in general and gradually increasing the intensity of the treatment as you deem fitting. 

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→ Informing clients well (using the appropriate informed consent forms) before going ahead with the treatment is also very important and can avoid surprises later.

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Infection

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Infection presents differently in lasered or plasma-arced skin. It appears blotchy and red. If beginning signs of an infection is suspected, send your client to their General Practitioner immediately to start antibiotics. This highlights the great importance of taking follow-up photos, so you can quickly help combat any possible complications. 

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Aftercare Instructions and Maintenance

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At home, the client should wash and rinse with a gentle cleanser, pat dry with a clean cotton cloth, being careful to gently pat and not rub the treated area. No makeup or any creams, other than what has been recommended, should be worn before the area treated with the plasma device has recovered completely.  

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How to reduce swelling and downtime: 

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  • We have investigated all possible ways to reduce the swelling period, the perceived down time and getting the discomfort to a minimum. It is important to emphasize that due to the very nature of this type of aesthetic treatment including those using lasers, swelling can be reduced but never eliminated. In order to minimize the downtime after any type of laser treatment for skin tightening, a soothing product is used in order to alleviate the burning feeling soon after the treatment. Any treatment focused to reduce the burning sensation and later reduce the swelling has to be carried out immediately after the treatment to be most effective – typically within 5 minutes from the time you have completed the treatment. 

  • We have found that if the treatment is carried out at low or medium intensity and an appropriate aftercare protocol is applied both soon after the treatment and at intervals a few hours after the treatment and the following day, the swelling is reduced to a minimum. If the treatment is carried out at the right intensity, the skin is not particularly sensitive, and the right product is applied, then the swelling is reduced to such a minimum that it is hardly visible and most clients do not feel any discomfort during the skin recovery period.  

  • Use of intense cold as a soothing solution.

  • Some technicians use ice packs as a soothing solution. This is an effective option used soon after burns of any type to soothe and decrease the adverse effects of the burn, and this is also most effective immediately after the burn has occurred. Hence, intense cold, is most effective if applied immediately after the aesthetic session has ended (within 5 to 10 minutes). 

 

It is important to note that this should be done using only the cleanest possible procedures in order to avoid dirt getting into the treated area. The use of inappropriately dressed cold packs on the treatment area can increase the likelihood of contracting an infection. If applying cold treatments as a soothing option the following day it will help to further reduce the swelling for up to 24 hours post-treatment.

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They should be placed for 10 minutes on and 20-30 minutes off. 

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Recommended protocol for pre-care and aftercare, is the following: 

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  • Pre-treatment starts 2-3 days before treatment: Twice-a-day, the client should take Arnica and Bromelain without food. Client Should start applying the fading gel after gently washing their face, twice a day. When going out into the sun, client should be applying sunscreen before and reapplying every 2 hours. 

  • Immediately post-procedure:  

  • Apply a topical cortisone to treated area. Then apply our highly moisturizing Placental Stem Cell Cream, followed by our Sunscreen Cream. The cream will also serve as a barrier, so application of ice packs can be placed at this time if need be. Do not wash treatment area for 24 hours.

  • Day 2-5:

  • The client should wash the area twice a day with a gentle cleanser, Rinse profusely with cold water (do not use warm or hot water to rinse). Continue to apply the fading gel and the cortisone twice a day, 3 days max. Apply the Placental Stem Cell Cream, every 3-5 hours, so that the area continuously feels moist. Wounds heal faster in a wet environment than they do in a dry. Apply the Sunscreen Cream, every 1 hour, if outside. If in doors, apply the Sunscreen Cream only before going outside.

  • Day 6-completion of healing:

  • Discontinue the use of cortisone. Continue the use of fading gel and Placental stem cell cream twice a day. Use the sunblock whenever outside, reapplying every hour.

 

As a reminder, we also recommend the client start the supplements 2 days before and continue the supplements until they are gone.

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Chapter 5 Quiz
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Chapter 5 Quiz
1. There is an immediate and permanent skin tightening effect, permanent and not representative of the end results of the particular treatment session you are carrying out.
2. A common mistake made as aftercare treatment is the use of antihistamines to try and alleviate the swelling. Does this type of swelling respond to antihistamine use?
3. Swelling starts on the following day and usually peaks on the second day. The third or fourth day after the treatment the swelling usually starts to subside slightly and in most cases the swelling will have subsided completely on the ________ day. 
4. Soothing solution that can be applied within 5 minutes of the treatment are:
5. Cortisone should be applied twice a day for ______ days max?
6. Wounds heal faster in a wet environment, than a dry. There will be less likelihood of scarring if moisture is always present.
7. Sunscreen must be used for how long after treatment? Because if not, the dots have a possibility of reappearing.
8. How long is sunscreen good for, once applied and intention is to go out in the sun?

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