Questions and Answers About Permanent Makeup
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. "Microblading" is a manual tattooing method for simulating hairs in the skin.  "Tapping" or the Softap Method is another manual tattooing technique.   As with any tattoo, inert colored particles are implanted in the dermis, or true skin, beneath the surface of your skin, called the epidermis.  This procedure 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 normally  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  can have their appearance improved with color.   Missing brows due to alopecia, trauma, medication, chemotherapy or trichotilomania can be naturally simulated with hairlike strokes of tattoo color.  Spars eye lashes can be made to look fuller, and clients with no lashes can have them tattooed onto their eyelids.   Hair follicles in the scalp can be simulated effectively to resemble a full, shaved head of hair.  Breast reconstruction clients can have convincing simulated nipples and areolas tattooed onto reconstructed breasts after surgery.  Cancer patients can have eyeliner and brows tattooed before or after chemotherapy, so that their change in appearance is not so extreme when they lose their hair.

What can't you do with permanent makeup?  Permanent makeup should not be used to try to cover dark spots, red or brown scars, undereye circles, or purplish hemangiomas under the skin.  Vitiligo skin rarely retains tattoo pigment.    It also 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 at a later time.

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 short, permanent makeup is for just about everybody!   
What should I look for in a permanent cosmetic technician?   Years ago, the first independent professional society for permanent makeup was the National Cosmetic Tattooing Association. That group provided the first serious education and testing in our industry.  Today, there are two recognized professional organizations in our industry: The leading group is the Society of Permanent Cosmetic Professionals, and the American Academy of Micropigmentation is a smaller group.    Each organization offers testing which assure you that a technician will be  conversant with generally accepted knowledge and practice within the industry.   But the big secret the general public doesn't realize is that these certifications don't test graphic ability.  Their emphasis is on  the theory of safe practice, and on protecting the public health.

So, if you want to look good as well as being safe, you must do your own research into a technician's particular skills, and choose wisely.  Permanent makeup is a demanding graphic art.  What you are paying for more than anything else is the taste, talent and graphic ability of the technician. Credentials may look the same, but people's real qualification for this job varies widely.  

In the early days of the industry,  permanent makeup training was only two days long, entirely voluntary, and totally inadequate.  The SPCP has worked for twenty years to create a body of knowledge for our industry which allows informed technicians to do much better work today than ever before, and I'm proud to have contributed to our authoritative publications.  But there is still no national standard for training, and it's hard for you to know what a technician does or doesn't know based on their certification alone.  

Today, the SPCP recommends a 100 hour basic course, and individual states have even longer programs. It's not necessarily bad that your technician's original training was a short program.  More important to ask is: What have you done to upgrade your skills since your original class?  Are you a member of one or more of these Societies, and do you take continuing education classes annually at their conventions?  I joined the SPCP in 1991, the year after it was formed.  But I still go to convention every year, and take continuing education to remain current in my practice.  There's always something new you can learn from another experienced colleague.  But technicians who were poorly trained and don't get continuing education may be making the same mistakes now they were making ten of fifteen years ago. Many technicians call themselves experts who have no business doing so.  It's up to you, the consumer, not to go like a lamb to the slaughter, and not to believe everything you are told without supporting evidence. 

The truth is, it takes years of real graphic practice  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.  My website  page of "Bad Work by Other Technicians"  attests to the problem. 

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.   So another good question to ask a technician is:  What other artwork do you do?  Have you taken any courses in conventional makeup application, and do you have professional experience applying regular makeup too?  If, in consultation, your technician can't create a beautiful brow or lipline with conventional makeup, don't expect them to do any better job with a tattoo machine! 

Remember:  There is no different graphic standard for good permanent makeup and good regular makeup.  Both should be soft, natural, and unobtrusive.   I  call makeup your permanent makeup "lingerie," because it is always under whatever other makeup you choose to wear, supporting it.  Without any other makeup, you should just look your natural best.   But permanent makeup should never be overdone and faddish.  If you like your makeup bold and trendy, do that with conventional cosmetics over your permanent makeup. 

What is your background as a graphic and cosmetic artist?

I started drawing when I was twelve years old, and learned to to makeup for theater 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. I also have done complicated troupe l'oiel murals as private commissions, and sculpted various realistic creature makeups as a special effects makeup artist.    By the time started doing permanent makeup in 1991, I had already been a professional makeup artist for ten years.   I have taught makeup at Northwestern University, and  at such major vocational 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 equipment is just another tool as a designer.

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," which continues to influence our industry. I am a former board member of the Society of Permanent Cosmetic Professionals, and a twenty-seven 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 have now been doing permanent makeup for twenty-seven years, and continue to work professionally in media makeup as well as a member of Chicago based IATSE Local 476.  

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  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 areolas 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 areolas!   Sure enough, you didn't see those scars anymore...but the client was devastated.    

In a tattoo parlor, you also will probably not be given any anesthetics, which would make the procedure less comfortable and increase risk of injury or misplaced 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 tattooing equipment. My machinery includes the   digital German cosmetic tattooing devices from  Nouveau Contour.    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.  I also use the finest  microblading devices from Softap, whose speical flexibility reduces risk of working too deeply and creating scarring. 

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 red light therapy.  This is a light that you don't feel, which reduces redness, swelling and discomfort.  It also promotes healing. 

The combination of the above means you will leave my office looking and feeling better than you might do going to other practitioners who use less sophisticated equipment.  

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.  If you really feel you need an in person consultation in advance, and don't schedule the procedure first, I may charge a small amount which I will apply to your service when it is booked.  However, normally,  I do the consultation at the time of the procedure.  That way, we both will remember what was discussed.  Also, if I preview your look with conventional makeup, I can keep that on, and use it as a template to assure that you get the look you wanted. 

What do I need to know before I come?

Anyone in normal good health can walk in the door and have this done.  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 condition.  If you have allergies to lidocaine or epinephrine, I won't be able to use my anesthetics on you.  If you are allergic to latex, you must let me know, because I might use either latex or nitrile gloves.  

Avoid ingesting things which make you bleed and bruise,as if you were going for surgery.     If you are on blood thinners, ask your doctor about stopping the meds for a couple days so you won't have excessive bleeding. For up to 10 days before you come, stop aspirin, ibuprofen and namabutone, which can interfere with blood clotting.  However acetaminophen (Tylenol) is ok to take.  On the day of the service, avoid fish oil, vitamin E and garlic supplements.  Also,avoid caffeine, which can make you more nervous and sensitive.  If you're doing your eyeliner, and you use Latisse, you must discontinue it's use for at least 4 weeks or run the risk of significant bruising and possible pigment migration.  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, Valtrex) and take them as directed by your doctor to minimized the risk of an outbreak, which otherwise would be severe. At the minimum, I believe you should take these medications the day before, the day of, and the day after your lip procedure.  If you've had any filler injected in your lips, allow 4 weeks before your permanent cosmetic service as well.

You will also retain more color if your skin is well exfoliated and hydrated.  Don't tattoo cracked, dry lips until they are better.  I also can't work over an active dermatological condition, such as eczema.  

If you are immune compromised, because of chemotherapy, HIV or any other immune disorder,  I normally will recommend that you avoid tattooing unless and until your immune system is restored.  My process uses sterile needles, but other items such as color cups and open bottles of pigment are only considered "clean".  That poses no risk to a client with a normal immune system, but could be fatal to someone without that.  

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 like.  But please, avoid waterproof mascara and staining lip colors.  Do bring any lip or brow color you want to use as a visual reference.  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.  AfterI 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.  

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 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, where it must be to stay long term, 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 cooler.   There also may be voids or missing spots which need to be filled.  That happens because the dermis doesn't contact the epidermis smoothly all along its base.  They connect with finger shaped extensions of dermal tissue, and any pigment placed between the "fingers" will be lost when the epidermal tissue cycles.  

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.  You will leave  those technicians looking and feeling like you have Groucho Marx brows or Lucy Lips!

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. Even though eyes and brows will look darker initially, and lips may look brighter, it should still look like normal, if strong,  day makeup.  After 4-5 days, the damaged surface epidermis will exfoliate, taking color off sometimes in chips or chunks as well (less, if you follow aftercare instructions), and the color will lighten radically.    It will appear to "come back" a big in a few days when the newly exposed skin matures.  But you may need to use some pencil or powder to reinforce the color until you come back for a touch up visit.

So if you look perfect when you leave, you'll only look 60-70% of "perfect" a month later.   The second visit, or touch up visit, is normally planned for four to six weeks after the initial visit.  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 90% result the second time. That's what most clients want and need.

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.  

Occasionally, 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. Brows will be darker somewhat, and lips will be brighter for at least 4-5 days, until the damaged surface skin exfoliates. 

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! However, a few clients do get significantly swollen eyes for as long as five days.  

So, you can go right back to work, and shouldn't have to hide.  But it really depends how sensitive you are about your appearance.  

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.  If it gets wet, blot it dry gently.   Use only a pH neutral cleanser, like Cerave.  No swimming during that time.  Avoid dirty work environments.  Don't work out for a day or two.  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 off the color attached to it which otherwise would heal into the skin.  

Once the skin is healed in a week, daily sunblock (SPF 30 or above)  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.   I still recommend this.  However, this is old technology, rapidly being surplanted by several products containing anti-oxidants and hyauleuronic serums which bind moisture to the skin.  I normally recommend either Cerave Healing Ointment, or Aquaphor applied lightly on top of Cerave Moisturizing Lotion, 3 times/day.  Cerave products contain hyauluronic acid, a naturally occurring substance which binds moisture to the skin, and ceramics, which help rebuild injured collagen.  

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.  

Colors have different degrees of light fastness.  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.   So a warm brown brow may turn pink two years later, or a cool brown may turn greyish or purple,  if you don't keep it touched up.  That's also determined by the base chemical of the pigment, and the undertones of the skin.  

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 everything touched up annually.  You want to reinforce the color before it fades too much or shifts in tone 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 or more, who still look great because they come back for those maintenance visits.  But it's up to you to do it.  To receive a discounted rate for your touch up, you must come back within two years of the last service.  Otherwise, I may start you all over.  

Is there risk of injury?

I have developed various protocols to insure the safety of my clients.  

In the early days, before we could effectively anesthetize our clients, there were lots of problems with corneal abrasions from poor technique and squirming clients, and corneal burns from the use of improper anesthetics around the eyes.  Today, I use anesthetics which are both strong enough and safe enough that my clients are comfortable enough to have their eyeliners tattooed with eyes open, just like applying regular eyeliner. 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 go to someone who doesn't use an adequate anesthetic, you'll be squeezing your eye shut and fighting your technician.  That can lead to misplaced pigment and corneal abrasion.  .

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.  It is also a  risk of microblading repeatedly, no matter how it is done.   By using the best equipment and safest techniques, I minimize this risk for my clients.  

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 regularly use.   However, previous tattooing with certain other pigments may make you more susceptible to a possible pigment reaction.    If you've been previously 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 contact sensitivity 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 of the results.

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, color stability,  and history of safety.  In twenty years of practice, no one has ever come back to report an MRI problem after their permanent makeup. 

What is my risk of getting a keloid scar?

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.  It is also more prevalent in the African American community.  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?   

Most often the answer is yes.  But there are risks involved. 

 In the old days, the only form of tattoo removal was mechanical, with dermabrasion,  or by carbon dioxide laser, which removed the color but always created a bad scar.  Such removal should no longer be done.

Today, Nd/YAG lasers and the new generation of picosecond lasers can break up the pigment effectively, 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 requires several treatments, works best on darkest colors, 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 white, or colors containing white, which include skin, lip, and pastel brow  colors, should not be lasered at all or they may turn black.  That black can also be layered out but may require many more treatments to do so.  

Doctors are often reluctant to attempt laser removal of any permanent makeup because they can't tell if it contains white.  Unfortunately, no doctor I know will attempt laser removal of eyeliner because of the risk of injury  to the eyes.  Your only other alternative to remove eyeliner, pigments containing white, or resisitant colors,  is mechanical removal by a permanent makeup technician. 

Mechanical removal can be done with various products.  Some are acids which work, but which have a great risk of creating a scar. I prefer to use a saline product, which  obtains good results over several treatments, with very minimal risk of scarring.  To do this removal, the skin is opened and the dermis is disrupted with dry tattooing. Then a saline solution is applied to the open skin, which sits for 10 minutes before being washed off. When the solution is removed, a dry scab must be allowed to form.  When the scab falls off, any  pigment attached to it will be removed   But the scab must be kept perfectly dry to avoid risk of infection.  Expect to pay for multiple removal sessions, 4-6 weeks apart, to see significant results.  Although the risk of scarring is minimal with saline removal, it can occur if the skin is overworked.  

Corrective color is a more artistically challenging process.  Colors mix together in the skin when the new tattoo heals.  Light tattoo colors don't really block darker colors when tattooed over them; they just mix together with the old color in the skin,  creating something intermediate.  If you try to cover up black with anything lighter and warmer, it will take three times as much lighter pigment to begin to shift it.  But it will only shift slightly and  it will never cover up.  Removal or lightening of any color that is too black is always recommended first.   Also, means if the old color is dark and cool, i.e., purple, green or grey,  the best corrective approach is to lighten the color over a series of a few removal treatments before recoloring the area with corrective tattooing. Adding warmer color will shift it towards brown for a while.  But it will cool again when the warm color fades.   However, warmer, more orange brow colors can typically be corrected in one or two sessions without removal because the natural tendency of color is to cool in the skin.  

The most readily corrected work is either too thin, too light,  too warm, or only mildly asymmetrical so that it 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.  A popular "fix" today is the addition of hair strokes to brows which were made too solid.  The hair strokes must be darker than the old, solid color.  But the two may look very good in combination when healed.

Will permanent makeup help vitiligo?   

Rarely.  In most, but not all cases, whatever is destroying the natural melanin in the skin also causes loss of the tattoo color as well.  Nobody has done a hard, scientific study as to why that is, to my knowledge.  Generally speaking, tattooing vitiligo skin is 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, with absolutely no guarantee of success.  However, I hav 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 and multidimensional.  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 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 physical 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.  Thicker, ropey scars may be treated first with dry needling to make them more receptive to color.  Scars which are raised (hypertrophic) will still be clearly visible after regimentation.  Dark scars on Fitzpatrick 3-6 skins especially, or fresh, red scars which have not matured, cannot be lightened with cosmetic tattooing. 

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.   In the end, scar tissue will always be smoother and shinier than the normal skin next to it, and they rarely look exactly the same.  Scar camouflage is best for clients with significant differences in color, for who a reduction in contrast and reduction of whiteness will make the client happy.  Clients with tiny differences in color who expect to micromanage the process, or think their skin will be perfectly normal again, are bound to be dissatisfied and should not even start the process.  

What about areola recoloration?

Restoration of the nipple and areola complex is a wonderful thing, which will make a cancer survivor feel whole again.  Very realistic simulation of the nipple and areola complex can be done today.  But, again, it takes a fine artist to accomplish that.   After breast surgeries, I must often work on thinner tissue, normal tissue,  scar tissue, and/or irradiated tissue, all adjacent or in close proximity to one another.  Sometimes color stays better than other times.  Multiple visits are typically required to create the most natural looking results.  

What do you charge?

As my cost of doing business varies from city to city, and location to location, so do my fees.  Please contact me directly for a quote based on where you want the work done.  My prices are still midrange for my areas of service.  Nipple and areola simulation are the only procedures which might be reimbursed by your insurance company.

When and where do you work?

 My schedule in each city varies, so you need to call or e-mail me to inquire which dates I will be where.  I'm in Chicago typically three weeks of the month, and in NY once a month for up to a week.

In the Chicagoland area, I see clients by appointment only at Skin Deep Medical Spa, owned and operated by plastic surgeon Dr. Steven Bloch, at 1986 Tower Drive in Glenview, and downtown Chicago at 100 E. Walton, in Colette Salon and Spa on the 3rd floor.   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, and at Paul Labrecque Salon at 171 East 65th Street.   All services are provided by appointment only.  For appointments at Skin Deep, call 847-901-0800.  For appointments at any other location, call me directly at  866-974-2378, my cell phone at 323-828-8740,  or email me, either through the Contact Me page of this website. 

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