• Other names: Permanent eyeliner, blepharopigmentation, permanent brows
• Primary goal: Application of "permanent" makeup by tattooing ferrous oxide and other metallic pigments into the dermis of the eyelid
• Secondary goals: Freedom from daily application of cosmetics
After permanent eyeliner
• Anesthesia: As the procedure is most commonly performed by cosmetologists rather than physicians, anesthesia options are limited. A stiff drink may help.
• Technique: Ideally, pigment is place between the lashes as a series of closely-spaced dots rather than as a solid thick line.
• Variations: Several different handpieces may be employed using anything from a single vibrating needle to a rotating multi-needle cluster. The dots are applied in single or multiple rows depending upon the desired effect and depth of coloring.
• Advantages: Freedom from the sometimes difficult task of applying makeup, especially in patients with poor eyesight, oily skin, allergies, chronic eyelash infection, eyelid scarring, arthritis, or those always in a hurry.
• Limitations: "Permanent" makeup is, in most cases, not permanent but fades slowly over several years. When applied properly, permanent eyeliner does not interfere with the eventual placement of skin incisions in blepharoplasty. On the other hand, some patients with forehead and brow droop may choose to pluck their normal brow hairs and have permanent color tattooed at a higher area. While this may help camouflage untreated brow droop, it precluded future surgery, if later desired, to return the forehead and brows to a higher position.
• Care and recovery: Artificial tears may be instilled for general comfort. Iced compresses may decrease swelling. The lids may become bruised.
• Risks and complications: Misplaced pigment too far out of the lash line, loss of lashes, infection, gradual fading (expected), injury to the eyeball. If the pigment is applied too superficially, it will disappear almost immediately. The biggest risk is that the pigment may be applied in a way that is not complementary to your eyelid shape and eyeball size. Consultation with a cosmetologist is advisable, even if a surgeon will be applying the tattoo (remember, most eyelid surgeons are men, and most men don't use eyeliner).
• Comments: When eyelid tattooing was first introduced, it became "the rage" for a short time (very short time) among cosmetic surgeons. Once it became apparent, however, that the "permanence" of permanent eyeliner was fleeting, most surgeons lost interest and some even came to condemn the procedure as "frivolous."
Today, the vast majority of applications are performed by trained cosmetologists working out of beauty salons. The procedure is often painful, and touch-ups are common. Despite all of the above, the level of patient satisfaction is high.