flexNT installation

Looking to purchase the flexNT as my 6th implant. I asked my primary care doctor about having her install it. But she seemed very aprehensive and I felt she thought I was literally insane. She said she will get back to me but they may not be willing to due to liability, ect.

My question is, have any of y’all had any luck asking a doctor to do the procedure? If so, how did you go about doing it?

Thanks.

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This is correct, but it’s completely up to the doctor to decide. To clarify what she means here, it means that if she proceeds, her malpractice insurance may not cover her for this elective procedure if things go sideways and you decide to sue. It is not that she is not allowed to do it… doctors can basically do anything they want… but it is a purely financial decision to risk her practice over a one-off elective procedure for a single “crazy patient”. This is a very important thing to understand, because it puts all the power into the doctors hands… and if they try to cop out by saying “sorry I’m not allowed”, that’s bullshit.

The point I’m making here is that you can alleviate liability with a legal waiver. Just look at any contract or even a professional services waiver that body piercers make everyone sign. There is a clear “hold harmless” indemnification clause that you should be more than able to replicate for the doctor in such a way that they should feel confident that you will not be in any position to sue them if things go sideways.

It is important to also note that these waivers do not alleviate negligence. I don’t think there is any form of contract that you can sign that would alleviate negligence. The whole idea of a waiver or contract indemnification clause is to indemnify a party or parties from unexpected repercussions and costs associated (including both financial and even loss of life), but negligence is an almost willful disregard that practically ensures a bad outcome, and you cannot sign that kind of thing away. So, if the doctor installs this thing for you and it gets infected and / or something terrible happens, as long as they were not negligent (they used dirty gloves and a rusty scalpel), then the waiver should hold… but if you go to them for treatment and they tell you to walk it off or something and not address the infection and you lose your hand, then that is negligence and it would open the door for a malpractice lawsuit that their insurance company would likely not cover because this was an elective procedure to install something that is not FDA regulated into your body… so you can see where they are coming from.

My point is, offer to supply and sign a solid indemnification waiver. Tell them “I was talking with some of my professional body piercing friends and they all use waivers, and I would be more than happy to supply and sign one to drastically limit your liability exposure.” … see what they say. Also, I would tell them this now, before they come back with their mind made up.

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Wonderful advice! I really appreciate the time. I messaged her back. So waiting to see what she says.

When you order the flexNT does it come with any numbing agent by chance?

It does not, but an actual doc will have definitely have this available. They may also use a scalpel, dermal elevator, and sutures method… so definitely lidocaine or some numbing agent will likely be used as well.

I heard back from my doctor. They refuse to do it. I guess my next option is to look into private practices

Ah interesting… were are you located? It kinda makes more sense if it’s some kind of NHS where the doc is actually a gov employee vs a private practice doc… maybe they actually can’t do it.

Central Texas.

I’m going to start emailing local private practices near me and see if I have any luck.

Hah… I’m confused now… was this a VA doc or something? How is your doc not a private practice doc? Even hospital docs are, in essence, private… but anyway… shopping around is a good plan :slight_smile:

Not a VA. I guess maybe technically they are private practice lol. I was referring to maybe asking like urgent cares ect.

And thanks. Worst case my piercer said he could do it. It’s not that I doubt him, is just rather have a doc if at all possible. Or someone who has actually done it before.

Have you considered a needle installation?
You Piercer may be more comfortable with that…

Yeah I considered it. But I feel scalpel would be the easiest and quickest

Fair enough.
I have no need for a flex at the moment, but if/when I do, I will give the needle install a crack. Sounds easy enough, what could go wrong?
I will also ensure I video it and upload it.
I am yet to see one done…

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I got my NeXT installed at a tattoo / Piercing shop. They used a scalpel & dermal elevator (rather than the DT injector). Look for one that specializes in ‘body modifications’

I have a piercer that does all my regular implants. But the flexNT is a bit more involved. Which makes me want to seek out a doctor perhaps.

I have a promising lead. Had a Dr call me this morning and was curious. Explained what it’s about and answers whatever questions she had. She said she will do some research and then call me and let me know if she feels comfortable doing it.

So fingers crossed.

In fact, it is not easy nor quick to use a scalpel… however your doctor is probably much more comfortable using one with a dermal elevator to incise and make the pocket. The needle approach, once mastered, is literally a speedy 5 seconds from start to finish. The scalpel method could take several minutes, and will require sutures after to close.

Several things :slight_smile: The biggest difficulty people seem to have is the bevel. If you keep the bevel up, the point will be down and it will collect quite a lot of skin inside the needle as it goes in. Once you’re past the back of the bevel however, the point will be down and away from the underside of the dermis, so risk of protruding back out through the skin is low as you insert the needle. If you keep the bevel down, then inserting into the skin is much easier, but the point will be up right under the dermal layer, so it is absolutely critical you keep the skin in front of the point pulled up as the needle is inserted, or it will poke right back out again.

We are exploring a rotation approach wherein the bevel is inserted facing down, but once fully under the skin, the needle is then rotated as it is inserted so the bevel ends up facing up with the point down. This approach combines the best of both worlds, but requires finesse and a keen understanding of spacial dynamics and procedural correctness to do properly.

Other risks include opening or completely severing a major blood vessel, infusion, and other nasty things… so, as always, definitely work with a professional to perform any installations.

Attached, for informational purposes only, is our professional guide for needle based flex installations.

VivoKey Flex Device Installation Procedure Guide.pdf (517.4 KB)

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Thank you for the information. I feel like a stupid monkey sometimes, but knowing you’re here to give us correct information is invaluable. If this doctor decides she doesn’t want to do it, I’ll go with my piercer.

I’ll be purchasing the flexNT sometime today.

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Glad to help! It’s nothing special, just experience :slight_smile:

Amal

Oh PS… the flexNT is 8mm wide in total with no wedge shape… the 7mm wide start of the wedge shape of other flex devices helps needle installation a whole hell of a lot. With the flexNT, the installer may need to kinda jam a corner in first, then pry it into the incision, if you know what I mean. Alternatively, the blade of the needle can be used to slightly open or widen the incision once the initial pocket is created. I’ve installed a few flexNT with a needle and it’s not easy.

Alternatively we are exploring the idea of adding a little wedge start shape to the flexNT… it’s extra material though that exists on one side for no other purpose than to make needle installations easier… so some people may not like the idea of extra useless material going in.

Final note… the needle method is really not suggested for difficult area installs like the finger. Fingers are delicate and difficult to work with and definitely requires a very steady professional… preferably a medical doctor or hand surgeon… in fact, hands are so difficult that most general docs or even general surgeons won’t even touch them and refer you to a hand surgeon.

Yeah I was thinking the finger. Seems to me like the best place for ease of use.

What other locations would you reccomend?

Back of the hand or knife edge also seem to be common. The flexNT has different placement concerns than the x-series injectables. Mainly you want to put it in a place that won’t have much skin tension, but bone is of little concern. The finger is a decent place but difficult to install there… and you need good sized fingers to fit it.