Questions and Answers About Permanent Makeup
Chicago - NYC - LA's Best Permanent Makeup by Jeffery Lyle Segal
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What is permanent makeup? Permanent makeup is a cosmetic tattooing procedure. It is also called "permanent cosmetics," "cosmetic tattoo", and "micropigmentation." They all mean the same thing. As with any tattoo, inert colored particles are implanted in the dermis, or true skin, beneath the surface of your skin. It is called "semi-permanent" in Europe and Australia because they want you to remember that all tattoos fade progressively from UV exposure, body chemistry, and macrophage activity. But we call it "permanent" in America because we want clients to know that unwanted work may not be completely removable if they don't like it without risk of scarring, if then. Because it will affect how you feel about yourself as well as how you look, you should take great care to select the right person to apply your permanent makeup.
What can you do with permanent makeup? Permanent cosmetics are mostly used to simulate conventional makeup for lips, eyes, brows and cheeks (although I personally do not recommend cheek blush procedures).
It can also restore lost skin color in flat, mature, hypopigmented (white) scars to make them blend better with the surrounding tissue, often imperceptibly. Damaged features, such as cleft lips and areolas after breast surgery, can have their appearance improved with color so that they look normal again. Lost brows, eye lashes, and even hair in the scalp can be simulated effectively with hairlike strokes of color.
What can't you do with permanent makeup? Permanent makeup should not be used to try to cover dark, red or brown scars, undereye circles, hemangiomas, or brown spots on the surface of the skin. It is not a cover up in the same sense that camouflage makeup would be. It almost never stays in vitiligo skin, and any attempt to recolor vitiligo skin with permanent makeup is considered experimental at the client's sole risk. It should not be used to color a mole black like a beauty mark, because it will interfere with the ability of a physician to diagnose any cancerous change in the tissue.
Who should get permanent makeup? Clients with difficulty applying their makeup due to poor vision or physical disability, sensitivity to perfumes and preservatives in conventional cosmetics, clients with active lifestyles, men or women with sparse lashes, missing brow hairs, thin or pale lips, asymmetrical features, burn survivors, cancer patients, women who just want to save makeup application time and wake up looking beautiful...in short, permanent makeup is for just about everybody!
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What should I look for in a permanent cosmetic technician? There are two leading professional organizations in our industry currently, the Society of Permanent Cosmetic Professionals, and the American Academy of Micropigmentation. Years ago, the first professional society was the National Cosmetic Tattooing Association. Each organization offers testing of the basic knowledge and competency of a member technician, and such certifications mean that a technician is conversant with generally accepted knowledge and practice within the industry. A technician will also have a certain amount of time in practice, and it's reasonable to expect that people in business longer have more experience.
But to create beautiful permanent makeup results requires much more than the above. This is an art as well as a science. What you are paying for more than anything else is the taste, talent and graphic ability of the technician. The average training course of permanent makeup technicians today is five days. That is not enough time to learn to be an artist. It's not enough time to train your hand and eye to work together, so that you can recognize whether what you've done is good or bad, and achive the results you intend to create. Student artists spend years copying the old masters in museums not because they want to replicate that work, but in order to train their hand and eyes to work together. It does not happen overnight, or without years of serious study and practice. My website page of Bad Work by Other Technicians, many of whom have years of experience making the same mistakes, attests to the problem.
Many people who do permanent makeup are nurses, doctors, cosmetologists, and others who have not necessarily put in the necessary time to become artists outside of their permanent makeup work. So, in many cases, what they think is attractive and natural looking may not be. You need to look carefully at the work of each individual to determine for yourself if their work is as good as they claim it to be. If such a technician also draw, paints, sculpts, or has years of conventional makeup experience, your odds of getting the desired result artistically are greater.
Why should I choose you over other technicians?
I started drawing when I was twelve years old, and learned to to makeup when I was in high school. By the time I got to college, I didn't take the makeup courses, I taught them! I spent many years doing special effects makeup for film, theater, TV and print, as well as conventional beauty makeup, honing my design skills, training my hand and eye, and creating complicated illusions with paint and color. By the time started doing permanent makeup in 1991, I had already been a professional makeup artist for ten years. I have now been practicing permanent cosmetics for twenty years, while continuing to work in conventional makeup, and teaching makeup at such major schools as Empire Academy in Costa Mesa, CA and the Cinema Makeup School in Los Angeles, CA. I know how to make you look your beautiful best with any medium. For me, permanent makeup is just another tool.
Within the permanent makeup industry, I am known as an expert in design. I created the leading training program on makeup design for permanent makeup, called "The Shape of Permanent Beauty." I am a former board member of the Society of Permanent Cosmetic Professionals, and a twenty year member of the organization. I also belonged to the earlier National Cosmetic Tattooing Association, and was certified as an Intradermal Cosmetic Technician by them in 1991. I have been the Cosmetic Advisor to the American Academy of Micropigmentation. I continue to work professionally in media makeup as well.
Leading doctors, aestheticians, and hair replacement specialists trust their patients and clients to me, and referrals are available upon request. You can trust your face to me as well.
Why not just go to a tattoo parlor?
Regular tattoo parlors normally have employees who are fine artists, and certainly they know how to put color in the skin. But there are certain differences which are extremely important.
The colors employed in regular tattoo are normally unmixed, pure, vibrant hues which do not resemble skin or hair color. The colors used in permanent makeup and sold to our industry are specially blended for our needs. A good permanent makeup artist must know a cool blonde brow from a warm blonde brow, and how to create the difference. A regular tattoo artist without permanent makeup training may have no idea how to do this.
Permanent makeup application requires all the knowledge of historical makeup styles and current fashion trends which a regular makeup artist would know, to create the look that's right for you in the long term. A regular tattoo artist may know how to transfer a design of a ship or a heart, but may have no clue how to shape an eyebrow or lipline.
Good permanent makeup should be designed to blend with your features, enhance their shape, correct asymmetries, and be unobtrusive when it's finished. Regular tattoo artists normally apply an independent design to a flat area of skin with no relation to the features (lips, eyes, or brows). So the way of thinking is completely different in the two areas of practice. As an example, I had one potential client call me hysterically begging for correction, because she went to a tattoo shop to camouflage scars around her areolae from breast implants. In permanent makeup, camouflage would mean recoloring the scar with a color matching the areola so it is unnoticeable. In the world of regular tattoo, a camouflage is normally a "cover up," where the artist applies something more obtrusive to disguise the tattoo underneath. So this conventional tattoo artist drew black circles around her areolae! Sure enough, you didn't see those scars anymore...but the client was devastated. In this case, the tattoo artist obviously wasn't very bright, all other considerations aside.
In a tattoo parlor, you may be given no anesthetics, which would make the procedure less comfortable and increase risk of injury or misplace pigment, particularly when it comes to eyeliner.
This isn't to say you can't get a good result at a tattoo parlor. There are also tattoo artists who have trained to do both conventional tattoo and permanent makeup who are very good, are members of our professional societies, use the materials and equipment intended for our industry, and understand the issues of both areas of practice. But it's up to you as the consumer to make sure you know what your technician's background is, and inquire how he or she approaches the work, before you let them work on you.
What do I get at your office that I don't get elsewhere?
First, you get me. That's hard to duplicate!
Also, I use the highest end equipment: The digital German cosmetic tattooing devices from Harmonix and Nouveau Contour. There's a reason my machines cost nearly $3000, and other equipment costs $300. Because the movement of the needle in this machine is so precise, without sideways fluctuation, it doesn not cause the unnecessary pain, swelling, and damage which may be caused by a lower end machine.
At the medispas, I have access to the best anesthetics to make you the most comfortable and safe during the procedure. Because they are enhanced with epinephrine, they shut down the surface capillaries to reduce bleeding and swelling to a negligible amount.
Finally, when I finish, I treat you with cold laser therapy. This is a red light that you don't feel, which makes the skin heal faster. It also reduces redness, swelling and discomfort.
The combination of the above means you will leave my office looking almost normal, and that you'll feel pretty when you leave instead of wanting to hide for days.
Do I need a consultation in advance?
No. I'm happy to talk with you on the phone or chat via email. If you want to send me pictures of yourself, I'm happy to talk to you in advance about what I recommend for you at no charge. If you really feel you need a consultation in advance, I will do that at no charge as well. However, normally, clients book the procedure time and I do the consultation at the time of the procedure. The only reason to do a consultation in advance is if you're not sure you want me to do the work, and you won't feel comfortable unless we meet first, or if you're not sure you want to do the work at all. I've tried to put enough information on this website that you can get all your questions answered in advance, and we won't have to spend unnecessary time in a separate consultation session.
What do I need to know before I come?
Anyone in normal good health can walk in the door and have this done immediately. However, you have any diseases which affect your healing, e.g, diabetes, you may not retain color well and should check with your doctor whether he will allow you to have the work done, depending on how advanced your conditions. If you have scleraderma, which makes your skin tight and brittle, you are not a good candidate. If you have allergies to lidocaine or epinephrine, I won't be able to use my anesthetics on you. If you have allergies to latex, you must let me know, because I might use either latex or nitrile gloves.
If you're planning to have work done, avoid ingesting things which make you bleed and bruise, e.g., ibuprofen, alcohol, vitamin E supplements, and caffeine -- which can also make some people more sensitive. Aspirin should be avoided, if possible, for as long as ten days before hand. If you are on blood thinners, ask your doctor about stopping the meds for a couple days so you won't have excessive bleeding. If you're doing your lips, and you have EVER in your life had a real cold sore -- the herpes II virus which never leaves your nerves in that area -- you need to obtain a prescription for antiviral medications (Zovirax, Acyclovir) and take them as directed 48-72 hours before AND after the procedure, to minimized the risk of an outbreak, which otherwise would be severe.
You will retain more color if your skin is well exfoliated. Microdermabasion a day or two before the procedure will aid in color retention.
What should I expect at my first appointment?
At your first visit, you'll fill out office paperwork. You can wear your own makeup to show me what you think you'd like (but please, avoid waterproof mascara and staining lipcolors). Then, I'll use conventional cosmetics to adjust what you've done as necessary, and simulate the result I intend to achieve. Only when we've agreed about shape, color and placement, and we both understand what that means, do I apply permanent color. After I remove your makeup, I apply topical anesthetic to the area we will tattoo. It will take 15-20 minutes for the surface of the skin to numb up. You'll still have a little sensation as I work, but mostly a scratching or tickling that isn't bad at all. Also, I will reinforce the anesthetic as I work to keep you comfortable.
After I remove the initial anesthetic, I may redraw the color topically with tattoo pigment, if there's any question about shape and placement, and work through that design to be sure I'm doing what you want.
Allow an hour for each procedure initially. When we're done, you'll be given aftercare instructions and sent home to heal.
When and why do I need a second appointment?
Your skin is divided into two kinds of layers. The top layers are called "epidermis." It is connected on the underside to the "dermis," or "true skin." The dermis doesn't change, and color is implanted in the upper layers of the dermis to be permanent. The epidermis changes roughly every 28 days. New epidermal skin cells generated at the base of the epidermis are round, fat, and full of fluid. As they rise up to the surface of the skin, they flatten out, dry up, and die.
So each day you exfoliate your skin, you are removing that day's layer of dead skin cells. In order to put color in the dermis, the tattooing needles must pass through the epidermis, where they also deposit color. When you first look at any tattoo, including permanent makeup, you are looking at color in the dermis THROUGH the color on top of it in the epidermis, which won't be there in a month. After that time, only 60%-70% of the color may remain, and new, translucent epidermis will have healed on top of it. That will make the color look softer and lighter. If color didn't "take" evenly or perfectly in the dermis, there may be voids or missing spots which need to be filled as well.
Many technicians try to compensate for that initial color loss by using too much color, too solid a color, or too dark a color initially. That makes you run the risk of a final result that is flat, hard and unnatural looking. Even then, there's no guarantee you won't need a touch up visit. But you will leave those technicians looking and feeling like you have Groucho Marx brows or Lucy Lips, praying that the color will lighten up enough ...which sometimes it will, and sometimes it won't.
I prefer to make my clients look beautiful when they leave. So I'll apply only enough of the right colors so that you look almost the way you will want to look healed when you leave me. But if you look "perfect" when you leave the first time, you'll only be 60% of perfect when you heal. After 4-5 days, the damaged surface epidermis will exfoliated, taking color off sometimes in chips or chunks as well (less, if you follow aftercare instructions), and the color will lighten radically. It will "come back" in a day or so when the exposed skin dries out. But you may need to use some pencil or powder to reinforce the color until you come back for a touch up visit.
The second visit, or touch up visit is planned for a month after the initial visit (occasionally a week or so one way or the other, as needed). When you come back, we repeat the whole tattooing process, and the skin goes throught the same healing cycle. But the color in the dermis builds up cumulatively. So if you had a 70% result the first time you heal, you can expect a 95% result the second time. That's what most clients want and need.
My fee includes two visits, as needed, within two months, to complete the initial application of the procedure.
Would I ever need a third visit to complete a procedure?
Clients do vary in certain things which are outside my control, e.g., skin thickness, body chemistry, sun damage, smoking damage, other factors affecting their healing, and aftercare compliance. These all affect how much color you retain.
About 5% of the time, eyeliner, eyebrow enhancement, and lip liner clients may want a third visit to complete the procedure. That is at an additional, reduced charge. Alopecia clients may also want a third visit to add dimension to their color, as they have no hair of their own to blend with it. Full lipcolor clients almost always need a third visit, and you should plan for that.
Ironically, the more subtle a result you want, the more visits you may need, because I will have to apply color in smaller baby steps so as not to overshoot the mark. I can always add more. But it's very hard to take it away.
What will I look like afterwards?
Initially, the color will be a little stronger and look more like topical makeup. As the color oxidizes in the skin, it may darker somewhat. Expect to look like you are wearing makeup, regardless, but it won't be unattractive.
The fairer you are, the more likely you are to have purplish discoloration around the eyelining. But in many cases, it just looks like additional eyeshadow!
Lips and brows tend to look perfectly normal when you leave me.
In the old days, before epinephrine enhanced anesthetics, better equipment, and cold light therapy, people left looking much more swollen and battered. If you go to someone who hasn't kept up and invested in the best technology, however, you may have the same problems.
What shoud I do for aftercare?
For 4-5 days, while the surface skin is healing, you must avoid any rubbing, scrubbing, tanning, chemical irritation or exfoliation of your skin. Wash around the area, and keep soaps off it. Use only a pH neutral cleanser, like Cetaphil for Sensitive Skin. No swimming during that time. Avoid dirty work environments. Stay out of tanning beds and don't get sunburned. If you work outside, golf, or go to the beach, wear a hat and glasses. Don't pick at exfoliating skin towards the last day, because you'll pull up the important color attached to it which otherwise would heal into the skin.
Once the skin is healed in a week, daily sunblock is recommended to slow the normal fading of color due to UV exposure. Otherwise, no special care is needed at that time, except that you should avoid chemical peels of the tattooed area as well.
Traditionally, permanent makeup and tattoo artists recommend that you buy petrolatum based aftercare, such as A&D ointment or Aquaphor, which you can buy at any drug store. However, this is old technology, rapidly being surplanted by several products containing anti-oxidants and hyauleuronic gels which bind moisture to the skin. I recommend a product called Wound Be Gone. It is more expensive than the others, but I believe it's worth it. At the moment, it is sold only in private pharmacies, and I don't stock it. But that may change in the near future, and I'll adjust this information at that time. It is also sold by Skin Deep Medispa, one of the places where I work, for $37/tube.
How long will my permanent makeup last?
Murphy's Law of permanent makeup is; Only the darkest and ugliest lasts forever without a touch up. Black is the only color that lasts more than a couple of years, and it's not appropriate in Caucasian clients for anything except eyeliner, in most cases. Too many artless technicians put black brows on blonde clients to make the color last longer...It never ceases to amaze me!
Yellows fade faster than reds which fade faster than blues and blacks. Mixed colors will fade at different rates and will need touching up if they shift in tone over time. Colors also fade towards their base color if you don't maintain them. So a warm brown brow may turn pink two years later if you don't keep it touched up.
Blonde brows will need retouching every 6-9 months. Medium browns every 9-12 months. Brownish black every 12-15 months. Black black eyeliner every 12-24 months. On the average, I suggest clients get touched up annually. You want to reinforce the color before it fades and shifts too much so that it always looks the same. If you maintain your permanent makeup, you'll always love it. I have clients who've been with me literally 15 years, who still look great because they come back for those maintenance visits. But it's up to you to do it. If you don't come back within 2 years for a touch up, you won't receive the discounted touch up rate starting in 2011.
Is there risk of injury?
I have developed various protocols to insure the safety of my clients.
My clients are comfortable enough to have their eyeliners tattooed with eyes open, like applying eyebrow pencil or liquid liner. That may sound dangerous, but it's actually safer than working with the eyes closed. Clients look away from the machine as I work, so that the cornea is always protected. If you don't have adequate anesthetic, you'll be squeezing your eye shut and fighting your technician. That can lead to misplaced pigment and corneal abrasion. Because of my precautions, I haven't had one of those in my office since the very earliest days.
The other physical risk is scarring from overworking the skin. That happens when you use machines which are either cheap and underpowered, or overdesigned and too powerful. It also happens when the technician doesn't have adequate experience. Again, you won't have that problem in my offices with my equipment and techniques.
Do you scratch or patch test for allergy first?
Normally not. Such testing is not considered sufficiently predictive by medical authorities. Also, I'm not a doctor, so I can't legally interpret any such test. It is always possible that you could develop an allergy in the future to any foreign substance in your body once sensitized. But real pigment allergies to permanent cosmetic colors are extremely rare. I have never seen or had a pigment allergy reaction to any of the colors I use. However, previous tattooing with certain other pigments may make you more susceptible to a possible pigment reaction. If you've been tattooed with Premier Pigments True Colors, which were withdrawn from the market, you are at risk of reaction from subsequent procedures. Also, if you have a genuine history of reaction to other dyes and colorants, there is a greater risk of sensitivity. If you request it, I can tattoo a small test patch at an additional charge, and allow you to make your own determination.
Can I still get an MRI?
Yes. Although iron oxide colors are ferromagnetic, and may respond to a strong magnetic field by heating up, the small amounts of them in permanent makeup do not normally represent a problem. If you ever were to be uncomfortable during an MRI, it is a simple matter to remove you from the field and apply a cold compress. There are non-iron oxide pigments. But I prefer to use mostly iron oxide colors because of their inert nature and history of safety. In twenty years of practice, no one has ever come back to report an MRI problem after their permanent makeup.
Will I keloid?
A keloid scar is a raised scar caused by excessive flooding of collagen into a wound. It normally occurs after a major injury, not a minimally invasive procedure such as this. But if you have had your ears pierced and developed keloids, you may well be at risk. I haven't seen it happen yet. But you undertake the work at your own risk.
Can bad work by other technicians be removed or corrected?
Sometimes. In the old days, the only form of tattoo removal was mechanical, with dermabrasion or carbon dioxide laser, which removed the color but always created a bad scar. Today, pulsed ruby and Nd/YAG lasers can break up the pigment so that it can be removed into the lymphatic system by your skin's own "garbage trucks," the macrophages, without causing thermal damage and scarring to the surrounding skin. But it only works on darker colors, requires several treatments, and may not result in complete removal. Any white pigment (titanium dioxide) will fragment into particles too large to be removed by the macrophages, and it will turn the remaining particles grey or black. So doctors are often reluctant to attempt laser removal of any permanent makeup which may appear to contain whilte, as much of it does.
Permanent makeup technicians can safely attempt a certain amount of mechanical removal by overtattooing the old tattoo with saline solution or stronger chemicals that disrupt the skin in small areas. If done a little at a time, the skin will heal normally and you probably won't get scarring in the area. But particularly for larger areas and multiple removal sessions, it is always a risk.
Light tattoo colors don't really block darker colors when tattooed over them; they mix together visually with the old color, creating something intermediate. If you try to cover up black with anything lighter, it will take three times as much lighter pigment to begin to shift it towards brown. It will only shift; it will never cover up. So That means that the best corrective approach is to lighten the color over a series of a few removal treatments before recoloring the area with corrective tattooing to achieve the best results. Unfortunately, no doctor I know will attempt laser removal of eyeliner because of the risk to the eyes. Saline is the only choice for that.
There is a promising new product, Eliminink, which can be tattooed into the skin to draw up old color as it heals without creating a scar. I've seen mixed results, and it is much more expensive to treat you with this than saline.
The most readily corrected work is too thin, light or warm, and can be adequately adjusted by simply adding color to it without removal. If you can "fix" your problem with an eyebrow pencil, I can probably fix it easily with more permanent makeup. I have been very successful correcting such poor results by other technicians. But the best thing to do is to go to the right technician in the first place, and avoid the problem altogether.
Will permanent makeup help vitiligo?
Rarely. In most, but not all cases, whatever is destroying the natural melaninn in the skin also causes loss of the tattoo color, and nobody has done a hard, scientific study as to why that is, to my knowledge. Generally speaking, it's an exercise in futility. But on the very rare occasion, I've seen the color stay. So it's considered experimental, and done at your own risk and expense.
However, I've had great success in at least one case with piebaldism, which is a hypopigmented (light) birthmark, over a large portion of the leg of one East Indian client.
When can you recolor scars?
To successfully recolor a scar, it should be flat, white, and mature. Normally that requires at least a year of healing after surgery or injury.
Scar camouflage requires a high level of artistry. It's not as simple as painting a house. Skin color is naturally translucent. Simulating skin tone with tattooing pigments requires that various colors be layered into the scar in watercolor-like washes, over a series of visits, to create a natural look. Scars turn red very quickly once the tattooing begins, and only so much can be done at once. Trying to do too much in a single visit can yield results which are either too light, too dark, or too opaque. Clients should not begin this kind of work unless they are willing to commit to a series of visit.
Scar tissue lacks the component parts of normal skin. Scars are a network of collagen fibres which have flooded into the injured area to repair it. Scar tissue does not hold color as well as normal skin. That affects how many initial treatments are necessary, and how long the color lasts in the skin.
Camouflage color does not tan or blush, but skin around the repigmented scar may change color naturally. So the degree to which the repigmented area "matches" the surrounding skin will vary from time to time. Although I've achieved some superior results, clients should aniticipate improvement, not perfection. Scars will never be normal skin again. Scars which are raised (hypertrophic) will still be clearly visible after repigmentation. Dark scars, either fresh or mature, cannot be naturally lightened with permanent cosmetics.
What about areola recoloration?
Restoration of the nipple and areola complex after breast surgeries often involves work on thinner tissue, normal tissue, and scar tissue all adjacent to one another. Sometimes color stays better than other times. Multiple visits may be required. The work often involves restoring both areolar color and the color of the adjacent skin to surgical scars.
What do you charge?
As my cost of doing business varies from city to city, so do my fees. Please contact me directly for a quote based on where you want the work done.
Where do you work?
At each office, I am there by appointment only. My schedule in each city varies, so you need to call or email me to inquire which dates I will be where. I'm in Chicago typically two weeks of the month, and travel the rest of the time.
In the Chicagoland area, I see clients now at two facilities: Skin Deep medispa, owned by plastic surgeon Dr. Steven Bloch, at 1986 Tower Drive in Glenview, and downtown at my art and makeup studio at 1040 W. Huron, just south of Ogden off Milwaukee in Chicago. At Skin Deep, I am restricted to normal daytime hours, and am usually there on a Tuesday through Saturday, as needed. At my studio space, I have 24/7 access, and can see clients evenings and weekends, including Sundays.
In NYC, I work out of the dermatology office and medispa of Dr. Howard Sobel at 960 Park, on 82nd Street just west of Park Avenue in Manhattan. I am there normally on Saturdays, Tuesday/Thursday mornings, and occasional Mondays.
I see clients sometimes at Empire Academy of Makeup in Costa Mesa, and sometimes at facilities in West Hollywood. I'm currently exploring other facilities there. I'm in L.A. now only occasionally. But I plan to be there the last two weeks of January, 2011.
Please call me directly at 866-974-2378 or email me at jlylesegal@aol.com for more specifics.
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