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Areola Question for Doctor Dixon

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Hello Dr. Dixon.  I hope the boot camp went well.  Those areola pictures are amazing.  My question to you is about areola micropigmentation.  I use the Harmonix digital machine with the 5 slope needle, but I do not know what exact speed I should be using.  Also, should my needles be at the same depth as doing eyeliner?  When they come back for their follow-up appt. how much fading  is normal?  Thanks a lot Dr. Dixon.

Wendy B


Hi Wendy,

1.  Needle depth:  Always start with the needles just barely out.  Remember, the thickness of a dime is 1.35mm and that may be too far out in some cases.  Paint on some pigment over the area where you are going to tattoo and then brush in the color with the 5 Slope®.  Use firm, even pressure like you're pressing in a thumbtack.  Don't worry.  Since your needles aren't out too far you will not hurt the skin.

If the color stays in the skin, then continue working.  If no color stays in the skin, then turn the handpiece 90º to increase the needle depth and do the test again.  I use Numpot to remove pigment so I know if I've gotten it into the skin.  With water you may not remove all the pigment and you'll get a false sense of having gotten the color in well.

2.  Eyeliner Needle Depth:  This is very shallow, as you know.  The epidermis of the eyelid may only be .5 to .75 cm... half the thickness of a dime approximately.  But I always do a depth test as well.

3.  Fading:  Color retention depends on how much scar tissue is present.  You cannot predict with certainty how much color will remain.  The important thing is to not overwork the areola area.

Also, color choice plays a large part in the healed result.  I use a lot of NUDE Lip Mix and Baby Lips/Areola plus Neutral Flesh and some Honey Brow for my areolas.  I'm in Hawaii so most of my clients are Asian and their areolas tend to be darker than a "fair-haired, blue eyed" patient.

4. Depending on which model Harmonix you have, you should run it on a setting of 100 (or 5).

5. Brush on the color before you start working with your needles. (see photo above)




Multiple Questions; Multiple Answers

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On 10/7/10 3:15 PM, "Maria De Santis" < This e-mail address is being protected from spambots. You need JavaScript enabled to view it > wrote:

Hi Dr Dixon,

Lately I have had ladies coming in that has had all sorts of the latest plastic surgery procedures,on medications and the newest anti-aging products.
I'm not sure if and/or when I am able to work on them.

Here are some issues I am coming across:
(sorry if spelling is off)

1. Thermage
2. Lifestyle Lift
3. A.H.A, Glycolic Acid, Retinal- if using before, how long to wait till can have P.M. and how long after. (I know to advise not to use directly on P.M. if they don't want the makeup to fade off)
4. Flu shot
5. Has Flu or cold already
6. Comidin
7. Cancer just complete treatments (P.M. for face and breast work)
8. Just had a baby and breastfeeding
9. Latese - before or after use on eyelashes and brows
10. Lasik - eye correction procedure
11. Sculpta, Juvaderm, etc (injectable fillers)
12. Shingles, chicken pocks
13. Laser hair removal or any other kind of treatments in facial areas that are to be tattooed.
14. Eyelift
15. eyelash extensions before or after eyeliner and how long?
16. Any other kind of misc. medications
17. Pinkeye: how long after?

Thanks so much

A Face Forever, LLC
Permanent Cosmetic Specialist
Maria De Santis
732-715-7391     908-654-0880   227 Elmer Street Westfield, NJ 07090
331 East Main Street Somerville, NJ 08876

website: www.faceforeverllc.com <http://www.faceforeverllc.com/>
email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

Thu, Oct 7, 2010 6:37PM

Hi Maria,

  1. Thermage and other radiofrequency devices, including eMatrix, warn against using them over a tattoo.  However, I have used the eMatrix over a tattooed eyebrow with no problem, however.
  2. Lifestyle Lift:  The potential exists for raising the eyebrows with any lift of the forehead.  Other than that, no problem.
  3. AHA’s (lactic, glycolic, citric and tartaric) can irritate the skin.  This inflammation might affect our color and may be one reason for them fading so fast.  We know Retinoic Acid affects our procedures; again, by causing inflammation and cell turnover.
  4. Flu shot: Might we wise to wait a week.  They can have some symptoms of the flu such as aches, low grade fever, etc.
  5. Flue or Cold: Don’t work on them during the infectious stage.  Wait a week or two.
  6. Coumadin:  Don’t do lips on someone taking coumadin.  Brows usually is okay.  If you try eyeliner, be careful.  I would not do top and bottom eyeliner at the same time in case of excessive bleeding or bruising.  But don’t have them stop taking Coumadin.  They usually need it to prevent a stroke from atrial fibrillation and throwing blood clots.
  7. Cancer:  Chemotherapy wipes out their immune system and white cells that fight infection.  Wait until their blood count is normal and get a doctor’s clearance.  They will be fine after that.
  8. Don’t work on anyone pregnant or breast feeding.  They can wait.  Too many metabolic changes plus there is the baby to think of.  A baby could sue you 21 years later if, for any reason, you were found to have transmitted any Blood Borne Pathogen.
  9. Latisse:  They people are okay.  Latisse does cause some discoloration of the skin and may decrease the time between touchups.
  10. Lasik:  Permanent makeup is ideal for people who have undergone Lasik surgery because they don’t have to use dirty cosmetics around their eyes.  Wait about 3 months.
  11. Fillers:  If they’re having fillers, then wait to do the permanent makeup until AFTER the Juvederm or Radiesse, etc.  Not because of any problem but the shape of their lips will change.
  12. Shingles (varicella):  If they have shingles on their face, then don’t do them.  Especially around the eye area.  This is serious when it is on the facial nerve, etc.  Just get a doctor’s clearance but wait many months.
  13. Laser hair removal:  put toothpaste over the lips to prevent darkening of the lipcolor.  Lasers can remove color or darken color.
  14. Eyelift or blepharoplasty:  Again, wait about 3 months.  I’ve seen scars break open after eyelifts when permanent makeup was applied too hard and too soon.  The older the patient, the longer you should wait.
  15. Eyelash extensions:  Have them put on AFTER permanent makeup, not before.  Working on women with eyelash extensions results in major loss of the extensions during the procedure.
  16. Pinkeye:  As soon as their infection is finished, then you can work on them.  Just not during an active infection.



Client with multiple Allergies

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Question: On 9/22/10 2:36 AM

Dr. Dixon

I have a potential client that I have some questions about her allergies.  She is allergic to Phenylenediamine; an ingredient in hair dye.  Is this ingredient in "Kolorsourse"?  Also she is allergic to rubber (which I use Latex gloves)  (or I use  latex free gloves on clients allergic to latex) and she is also allergic to petroleum.  SHOULD I EVEN CONSIDER HER FOR A CLIENT?  I have another potnetial client that  has "Leiden Factor 5" ; I feel that this would be a very risky client?  When I looked it up, this is what I found;  It I the most common hereditary blood disorder in the U.S.. It is present in 5% of Americans. Would you consider either of these people for permanent makeup?

Thank-you for your time & input (ERM)

Answer: Wed, Sep 22, 2010 10:13AM

Aloha Eileen,

Allergy client:  

  1. Phenylenediamine:  Our Kolorsource pigments do not contain phenylenediamine.
  2. I have seen a patient who was allergic to petrolatum.  The question is if they are allergic to Vaseline which contains a fragrance rather than petrolatum.  I spoke with the Vaseline people and they Vaseline is not for use around the eyes because of the fragrance.  I rather doubt she would be allergic to petrolatum (pure).
  3. Latex Allergy:  Even if you use “latex free” gloves, your client could still have an allergic reaction to the gloves.  Why?  Because the same chemical is used to cure “non-latex” gloves as latex gloves.
  4. Leiden Factor 5: I haven’t seen these clients.   But I am well aware of hypercoagulable disorders and their problems with deep venous thrombosis.

Take care.


Client allergic to Contrast Dye

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Question: 9/20/10 11:58 AM

I have a potential client who has allergies to contrast dye.  Does this in any way relate to having a potential pigment allergy?  I cannot find any info on this on the net, so any help you could give would be wonderful!

Answer: Mon, Sep 20, 2010 10:36PM


The allergies to contrast dye involve Iodine and your client may also be allergic to shellfish such as shrimp.

There is no problem with a pigment allergy as Kolorsource pigments do NOT contain Iodine.  I can't say with certainty about other pigments except that I doubt any have iodine either.


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