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North County Times San Diego
Loraine-Dale Hall
Burn Victim Shelli Dempster of Encinitas had her eyebrows and eyelashes tattooed at spaViolet by Loraine-Dale Hall. J. Kat Woronowicz for the North County Times

Healing Beauty: Medical Tattooing Can Improve Patients' Self Image

By: Ruth Marvin Webster, Staff Writer

Loraine-Dale Hall wiped Shelli Dempster's eyebrows with a swab of alcohol once the buzz of the tattoo machine was silenced. Then Hall, a cosmetic tattooist in Cardiff, gave her client a mirror.

"What do you think?" she asked Dempster about her newly tattooed eyebrows and eyelashes.

"I look beautiful." Dempster told Hall, tears welling in her eyes, starting to trickle down her cheeks. "Thank You."

For burn victims, cancer survivors, those with alopecia (hair loss) or motor control conditions such as multiple sclerosis or Parkinson's, permanent makeup, or cosmetic tattooing, is a bit of a misnomer. The procedure, especially for women, is often much more than just mascara and lip liner.

Dempster suffered burns over 85 percent of her body when her car caught on fire in and accident nearly 16 years ago. Her new permanent makeup helps her feel attractive enough to go out into the world with confidence. "My childeren don't see my burns," she said. "But I feel much better about going to their school to volunteer."

The Finishing Touch

The technique is called dermapigmentation or micropigmentation. It's practitioners, who do not require any particular training and no license to practice, operate in estheticians' offices or even nail shops. They use natural pigments that can change color or fade over time and tattooing equipment to draw on eyebrows and eyelashes as well as to fill in lips or to blend out scars elsewhere on the body.

Cosmetic tattooing is also particularly effictive after breast reconstructive surgery, essentially tattooing a new areola on the breast.

"it is beautiful for the areola," the area around the nipple, said Kris Pinto, a registered nurse who has been doing this kind of tattooing for almost 15 years in Poway. "it is the finishing touch of their treatment. For a lot of women after they have breast reconstruction, they have a breast and a nipple, but they still feel their is something not right about them. It is like the icing on the cake."

For Dempster, Hall tattooed delicate brush strokes resembling hairs to form natural-looking eyebrows where no hair would grow. She thickened Dempster's eyelashes with dots of eyeliner along the rim of the lashes.

"It so goes beyond cosmetic," said Hall, owner of spaViolet in Cardiff, "I had one woman who lost all of her hair when she was 21. She was young and hip, and I did thick eyebrows and eyeliner for her. It was not for everybody, but she told me that I had changed her life."

Sizteen years ago, Dempster was in a near-fatal car accident near Rsarita Beach in Mexico when the Miata her friend was driving hit a stopped van and the gas tank exploded.

During five months of intensive care, a year and a half in the hospital,29 surgeries and more pain that most could ever imagine, she persevered. It took her an entire year to regain the feeling in her hands.

"The human will is amazing. I surprised myself and a lot of other people. I never thought I would get marrieed and have children," said the Encinitas resident, now a wife and a mother of five.

A Powerful Tool

But though the most visible physical woulds have healed, she still had difficulty working up the courage to go out and meet people. Experts say that for many patients, cosmetic tattooing can be a powerful means to improve self-image, especially after an injury or onset of symptoms from a disease.

"I would never have thought of permanent makeup unless Dale (Hall) had come up to me at that pizza party at Pizza Port," said Dempster, recalling how they met at a birthday party years ago.

Hall approached Dempster's husband first, giving him her card and discreetly commenting that she thought she could help his wife and would like to donate her skills.

Sill, it took Dempster almost two years to have the confidence and the courage to make an appointment. "I would stop in, and Dale would say she had thought of me," recounted Dempster. "She would sit and talk with me, and then I would call her again a few months later or come in. She was so patient with me."

Hall said patients with conditions such as Dempster's often require more hand-holding that those who come in simply for cosmetic work. These patients can pose challenges, since they have often already undergone a plethora of medical procedures and bring a host of anxieties to the chair.

"That is where my nursing background comes in," said Pinto, "dealing with this clientele because you have to be a little more sensitive to their needs. I treat all my clients like patients instead of clients."

Said Hall," These clients have had already their fair share of needles and surgeries. I had one woman who came for a areola repigmentation after breast cancer... and the first things she said to me was, "Where's the nearest martini?" she was so done" with surgery.

"It is a very safe environment", Dempster said, to whom Hall applied novocaine because her facial scarring from the burns were so severe. "It's soothing, with soft lights, and I would hold onto a teaddy bear. I felt taken care care of." SHe is now planning to have her lips outlined and tinted.

New Pigments, Techniques

Originally used by movie stars in the 1940s who were tired of applying makeup, cosmetic tattooing is gaining popularity, partly because of the pigments, techniques and equipment have improved.

"I tell people that no one will know you're tattooed unless you tell them," said Hall, who spent nearly a year driving up to Hollywood's Sunset Strip to apprentice. "I learned how to tune the machine and when the sound of the machine was right. I learned how it felt to get the needle right, to get the strokes down and even to scrub tubes."

But as tattoing's popularity increases, said Pinto, the registered nurse, so does the potential for shoddy workmanship. "I think that the people who have been doing this are getting better, and their results are more natural. But because it is so popular, it is sprouting in every nail shop or in the back room. Everybodaywants to do it, and they can use the wrong colors, that happens a lot, or they don't use clean needles."

Barbara McCoy, 59, also a registered nurse, has worked at UC San Diego as an anesthetist for 33 years and now does cosmetic tattooing at the Center for DermaGraphics in La Jolla.

"Unfortunately, it has not been a licensed field, and anybody can do it," she said. "The national association has really tried to raise the standards of the training, but until a couple of years ago, you could to to a weekend class and do it. A lot of people are lay people and don't have a really good sense of sterility. You have to know your colors, the end result of the pigment color plus skin tone. There is a lot of artistry and practice you bring to it."

Many expert cosmetic tattooists said that a certain portion of their workload is correcting the mistakes of those less skilled. Traditional tattoos use inks that have a high level of iron ixide in them, so the errors last virtually forever.

"A person who has a fresh tattoo can't have an MRI because of the high levels of iron oxide," explained Pinto in a telephone interview. "But with permanent cosmetics, we use pigments and they do fade over time. I tell people they will last one to five years, but you usually have to do a touch-up on eyebrows every year."

Fading occurs particularly under sunlight, tattoos that are kept covered tend to keep their colors truer and longer. This is one reason that breats re-pigmentation is often particularly satisfactory. "when you look at yourself in the mirror, it will hide those scars and make you feel like a woman again," said McCoy. "One of mypatients put it really well, 'You are helping me feel comfortable in my own skin' she said".

More Acceptance

McCoy noted that the medical community is starting to embrace cosmetic tattooing techniques. SHe said she has been asked to speak at medical conferences, such as the 22nd Annual Superficial Anatomy and Cutaneous Surgery Conference in La Jolla in 2005, where she discussed reconstructive tattoing, its benefits and its limitations.

MyCoy added that consmetic tattooing can be helpful to elderly women, those who are blind or with poor eyesight, and those with arthritis or who have tremors associated with multiple sclerosis or Parkinson's disease and may have difficulty applying makeup.

"I would say the majority of my clientele ranges from 30 to 70, with my oldest client being 97," said McCoy. "There is a whole range of people who can benefit from this. That is the part that appeals to me, it is not the foo-foo kind of benefit, but one that really helps with people's self-image and self-esteem."

And as long as the patient's expectations are reasonable and the esthetician's skills ard equipment top-shelf, cosmetic tattoing can deliver those results.

"That's enought for me," Hall said later as shewas talking about Dempster's reaction to her new eyebrows and eyelashes. "I have a goal to start a foundation. The better I get and the more that it is evolving, the more I love what I do. I'll be tattooing forever."

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