Micropigmentation (Medical) Information

Micropigmentation can simply be described as minute particles of coloured pigment being placed mechanically below the surface of the skin. This treatment can be used in a medical capacity to correct scarred or discoloured skin following accident, surgery or disease, such as the recreation of an areola (the brown area surrounding the nipple) following reconstructive surgery for breast cancer. Depending on the area being treated, and your tolerance of pain, an anaesthetic cream may be applied first to help reduce any pain. A very fine needle is then used to place pigment into the skin at a very high speed via a small hand held electrical device. Micropigmentation can be compared to having a tattoo as the new pigment or colour is deposited in the dermal layer of the skin, just below the surface. You can return to work and normal activities immediately after a treatment. The cost of micropigmentation can vary considerably with recreation of the areola costing approximately £500 per breast.

We would like to thank Debra Robson-Lawrence for her expert help.

Background

Micropigmentation (Medical) background information

The specialist techniques used to create a kind of semi-permanent make-up are often referred to as micropigmentation, dermagraphics, permanent cosmetics or permanent make-up and are a type of tattooing.
 
The process involves hypoallergenic pigments being inserted into the dermal layer of the skin. This pigment will, after a healing process, stay in the skin for a number of years - breaking down and fading with time, dependent on age and skin type.

This treatment can be used to correct scarred or discoloured skin or merely as a cosmetic enhancement for your skin as it provides a convenient alternative to cosmetic pencils applied to the eyebrows, eyelids, lips and cheeks, known as semi-permanent make-up.

This concept is not really new. We know that Queen Cleopatra in ancient Egypt and some women in India and Africa have sought permanent eye enhancement with various substances over the years. They used plant and nut pigments or ground coals (carbon) as eyeliners or eye-shadows and inserted the substances around their eyes with fine, sharp implements.

However, semi-permanent make-up as we know it today is a relatively recent phenomenon, becoming more prevalent in the last fifteen years.
 
Reconstructive or medical micropigmentation attempts to correct birth defects such as cleft palate, vitiligo or alopecia and repairs disfigurement from accident or illness. It may also provide corrections to some surgery where there is subsequent scarring and in many cases simulate the areola (brown area around the nipple) after mastectomy.

If you are considering medical micropigmentation, the following information will give you a basic understanding of the procedure. It can't answer all your questions, since a lot depends on the individual patient and the practitioner. Please ask a practitioner about anything you don't understand.

How It Is Used?

Who has Micropigmentation and how is it used?

People who undertake micropigmentation can do so for many different reasons, ranging from those who simply want to look their best at all times, to those who require some form of corrective skin enhancement for medical reasons.

Some people who might choose to have medical micropigmentation are listed below:

  • those who need to restore the appearance of eyebrows, lashes, hair or skin that may have been damaged by accident, surgery or disease;
  • patients requiring the recreation of the areola surrounding the nipple on a breast following reconstructive surgery;
  • persons who require reconstructive procedures on cleft lip conditions;
  • surgical scars may be camouflaged by micro pigmentation;
  • uneven or receding hairlines can be "filled-in", alopecia (hair loss), hairline enhancement can all be treated;
  • patients with Vitiligo (uneven pigmentation).

Procedure

What happens during a Micropigmentation treatment?

Your first appointment with a practitioner should be a consultation to discuss your requirements and expectations from medical micropigmentation. Your practitioner should explain the treatment process and take notes on your medical history to make sure that there are no reasons why you shouldn’t undergo medical micropigmentation.
 
You will also discuss your skin tone, in order to ascertain the correct choice of pigment.
 
Make sure that you obtain as much information as necessary to enable you to make a fully informed decision about this procedure and whether it can achieve the results you’d like.

The procedure

On the day of treatment you would normally be asked to sign a consent form which means that you have understood the future benefits and possible risks associated with the procedure.

Photographs of the area to be treated may also be taken by the practitioner for a “before and after” comparison later.
 
Depending on the area being treated, and your tolerance of pain, an anaesthetic cream may be first applied to help minimise discomfort.
 
The selected pigments are blended and applied into the skin with a very fine needle via a small hand held electrical device.
 
The initial appointment should take from ½ - 2 hours depending on the areas being treated and the skill/speed of the technician. There should always be one or in some cases two follow-up appointments, which should be included in the overall cost of the treatment. The follow-up appointments will take less time.

Repeat procedures

It is not possible to determine the length of time the pigment will remain visible in the skin as each person varies, however it is recommended that treatments are re-applied when necessary to freshen the appearance of the application; this may be anything from 6 - 18 months. 

Recovery

How long will it take to recover from Micropigmentation?

No recovery time is necessary, however treated areas will appear a little dark for a few days and subsequently exfoliate and lighten to a more natural looking shade.
 
In some instances, on delicate skin there may be swelling and or slight bruising, however you can return to work and normal activities immediately after a treatment.

Side Effects and Risks

What are the risks and potential complications from Micropigmentation treatment?

Micropigmentation procedures are of a skin invasive nature (as they are a form of cosmetic tattoo) and therefore you may experience some discomfort. This may vary according to each individual's pain threshold and the skills of the technician performing the service. However, keep in mind that there are different methods available to help with pain management, including various topical anaesthetics.

Your skin should return to normal relatively quickly as any side effects such as swelling or redness is generally mild.

Allergic reactions to permanent pigments are quite rare. You may request a skin sensitivity test in an invisible area beforehand to see how your skin responds. Some technicians routinely recommend a sensitivity test as part of the treatment.

Needles inserted too deeply in the skin can cause bleeding, spreading of pigments, and damage to hair follicles.

Scarring is very rare, and usually because of an error by the practitioner performing the treatment.

If proper hygiene and sterilisation guidelines are followed, micropigmentation should be very safe with few risks.
 
It is advisable not to pick or rub the treated areas to minimise the risk of infection.

Post-Treatment Advice

What should you do after a Micropigmentation treatment?

It is very important that you follow the advice of your practitioner carefully after micropigmentation to reduce the risk of complications.

Post-treatment advice includes:

  • Avoid direct sunlight on the treated area.
  • Avoid swimming for several weeks.
  • Do not pick peeling or any flaking skin.
  • Avoid wearing conventional make-up on the treated area(s) for 3 - 5 days.
  • Apply Vaseline (petroleum jelly) to form a barrier for 3 - 5 days post procedure.

Contra-indications

Who should not have Micropigmentation treatment?

As long as you are generally healthy and don’t have any skin diseases or infections in the area treated, there are few medical reasons why patients should not undergo this treatment.
 
Those who are pregnant or breastfeeding are recommended to delay treatment. Insulin dependent diabetics and people with some heart conditions will also not be suitable for treatment. Please inform you practitioner of any medication you are taking, if in doubt seek medical advice.

If you are prone to keloid or hypertrophic scarring (red, angry, raised) you may develop scar tissue at the treatment site. Please think this over if you have experienced this in the past.

Who Can Do It

Who can perform Medical Micropigmentation?

This is not officially recognised as a medical procedure, so someone can perform it without a medical background. However, these days insurance companies are becoming more strict and many are refusing to insure those without a medical or beauty qualification.

NOTE: some of these procedures are more advanced than others. Conditions such as scar camouflage and areola re-pigmentation are more complicated and thus require an experienced technician with advanced training to carry them out.

You should therefore choose a technician carefully by considering their training, experience and their portfolio. Do they have experience in performing the type of treatment which you are considering? Below are some questions, which you should ask as you “shop around” before undergoing treatment.

  • How long have they been practising?
  • How many treatments have they performed?
  • Are they providing the latest most up-to-date treatments?
  • Do they provide advanced procedures?
  • Do they only specialise in micropigmentation?
  • Do they update their knowledge frequently by attending seminars, conventions and refresher courses?
  • Did they come recommended?
  • Does their clinic meet with health and safety requirements?
  • Does it look clean and hygienic?
  • Does their equipment meet with local Health Authority regulations (the most up-to-date equipment uses safe disposable cartridge style needles)?
  • Ask to see “before” and “after” photos of their previous work.

You will obtain your desired look after a combination of consultations and discussions, the first treatment and then the follow-up procedures. A good relationship between you and your technician is of the utmost importance to guarantee success.

Price

What is the average cost of Medical Micropigmentation?

The cost of the procedure should not be the most important issue when consulting a potential technician.

Most important is the training and skill of the technician in performing the advanced micropigmentation techniques required for reconstructive results, and the confidence of the client in that skill; as well as their reasons for wanting the treatment.

An indication of prices for medical micropigmentation are as follows, but can vary considerably:
 
Camouflage -  £250 per session
Colouring complete areola (one breast)  - £500

Conclusion

Summary of advice for Medical Micropigmentation

Micropigmentation treatments can range from the very subtle to the dramatic, depending on what the client is looking for. A general rule is the more dramatic, the longer it will last. The most frequently requested medical or reconstructive procedures are explained below.
 
Eyebrows
 
Eyebrows are the frames of the face. When sets of brows are designed correctly they can lift the eyes and give a more youthful appearance to the face. Clients with sparse eyebrows can have them corrected, and they can be totally reconstructed for those will total hair loss such as Alopecia.

Advanced techniques for eyebrow reconstruction include the art and skill of replicating real hair.

Nipples

Aeolas or the brown area around the nipple can be defined to correct damage and scarring incurred following breast surgery such as lumpectomy, mastectomy and/or reconstructive or reductive operations on the breast area.

Advanced techniques for nipples include colour blending.

Please take into account that although the pigment does fade over time, it may never completely disappear. If you are really unhappy with the results, laser treatment may be required to remove the pigment permanently.

Before and After Pictures

Before and after photographs of Medical Micropigmentation

Aerola on a female before semi permanent make-up

Areola restoration on a female using micropigmentation

Before (left) and After (right), areola restoration on a female.

Eyebrow hair loss

Eyebrow redefinition with micropigmentation

Before (left) and After (right), eyebrow redefinition on a male (hairloss caused by alopecia).

Photographs above courtesy of Natural Enhancement (UK) Ltd


Aerola on a female before micropigmentation

Areola restoration on a female using micropigmentation

Before paramedical micropigmentation (left) and After (right).

Having undergone a mastectomy this client requested cosmetic tattooing to create a realistic looking nipple and areola.

Photographs above courtesy of Karen Betts - Nouveau Contour.

All before and after photographs are actual patients, your results may differ.