Vivace® Direct – December 16th

Vivace® Tips and Tricks… The Importance of Always Performing a Pre Treatment “Test Spot”

The skin is constantly changing and adapting to the environment, skincare products, and to the treatments to which it is exposed. In addition, internal factors such as stress, nutrition, hydration status, illness, and medications can also impact the health and condition of the skin. A thorough assessment of a patient’s medical history, sun exposure, habits, medications, and supplements should be conducted prior to selecting candidates for a Vivace® treatment.

Once an ideal candidate is selected and scheduled for a Vivace® treatment, the next consideration is the selection of treatment settings. These settings include power level, depth and radiofrequency (RF) time. Once the treatment settings are selected, it is recommended to first perform a “test spot.” Regardless of whether it is your patient’s first or fourth Vivace®, a settings “test” should be performed before each treatment.

As a reminder, a 1MHz RF should always be selected for electrocoagulation and hemostasis.

Once a provider has selected the appropriate power level, depth, and RF time, it is recommended to perform 4-5 test shots in the temple region, with a 50% overlap technique. Next, assess the patient for skin tolerability, and make sure there is no “kickback” from the handpiece while performing the test shot. Kickback is an indication that the selected depth is too deep and should be reduced by 0.1mm until there is no further kickback felt.

It is a recommended practice to provide some sort of pain scale for the patient to gauge their level of comfort. An example of this is to have the patient rate their discomfort on a scale of zero (no pain) to five (worst pain ever). A good rule of thumb is to not exceed a pain threshold of 3, as the treatment becomes intolerable, and can also be associated with post-procedural tracking.

When assessing the skin, the proper settings should produce an end result of erythema, while the skin remains visibly flat. Another appropriate endpoint is that the patient verbalizes feeling “heat” while the treatment is being performed.

After performing a “test spot,” providers can keep their current settings, increase power level or RF time if the patient and skin can tolerate an increase, or reduce power but extend the RF time. Vivace® settings can be tailored to meet individual patient needs, which could change between treatments, and is a major factor to always perform a “test-spot” prior to starting a Vivace® treatment.

We will see you next time as we discuss more clinical education updates and useful treatment techniques. Please feel free to send any questions or comments to


Disclaimer: The Vivace® Guidelines are not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician, medical director, or qualified health provider with any questions you may have regarding a medical condition. All suggested treatment settings are for suggested use only.