Permanent Makeup

Also known as micropigmentation and permanent cosmetics

Permanent makeup uses tattoo techniques to enhance or reproduce features that are not pronounced or have been lost due to aging, a medical condition, or scarring. “Cosmetic tattooing” is most often used for the face, on the eyebrows, lashes and lips, but also can improve scars or uneven coloring of the skin (vitiligo) and restore the areola around a woman’s nipple after breast surgery.

When to Consider Permanent Makeup

  • If your eyebrows, lashes and lips are pale or lacking definition
  • If you are active, swim or do not wish to apply makeup daily
  • If you have a skin or makeup allergy
  • If surgery or scarring has left you with uneven coloring or loss of pigment (color) in some areas

Many people who consider permanent makeup also consider laser skin resurfacing, chemical peels and laser hair removal.

Considerations

Pros

  • Quick procedure with very little downtime
  • Customized results for your skin tone and coloring
  • Good alternative for those with allergies and makeup issues

Cons

  • Permanent makeup is a permanent procedure that is difficult to remove
  • You may be susceptible to infection or allergic reaction to pigment
  • Pigments may interfere with cranial MRI scans

These are the top three pros and cons to weigh when considering permanent makeup. If you want to focus on what is unique to you, please consult with your aesthetic plastic surgeon.

Am I a good candidate for permanent makeup?

The following are some common reasons why you may want to consider permanent makeup:

  • You have sparse hair on your eyebrows or have poorly defined eyelashes
  • Your lips are pale and you do not like wearing lipstick or gloss
  • You are undergoing breast reconstruction and would like to recreate the areola area of your breast (around your nipple)
  • You have scarring that could be improved by tattooing pigment
  • You want to eliminate daily makeup application

If you are in good general health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.

About Your Procedure

How is a permanent makeup procedure performed?

Micropigmentation is a form of tattoo art, but is specialized to achieve specific cosmetic goals. Depending on the practice, your surgeon may have a specialist such as a licensed aesthetician or a registered nurse administer the treatment. It is important to ensure that there is a board-certified plastic surgeon who has oversight of the facility and that your specialist is licensed to perform permanent tattooing. Their qualifications and experience are integral to achieving the right look and preventing any risks or complications.

A topical anesthetic is usually applied to numb the skin and make you more comfortable during the procedure. Before the procedure begins, a scratch test on your finger will be performed to check if you are allergic to the pigment. This is important to determine if you have any reaction to the pigment before tattooing a larger area on your face.

If appropriate, there will be an outline of the area that will be tattooed. Needles penetrate the skin a few millimeters in depth and implant pigment below the epidermis for cosmetic enhancement or correction. Once the treatment is complete, ointment is applied to keep the area soft and to promote healing. A bandage may be applied to protect the area for a few hours, but is not required. More than one session, spaced four to six weeks apart, may be necessary to achieve the best results.

Selecting Your Surgeon

Select a surgeon you can trust

It's important to choose your surgeon based on:

  • Education, training, and certification
  • Experience with permanent makeup treatment
  • Your comfort level with him or her

Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.

After finding a board-certified plastic surgeon in your area who is experienced in performing permanent makeup treatment, you will need to make an office appointment to set up your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.

Your initial consultation appointment

During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for permanent makeup and clarify what permanent makeup can do for you. Once your surgeon understands your goals and medical condition, alternative and additional treatments may be considered (see related procedures.)

You should come to the consultation prepared to discuss your complete medical history. This will include information about:

  • Previous surgeries
  • Past and present medical conditions
  • Allergies and current medications

Your treatment plan

Based on your goals, physical characteristics, and the surgeon's training and experience, your surgeon or tattoo specialist will share recommendations and information with you, including:

  • An approach to your treatment, including the type of device or combination of devices to be used and the number of treatments anticipated
  • The outcomes that you can anticipate
  • Your financial investment in the procedure
  • Associated risks and complications
  • Treatment location options
  • What you need to prepare for your treatment
  • What you can expect to experience after treatment
  • The doctor will also share before-and-after photos of cases similar to yours and answer any questions

Questions to ask your aesthetic plastic surgeon

For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety, and to plan your procedure, visit the Planning Toolkit.

We developed these questions to help you:

  • Make the most informed and intelligent decision about your procedure
  • Confirm that you have the right surgeon for your procedure
  • Make your initial consultation as rewarding as possible
  • Understand your options, potential outcomes, and risks

It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation.

  • Am I a good candidate for permanent makeup?
  • Are the results I am seeking reasonable and realistic?
  • Do you have before-and-after photos I can look at for the procedure I am undergoing?
  • Will there be scarring or discoloration?
  • Will a local anesthesia be used during the procedure?
  • What will be the costs associated with my treatment?
  • What will you expect of me to get the best results?
  • What kind of recovery period can I expect, and when can I resume normal activities?
  • What are the risks and complications associated with my procedure?
  • How are complications handled?
  • What are my options if the cosmetic outcome of my surgery does not meet the goals we agreed on?

Preparing For Your Procedure

How do I prepare for a permanent makeup procedure?

Your surgeon will provide you with pretreatment instructions, answer any questions that you may have, take a detailed medical history, and perform a physical exam to determine your fitness for treatment.

In advance of your procedure, your surgeon will ask you to:

  • Wear sunscreen and/or avoid the sun
  • Avoid pretreatment shaving, waxing, or exfoliating
  • Avoid tanning and spray tans several weeks before your procedure
  • Stop smoking at least six weeks before undergoing treatment to promote better healing
  • Avoid taking aspirin, certain anti-inflammatory drugs, and some herbal medications that can cause increased bleeding
  • Regardless of the type of surgery to be performed, hydration is very important before and after surgery for safe recovery

Permanent makeup is usually performed on an outpatient basis and you are usually able to return to your normal activities immediately after the treatment. If necessary, arrange for someone to drive you home after treatment.

What can I expect on the day of my permanent makeup procedure?

Permanent makeup is performed on an outpatient basis. Some form of local anesthesia, such as a topical anesthetic cream, may be applied before treatment. The pain experienced during treatment is quite tolerable, but will be different from person to person, and from area to area. Your specialist will take as many breaks as you need.

Most permanent makeup sessions last two to three hours including the preparation (topical anesthetic and scratch test), but will vary depending on your treatment area.

Generally:

  • Your specialist will follow the treatment plan discussed with you.
  • After your procedure is completed, the area will be red and slightly swollen.
  • Ointment will be applied to keep the area moist and soft.
  • Once you have received instructions, you will be able to return home and resume your normal activities.

It is important to follow your post-treatment instructions and to limit any activity that might irritate the tattooed area.

Aftercare And Recovery

In most cases you may return to work and other daily activities immediately following your treatment. After the procedure, you will receive detailed instructions about your post-treatment care, including information about:

  • Skin care
  • Normal symptoms you will experience
  • Potential signs of complication

It is important that you follow all patient care instructions provided by your surgeon. Your surgeon will also provide instructions about the normal symptoms you will experience and any potential signs of complications. Contact your surgeon to find out if your pain, redness, and swelling are normal or a sign of a problem.

Immediately following my permanent makeup procedure

It is normal to experience some mild pain or discomfort for up to forty-eight hours after treatment. There will be redness and swelling, but it will subside completely within one or two days. It is important to keep the area moisturized with ointment for several days as the skin heals.

Two to three weeks

A crust will eventually form over the entire tattoo, which will fall off after about two weeks. You will be able to see the full results in approximately three weeks, to determine if the color and shade is appropriate. If not, you will need a touch up.

How Long Will My Results Last?

Permanent makeup is permanent, but it may take two or three sessions to achieve the right look for you. Over time, tattoos fade and may need to be touched up.

Maintain a relationship with your aesthetic plastic surgeon

For safety, as well as the most beautiful and healthy outcome, it's important to return to your plastic surgeon's office or tattoo specialist for follow-up evaluation at prescribed times and whenever you notice any changes in the treatment areas. Do not hesitate to contact your surgeon when you have any questions or concerns.

Associated Costs

The cost of permanent makeup varies from doctor to doctor and from one geographic area to another. Costs are also related to the size and complexity of the tattoo, as well as the number of sessions required for you.

See the national average for physician fees per procedure.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments or other miscellaneous costs related to surgery.

Because permanent makeup is an elective procedure, insurance does not cover these costs. Many surgeons offer patient financing plans to make the procedure more affordable.

Choose your surgeon based on quality, training, and experience—not cost.

See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training, and certifications.

Limitations And Risks

Fortunately, significant complications from permanent makeup are infrequent. Your specific risks for permanent makeup will be discussed during your consultation.

All procedures have some degree of risk. Some of the potential complications of all procedures are:

  • Infection and bleeding
  • Scarring
  • Allergic reactions
  • Damage to underlying structures
  • Unsatisfactory results that may necessitate additional procedures

Other risks specific to permanent makeup are outlined below:

  • Skin discoloration such as hypopigmentation and hyperpigmentation
  • Temporary changes in skin texture

You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon or tattoo specialist, both before and after your permanent makeup treatment.