61.6.1 Longevity

After 30–45 days an assessment should be carried out to assess the healed result. A touchup may be required to ensure evenness of color tones. The client may benefit from a color boost 12–18 months after the initial procedure, particularly if they chose subtle pigment colors. After 18–24 months, fading and degrading of the color is likely to commence.

61.6.2 Risks

In the majority of instances, permanent cosmetics should be applied after surgical procedures. If changes to the facial structure are made following permanent cosmetics, there is a risk that the symmetries and placement will alter and become problematic. This is particularly relevant for eyebrow procedures. Removal of some pigment may be required, plus correctional work.

By contrast, it is advisable that permanent cosmetics are applied prior to lip augmentation procedures. This allows the lip shape to be accurately assessed and contoured prior to any changes effected by the surgical procedure.

The color-fade associated with permanent cosmetics is often seen as a benefit because it enables the pigment to be refreshed or the design amended to suit the needs of the client in future years. If the pigment is implanted too deeply, it will not fade sufficiently. Instead, the pigment will be subjected to the typical aging process of traditional tattoos, which are more susceptible to pigment migration and often undesirable

changes in color tones. Removal of the pigment is usually required in these instances.

During the fading stage, some clients can experience a type of color fade that causes the base colors to be accentuated – most commonly reddish or grey hues. Color correction techniques can be used to neutralize these colors and restore the desired color.

Other risks associated with permanent cosmetics are similar to those of traditional tattoos and include infections, allergic reactions to pigments, scarring, and ink migration. Client dissatisfaction regarding the shape, placement, and color of the procedure outcome is also a potential risk.

61.7 Conclusions

Permanent cosmetics can be used alone, or in conjunction with a range of facial rejuvenation procedures. The range of achievable outcomes is extremely broad, ranging from subtle camouflage to more dramatic recontouring and recoloring. In the hands of professionals, permanent cosmetics can form a beneficial final step in the treatment of many clients.

Recommended Reading

Armstrong ML, Saunders JC, Roberts AE. Older women and cosmetic tattooing experiences. J Women Aging. 2009; 21(3):186–97.

De Cuyper C. Permanent makeup: indications and complications. Clin Dermatol. 2008;26(1):30–4.

Hoffman H, Gisbert M, Ortega A. Micropigmentation: technology, methodology and practice. Madrid Videocinco. 2008.

Mazza Jr JF, Rager C. Advances in cosmetic micropigmentation. Plast Reconstr Surg. 1993;92(4):750–1.

Traquina AC. Micropigmentation as an adjuvant in cosmetic surgery of the scalp. Dermatol Surg. 2001;27(2):123–8.

Vassileva S, Hristakieva E. Medical applications of tattooing. Clin Dermatol. 2007;25(4):367–74.