New Year… New You!
June 12, 2022
Some of the most intimidating procedures we will ever perform are those that require color corrections and color removal. The reasons are many, starting with the liability involved with correcting work that was performed by another practitioner. We must remember that once we attempt to correct a problem, we become part of that problem. Although our intentions are good, we must know that we are entering dangerous waters.
There are other factors with corrective procedures we must be aware of. Emotions run high with these procedures. We must always keep in check and guard that our Hero Archetype (ego) or our Martyr Archetype, (I’ll save them, regardless of possible consequences) are clearly not in the way. We may feel badly that this client has a procedure that was done poorly, and this is a normal response, however, we must keep these emotions in check and weigh out the facts and the possible consequences. Keep your head on straight. We cannot save the world. So, with this in mind, let’s get down to how we can protect ourselves when we wish to perform color corrections.
1. Under-promise! Be sure your client understands that this is a process and we never know how things will lift out of the skin or how many color corrections they may need. Don’t commit to making things completely disappear. Also, if I feel I can possibly make something look worse, I say no! An example would be a color removal on a Fitzpatrick 5 or 6.
2. Evaluate your client! Observe your client’s anger. Is it more that they are just upset and angry that their procedure was done poorly or are they speaking in a vindictive tone that sounds disturbing? The latter may be a problem and all I can say is go with your gut whether to take this client on or not.
3. Choose only well-motivated clients. Is your client motivated to return for follow-up appointments and understands that this is a process? If not, do not begin to work on them! Do not be bullied either! I don’t care how far they drove or flew to get to me. I cannot speed up the process any faster than their skin will allow. If this is the case, I simply won’t start working on them.
4. Prepare your client for how the color correction or removal will appear and for how long. Will it be very red, swollen, a strange color when they leave you, etc.? Prepare them well. Generally, redness lasts about 2-weeks.
5. Who did it? You can decide whether it is important that you know who the initial practitioner was. Personally, I do not!!! What’s the point? If they intend to sue the practitioner, again, it is up to you if you wish to give them a head’s up and explain you are attempting to make things better.
6. Be sure you know the base color of each pigment you will be using for your color corrections. You can place your pigments on white paper, then run them under water to see what color remains. If you place a brown pigment on white paper, run it under water and it leaves a pinkish stain on the paper, this pigment has a red or purple base which would be warm. You may be looking to take warmth out of a brow that is already pinkish. In this case, if you selected this pigment, you would be adding more pink, thus attain a purple hue. In the event you are not clear, then ask the pigment manufacturer for the undertone. If the manufacturer is not willing to share this information, it is wise to find a new one.
7. Document and photograph each step that you are about to perform on this client. People tend to forget how they first came into you and the progress you made. Some corrections will take more than one application of the corrective color or colors. Document the machine, needles, movement of the needles (circular or fanning motion, pointillism, etc.), pigments, topical anesthetics and most
importantly, post procedure care. A change in needles can create an entirely different result than your desired outcome. If you started with an 7-round and didn’t document it and proceeded with a 3-round needle on the subsequent visit, you will most likely achieve a more intense and cooler (grayer) color. A 3-round needle, being finer, will travel deeper into the skin, depositing color differently, with less warmth and more cool intensity.
8. Education, Education and Education, is what I recommend before performing these procedures. I have heard horror stories of practitioners attempting corrections using white or primary color pigments. Color corrections and permanent camouflage require an exclusive and specialized education, since intra-dermal color theory, regarding these procedures, has its own set of rules.
9. Don’t give it away! Here are some ideas on fee schedules for color corrections. Demographics play a large part in this but what I really don’t like to see happen is that you undercharge because you feel badly. You deserve to be compensated for your work, as much as that initial practitioner was. You paid for this education, your materials, your rent, not to mention your time. A reasonable fee for the initial visit, where you consult with the client and patch test the area for color, can be minimally, $150.00 to $200.00. This could take 30 minutes to an hour. By the time you turn over your room, you possibly could have done a brow procedure for $500.00. I truly am not hard-nosed, but I am trying to make a point. Many corrections take more than one treatment. A fee for each visit is the safest way to go! Then, you know you will be compensated with each correction treatment. On the other hand, don’t gouge your clients. You want them to remain with you and elect other procedures. This is intended to become a long-term relationship.
Remember…Your client can go back to the initial practitioner and ask that the removal be paid for by that practitioner’s insurance. Don’t you take the hit!
It’s a great idea to develop a relationship with a skilled laser specialist in the event you cannot lighten or remove an area or areas.
Remember, you cannot cover a dark concentration of pigment with a light color pigment. Worse yet, you will prevent this person from having laser removal, since the light color will likely have titanium dioxide and will turn black upon contact with a laser.
When you are performing a correction, be sure that you only use the corrective color on the exact location of the wrong color, or you can create a new disaster. For instance, if you are using a bright orange to correct blue dots in lips, do not use the orange on the area that is not blue, or you will then create orange areas, that will require further correction.
“Documentation, Documentation and Documentation,” to quote Pati Pavlik, and part of that is photographing this client. Invest in a digital camera that allows you to photograph the integrity of the skin in the area that you will be correcting. You want to be able to see the porosity and actual condition of the skin. In the event the former practitioner gouged out tissue or created visible scarring when performing the initial procedure, you do not want to be held liable, please understand that you can and will if this becomes a legal matter. Photograph this client before you touch him/her, and photograph from a few angles so that the integrity of the area is clear. If an area is scarred or disturbed in any way, a good idea is to write this out clearly on the consent form and have them sign it. If this area is considerably scarred or gauged, do not touch this client. This should be considered an exception to the rule. You can’t fix this! Further trauma can only result in further scarring and damage and you will become part of it.
Here is a question that I often hear, often. Do you inform the initial practitioner that their client is seeking correction in your clinic? This can be viewed several ways. There really isn’t a clear answer for this question, since there are so many variables. First, I do not approach the client with, “Who did this.” I will gently ask if the procedure was performed in the area. They may not offer the name, but they generally do. If I know the practitioner, and they operate ethically, I will call them once the client leaves, to let them know that their client has come in, seeking correction. I always preface that with the fact that we can never please everyone (and we can’t) and minimize the issue. The last thing I want to do is make a fellow practitioner feel incompetent. I have found that a supportive relationship with fellow practitioners has always been beneficial, for all involved, and I’ll tell you why. The initial practitioner now has the option of calling this client in an attempt to make good and make this client happy. This only promotes good will, whether the client allows an attempted correction or not. The initial practitioner may inform me that they do not want this client back in their office, for any reason, or that they just aren’t comfortable attempting a correction. I also have the opportunity to ask the practitioner what pigments were used, and possibly a heads up on some difficulties that they had with this client. In my mind, it shows respect and support for my fellow practitioner. When the client returns and I mention that I spoke with their practitioner, this communication can really disarm the client. This sends a message that we are a united front, all working to make this client happy.
* Remember to keep your words sweet, since you never know when you will be eating them! Someday, a fellow technician may have one of your former clients in their office, so imagine how you would want your fellow practitioner to handle the same situation.
– Rose Marie Beauchemin-Verzella, CMI, CPCP
