61.1Applications of Permanent Cosmetics

Permanent cosmetics can be used to complement a range of facial rejuvenation procedures. Using modern techniques, equipment and pigments, a broad spectrum of end results are achievable. These range from skin camouflage procedures to natural-looking enhancements, to the imitation of more youthful facial features, and finally to the replication of traditional makeup.

In terms of facial procedures, the most significant changes in appearance can be achieved through permanent cosmetics for eyebrows and lips. Eyebrows can be enhanced and reshaped, or imitated entirely where there are none. These procedures are particularly useful after brow-lifts, whereby new eyebrows can be designed and pigmented to complement the outcomes of the surgical procedure.

Permanent cosmetics can also provide an excellent complement to lip augmentation surgery. In the first instance, permanent cosmetics can be used to improve the definition of the lip line and also enhance the intensity of color within the lips. Should a significant change to the shape of the lip be required, permanent cosmetics can be used to redesign the lip contour.

Procedures around the eyes also have a role to play. After blepharoplasty surgery, patients can benefit from enhancements designed to add extra definition to the eyelids. These can take the form of subtle lash enhancements through to eyeliner procedures in imitation of traditional makeup. As with traditional makeup techniques for the

K. Betts

Nouveau Beauty Group, Nouveau House, Barnsley Rd., South Elmsall, Pontefract, West Yorkshire, WF9 2HR, UK e-mail: info@karenbetts.co.uk

eyes, permanent cosmetics can also be selectively utilized to improve the illusion of balance, size, and symmetry.

61.2 Preprocedure Preparation

Following a general consultation during which requirements and medical health are assessed, all clients should undertake a sensitivity patch test for pigments and topical anesthetics. Reactions to permanent cosmetic pigments are relatively rare. Topical anesthetics are required to aid the patient and to minimize any flinch responses, thus helping to maximize control and accuracy of depth when implanting pigment.

61.3 Pigment Blends

Best results are achieved if pigments are individually blended to suit the requirements of each patient (Fig. 61.1). At this point, the base tone of the pigment blend must be compared to the natural skin tone of the client to minimize the risk of an unnatural-looking color fade in future years.

61.4 Eyebrows

The eyebrow enhancement should be custom-designed and sketched onto the skin using a cosmetic pencil (Fig. 61.2). The general flow and direction of any natural hairs should be imitated for a realistic-looking result (Fig. 61.3). The procedure begins with a light first pass to provide a general indication of the guidelines. The design is quickly sketched in with the needles using light pressure and minimal depth (Fig. 61.4a).

Fig. 61.1 Pigments are individually blended to suit the requirements of each client

Fig. 61.2 Eyebrow enhancements should be custom-designed, using callipers to assess symmetry and estimate general guidelines

Fig. 61.3 The general flow and direction of any natural hairs should be imitated for a realistic looking result

More pressure is applied in the second pass to implant pigment to the required depth (Fig. 61.4b).

Depth is ascertained by tightly stretching around the work area and monitoring the vibrations in the skin (Fig. 61.4a).

Fig. 61.4 (a) The first pass is extremely light and is intended to provide a general indication of the new eyebrow design. (b) More pressure is applied in the second pass to implant pigment to the required depth. Note the difference between the first and second passes

Fig. 61.5 Subtle line curvature and a gradual reduction in line thickness can make the difference between a line that looks like an eyebrow hair and a line that looks like a tattooed line

Subtle line curvature and a gradual reduction in line thickness can make the difference between a line that looks like an eyebrow hair and a line that looks like a tattooed line (Fig. 61.5). Changes to line thickness are achieved by varying the depth into which the needles are implanted into the skin.

Fig. 61.6 Careful imitation of the finer features of natural brow hairs, particularly at the bulb and tail, are then added to maintain the visual illusion of real eyebrows

Careful imitation of the finer features of natural brow hairs, particularly at the bulb and tail, are then added to maintain the visual illusion of real eyebrows (Fig. 61.6).

Final healed results can be seen in Figs. 61.7 and 61.8.

61.5 Lips

Decisions regarding lip shape must be considered alongside the pigment color to be used. This is

a

because increased depth of color and use of shading will add to the visual illusion of size and plumpness (Fig. 61.9).

A gentle first pass is used to delineate the new lip line, using light pressure and minimal depth (Fig. 61.10). The second pass is used to fully define the lip line (Fig. 61.11). A fine needle grouping is used to enhance color intensity and provide a crisp outline.

Permanent cosmetic pigments are translucent. It is therefore necessary to compensate for differences in the underlying skin tone when applying them. In Fig. 61.12, the areas of skin outside of the natural vermilion border have been intensely pigmented with a relatively small needle grouping. A larger needle grouping and slightly modified pigment blend is used to shade within the vermillion border (Fig. 61.13). This provides less intensity of color, which helps to compensate for differences in skin tone between the new lip contour and the natural lip.

Shading techniques allow for subtle visual illusions, enabling flatter areas of the lip to be highlighted, thus giving the impression of more rounded and plump lips (Figs. 61.14 and 61.15).

Subtle modifications to the pigment blend and the use of different needle groupings and shading techniques are essential elements in producing naturallooking outcomes (Figs. 61.16 and 61.17).

b