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INFORMED CONSENT & POST TREATMENT CARE:

BBL

Purpose and Background

BBLTM is an innovative technology that treats skin conditions associated with aging and active lifestyles. BBLTM offers safe, FDA cleared option for sun damage, anti-aging and skin rejuvenation. BBLTM energy allows us to precisely treat age and sun spots, pigmented lesions, vascular lesions (small vessels), freckles, rosacea and uneven skin texture. The light energy delivered by BBLTM will gently heat the upper layers of the skin. The heat absorbed by the target areas will stimulate your skin cellist regenerate new collagen. This process will make your skin smoother, more vibrant and younger looking. In addition, the photo thermal energy will eliminate fine vessels that cause redness and will reduce unwanted melanin that produces pigmented lesions. BBLTM can also be used to target unwanted hair. 

The purpose of this consent form is to make you aware of the nature of the procedure and its risks so that you may decide if you would like to move forward with the treatment.

Alternative Treatment

Always remember that BBLTM therapy is an elective treatment and that there are alternative treatments such as no treatment, topical skin care products, chemical peels, microneedling, among others.

Procedure

BBLTM is administered by a Licensed Aesthetician or RN. Treatment begins with a consultation which includes Fitzpatrick Skin typing and a test patch. During the treatment, each pulse sends a beam of light through the skin. A flashing light, audible tone and a mild sensation on the skin will occur when the hand piece is being puled and light is being absorbed. Generally topical anesthetic is not needed; however, your provider may choose to use some on more sensitive areas. Various cooling methods keep the light pulses mild and safe. This allows for a more comfortable treatment. Your eyes will be protected with safety shields or goggles.

The number or treatments required will vary from patient to patient and your provider will personalize a treatment plan based on the level of improvement that you desire. Although one treatment is beneficial, a series of treatments is usually recommended. After your initial treatment series (commonly 3-6 treatments spaced 4-6 weeks apart), periodic maintenance will be necessary to maintain your results. Your provider may also combine treatment with other popular aesthetic procedures to further personalize your treatment and enhance your results. 

For Hair Reduction

Concentrated pulses of light loosen the har and disable the cells responsible for new hair growth. Treated hair will continue to appear 7-30 days. At any given time, some hair follicles are in a growth phase and others are in a rest phase. Because of this, multiple treatments will be necessary to affect the growth of all the unwanted hair.

Risks/Discomfort

Prior to receiving treatment, you will need to inform the Licensed Clinical Aesthetician or RN about any conditions that you may have bearing on this procedure, such as any medical conditions and all medications that you are currently taking. Although every safety precaution is taken, common treatment-related reaction(s) may occur. Temporary redness and mild sunburn sensation that may last 2-24 hours but can persist in some up to 72 hours. Mild swelling may accompany this reaction and most often resolves in 2-3 days. Treatment for benign pigmented lesions and vascular lesions cannot be accomplished without producing some epidermal damage and this may take 2-4 weeks to resolve. Pigment changes - light or dark spots on the skin - lasting 1-6 months or longer may occur. There is an increased likelihood of coincidental hair removal when treating pigmented and/or vascular lesion(s) in hair bearing areas. Other potential risks include blistering, crusting, bruising, scabbing, swelling and failure to achieve the desired result.

Contraindications

BBLTM should not be used with patients who:

-have been exposed directly to UVA/UVB lamps (i.e. tanning beds) and sun exposure within 30 days prior to treatment.

-are sensitive to light or on medication that is known to increase sunlight sensitivity, such as Accutane and some antibiotics.

-have used Retin-A, Renova, Differin, Tazorac, tretinoin or products containing retinol, alpha-hydroxy acid (AHA) or beta-hydroxy acid (BHA) or benzoyl peroxide within 72hours.

-are pregnant

-have a history of seizures

-are using oral steroids, anti-coagulants and/or St.John’s Wort within 6 months of procedure. -have herpes simplex (1 or 2). A Valtrex prescription should be taken prior to treatment.

-are being treated for an active infection and/or lesion within target area. 

Which is 

Avoid the following after your BBLTM treatment: (please initial all)

Direct exposure to tanning booths or sun, excessive exercise (sweating may aggravate the treated area), chlorinated water, saunas, hot tubs, steam rooms, aggressive scrubbing, exfoliants, scrub brushes and or microdermabrasion for 7-10 days. 


 

Exposure to any of the above may cause complications. Contact Licensed Aesthetician if any of these occur. 


Most patients are pleased with the results of BBLTM, however, like other cosmetic procedures, satisfaction is not guaranteed. There is also no guarantee as to the results of this procedure and no medical claims are expressed or implied due to many variables, including but not limited to, skin condition, environmental damage, climate and patient medical history, as each case is individual. 


 

Consent

Benefits and risks of the procedure have been explained to me including alternative treatments. I have been provided with the opportunity to have any questions answered. I have read this consent and certify that I understand its contents in full. I have had enough time to consider the information and I feel that I am sufficiently advised to consent to this procedure. I further agree to follow all pre and post treatment care instructions as directed. I hereby give my consent to this procedure. 

POST TREATMENT CARE - PATIENT COPY

  • Strictly avoid any sun exposure to the treated area for a minimum of 7 days after the procedure. The treated area is more prone to sunburn and pigmentation change. Keep the area covered and use a sun block with a protection factor of 30+, and reapply ever 2 hours. Delayed blistering secondary to sun exposure has been noted up to 72 hour post treatment. Vigilant care just be taken to avoid sun exposure (tanning beds included) before and after the treatments to reduce the risk of color change. Sunscreen and/or sunblock should be applied when sun exposure is necessary.
  • Patient response can vary after a non-invasive laser treatment. Erythema (redness) is usually noted within a few minutes after the completion of the procedure. A slight sunburn sensation in and around the area treated is also normal and expected. These reactions can last from a few hours to days after treatment. A cold compress or an ice pack can be used to provide comfort if the treated area is especially warm and will help minimize swelling.
  • Until sensitivity has completely subsided, avoid all of the following:
  • Use of scented lotions or soaps, exfoliant creams (Retin-A, glycloic/salicylic and alpha- hydroxy acids), acne creams or gels, loofa sponges and aggressive scrubbing
  • Hot or cold water - wash with tepid water
  • Shaving
  • Swimming in pools and spas with multiple chemicals/chlorine and severe temperature changes.
  • Activities that cause excessive perspiration
  • Vitamin E, Aloe Vera or post-treatment ointment can be applied to the treatment area and may provide a soothing effect.
  • Post treatment discomfort is typically minimal but if the area is very uncomfortable, oral pain relievers; I.e. Extra Strength Tylenol or Advil, may be used.
  • Makeup may be applied immediately after the treatment as long as skin integrity has not been compromised and there are no signs of blistering.
  • If the skin is broken or a blister appears, in the unusual case of crusting of the skin in the treated area, apply an antibiotic ointment. Keep the affected area moist and avoid direct sunlight. Do not pick at these areas, this may result in infection or scarring. Contact the office immediately.
  • The treated area must be treated with care. BE GENTLE! Do not rub, scratch or pick at your skin. 

Date: February 22, 2026

6667 Vernon Woods Dr I Suite B-40 I Atlanta, GA 30328 I 404-354-5302
https://www.restorativeskincareatl.com

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