Tixel Consent Form

Tixel is a skin rejuvenation treatment that uses a hot metal plate to deliver heat energy to the skin in a safe and effective manner. Tixel is gentle and safe to use on delicate areas such as the upper and lower eyelids, whole face and neck and decolletage.

An initial session of 3 Tixel treatments is advised, 6 weeks apart. Most people who have this complete a session note clinical changes 3 months post treatment including improved skin tone, clarity and texture, reduced scars and fine lines, healthier skin and reduction in laxity of skin around the eyelids. Note to address laxity of eyelids, 5-6 sessions may be required. We advise a session every 9- 12 months to maintain your results.

I certify I am over the age of 18

I understand the nature of my condition, the nature of the procedure, the alternative treatments available, and the benefits to be expected compared with alternative approaches.

I understand that optimal results are achieved only with a series of treatments and that I will not see optimal results after one treatment. The need to complete a treatment plan has been fully explained to me. Just as there are benefits to the procedure proposed, I understand that this procedure also involves risks.

I understand that serious complications are very rare but are possible. 

Common side effects include temporary slight swelling and “pinkness” (similar to a mild sunburn). The temporary side effects generally last a few hours but may last 1-2 days. Bronze micro-spots usually appear after 1-2 days and will last 1-2 days until they flake off. 

For treatments with very aggressive settings, some patients might experience mild exudate and flaking/peeling of skin in the aggressively treated area. Other potential risks include milia/acne or Herpes Simplex breakout, itching, pain, or minor infection. There is a rare possibility of burn, blistering, erosion, or a scar at the treatment site may develop.

I recognize there are no guaranteed results.

This form is designed to provide you with the information you need to make an informed decision on whether or not to have a Tixel treatment performed. If you have any questions or do not understand any part of this consent, please do not hesitate to ask us. 

“Before and After Instructions” have been discussed with me. The procedure, as well as potential benefits and risks, have all been explained to my satisfaction. I have had all my questions answered. I freely consent to the proposed treatment.

I have read and fully understand this agreement and all information detailed above. I understand the procedure and accept the risks. I agree I will assume the risk and full responsibility for any and all injuries, losses, side effects, or damages which might occur to me while I am undergoing this procedure. I do not hold the technician or the company, Bossy Glam Studio Inc, responsible for any of my conditions that were present, but not disclosed at the time of this procedure, which may be affected by the treatment performed today.

By signing below I give my informed consent to Bossy Glam Studio Inc to perform the procedure, Tixel, today.