The world of medical aesthetics is ripe for questionable devices and risky procedures, many of which can lead to serious side effects for your skin and wallet alike. But the Plasma Pen is different.

While the procedure has been banned entirely in Canada due to the potential associated health risks, including pain, swelling, redness, sagging skin, hyperpigmentation, and more, it’s available in medical spas and doctors’ offices across the United States. Its Worth It Rating is currently 50% among RealSelf members who’ve tried it, making it squarely average but not necessarily terrible. Some doctors like it, while others don’t recommend it at all. What’s the deal?