RF micro needling- Vivace: Should this procedure be done by an MD, or would it be safe to have an experienced esthetician do it?

Question

Should this procedure be done by an MD, or would it be safe to have an experienced esthetician (but with only a few months experience with the Vivace) perform this? Is it somewhat robotic in nature, or is there room for operator error? Concerned about the possibility skin damage.

Larry S. Nichter, MD, MS, FACS · Answer

Thank you for your question. Depending on your state law requirements an MD, RN, MA or Esthetician can perform this laser treatment. The jcm and ms settings, treatment tip, and treatment level can all be customized to each patients specific needs and thickness of the skin so it is best to be treated by someone with great knowledge of skin type, skin disorders, and an overall comprehension of both micro needling and radio-frequency technology.  As long as the person performing this treatment has been extensively trained by Vivace's representatives and is equipped with the proper pre and post care products, I think you'll be in good hands. I hope this helps.

Tara Brown, MD · Answer

Hello - I am a board certified physician and I perform all Vivace procedures myself. Rather than tell a nurse or aesthetician what setting to use and then walk away, I continually assess the skin's response to the power and depth settings and I make adjustments in real time. I make extra and deeper passes if I am dealing with excess submental fat or heavy jowls, for example. I also customize my treatments based on the skin needs I see: I add PRP if there is an overall volume loss, I add skin lightening agents or other chemical compounds immediately after if I see melasma or sunspots. The procedure is expensive, and I want to make sure that every patient receives the best possible treatment to achieve their best possible result!  - Dr. Brown

Susan Fox, DO, RPVI · Answer

THis devcie being a class 2 device can be done in the office by an aesthetician, nurse, ma etc.  Usually in my office the doctor or nurse practitioner does the consult and determines the settings and the aesthetician or assistant runs the machine and knows what to look for.  THe procedure is very safe.  Each state is different with who can run machines.

Grant Stevens, MD · Answer

Hi and thanks for your question! In our office, my three providers perform these types of procedures, such as Vivave and all lasers and all injections. Jennifer is an NP and Carla and Cory are PA's. Not sure how other offices are setup, but when there is "energy" being delivered, the potential for issues, side effects etc is a little increased and our providers have 15+ years experience with non-surgical aesthetic treatments and lasers, etc. Additionally, in our office, my providers go through advanced training for these treatments, so we are sure to offer the patient the maximum benefit, safely.Best, Dr. Grant Stevens

Emil A. Tanghetti, MD · Answer

The laws on which professionals are able to perform treatments like the Vivace vary from state to state. In California, for example, estheticians are not permitted to perform these treatments, which in my opinion is prudent. At my clinic, Vivace treatments are performed by my RN, who has years of training in lasers and device treatments, in addition of course to her medical training as a nurse. These treatments are powerful and there should be physician oversight for individuals performing them.

Anita Saluja, MD · Answer

Hello, Vivace microneedling is considered a medical procedure. It should be performed in a physician's office under direct supervision. I can speak from our experience with Vivace. 1.  I review patient's case with our aesthetician. We discuss treatment settings for Vivace and number of passes, as well as expected endpoint to treatment. We discuss skin care pre and post treatment.  2. Technical portion of Vivace is then performed by aesthetician. Patient feedback on heat and/or pain is important. 3. Physician directly supervises the treatment so I or my colleague must be in the office. 4. Our aestheticians are also certified dermatology technicians (which requires additional training, coursework, and examination in skin). Hope this helps!

RF micro needling- Vivace: Should this procedure be done by an MD, or would it be safe to have an experienced esthetician do it?

Answers (6)

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