CONSENT FOR PERMANENT COSMETIC PROCEDURE

Procedure: Ombré Brows

1. I hereby authorize DIANA POLLARD OF DAUNTLESS BEAUTY to perform the elective cosmetic pigmentation procedure understanding that this procedure is for cosmetic purposes only and not for health reasons. If any unforeseen conditions arise in the course of this procedure calling for his/her judgment for procedures in addition to, or, different from those now contemplated, I further request and authorize him/her to do whatever necessary in the circumstances. I am aware that no guarantees have been made to me concerning the results of the procedure(s).

2. I also understand that the permanent skin pigmentation procedure carries with it the possible complications and consequences associated with this type of cosmetic procedure, which includes risk of infection, scarring, eye damage, inconsistent color, hemorrhage, and possible spreading, fanning or fading of pigments and or allergic reaction to any products used. I understand the actual color of the pigment may be modified slightly due to the tone and color of my skin

3. I fully understand as with all such procedures that this is not a science but rather an art and that anything that can go wrong may go wrong. I request the permanent skin pigmentation procedure, appreciating and accepting the permanency of the procedure as well as the possible complications and consequences of the said procedure(s).

4. For the purpose of documentation and the advancement of cosmetic education, I consent to the admittance of observers and “before” and “after” photograph of said procedure/s. I also give my consent for the photos to be used for advertising purposes.

5. I understand that Permanent Cosmetics or any other tattoo should be considered permanent: that It can only be removed with a surgical procedure: and that any effective removal may leave scarring. These procedures should not be performed on skin surfaces which have sunburn, rash, pimples, infection, open lesions, or other unhealthy conditions. Permanent Cosmetic procedures will not be performed on anyone impaired by drugs, alcohol, or impaired in any other way. These procedures may not be performed on a pregnant woman unless approved by a physician.

6. I understand that the use of acne treatment products including face wash, toners, and moisturizers with the active ingredient Benzoyl Peroxide will cause my permanent procedure to fade rapidly and change colors.

7. It is my understanding that the inks used in my procedure are not FDA approved

Home Care &
Healing Instructions

 (FOR POST PROCEDURE AND AFTER ALL TOUCH-UPS)

IMPORTANT! Some redness, swelling, light bruising and slight itching during healing process post procedure is normal. If you experience heavy itching, extreme swelling, blistering, or any other complications within the first 24 hours, post procedure please consult with technician. If symptoms continue, or you experience abnormal swelling, redness, or shortness of breath/trouble breathing, go to nearest Hospital/ER immediately, you may be having an allergic reaction to the pigment.

General instructions for post procedure for all permanent make up application(s):

-This will be a dry heal, please follow these instructions to prevent infection.

-Do not use any makeup, tinting of brows or makeup remover for the first 7 days on your brows and no makeup on the face for the first 24 hours.

-Be sure to sleep in clean linen. Swipe out your pillow cases every 2 days while healing.

-Do not touch, rub, pick, scratch or traumatize the procedure area(s) with your fingers as it may cause an infection due to bacteria, remove pigment, and/or cause scarring. By doing any of these, you may also run some pigment out of the brows

-No Neosporin, A&D ointment. Vaseline or Aquaphor.

-NO washing of the brows, do not allow shower head to spray directly on the brows, keep dry at all times. Allowing brow to get wet will reopen the wound and allow for bacteria to enter. (7-10 Days) Please keep and reuse your shower brow shield.

Make sure to avoid ALL the following:

-Excess sun exposure, increased sweating, sports, work outs, swimming, chlorine, hot sauna, hot bath, jacuzzi, sun tanning and salon tanning for 7 days!

-Any tasks related to heavy household cleaning where potential airborne debris may infect the procedure area.

-All laser or chemical treatments or peeling, and/or any creams containing Retin-A or Glycol Acid on face and neck. (30 days) Or risk damaging integrity of skin and/or possible fade your color.

-No facials for at least 2 weeks. Basic facial will be allowed after the 2 weeks. Avoid brow area.

-Fragrant soaps and fragrant makeup.

-Drinking excess alcohol, it may lead to slow healing of the wounds.

-Driving open air vehicles such as convertibles, boats, bikes or motorcycles.

-To preserve color for a longer time frame, always use a “total sun block” sunscreen, once the area is healed.

-Please no gardening and limit your pet exposure to prevent infection.

-REMINDER: If after care is not followed correctly, the healing process will be delayed and results will not be as expected.

Most permanent makeup procedures are a 2-step process. Results cannot be determined until the touch up application is completed. The touch up is intended to fill any discoloration caused by the healing and

shedding process.

HEALING SCHEDULE

Week 1

• Day 1-2: Color is 20-40% darker then what it will look like healed. Don’t freak out. Color is more solid and crisp. Mild swelling, light bruising, redness, and discomfort will subside. Do not touch otherwise.

• Day 3-7: Outer skin healing and exfoliation begins. Top layers of skin may shed, causing excess pigment to flake away. DO NOT pick at the peeling skin or scabbing, you will end up removing all pigment. Skin may begin to itch. DO NOT scratch!

Week 2

• Day 8-10: Flaking is final stages. Color may look gray, light or spotty in some cases. It may temporarily disappear, only to reappear later.

• Day 11-14: Skin begins to normalize again. Remember, no touching or picking.

Week 3

• Inner skin healing begins. Color will start to come back after disappearing or looking gray, light and/or patchy. Color begins to soften.

Week 4-6

• Inner skin healing reaches final stages. Color continue to soften.