Alesya Khokhlova , artist, teacher of permanent make-up and artistic tattoo, founder of the school-studio of permanent make-up and artistic tattoo Millecenta (www. millecenta.com , tel.: +3 7529 171-17-71, millecenta.com@gmail.com ), author of the unique methodology "5-step system of permanent makeup training", author of the INKJECT training system: Ink-Technique + Inject-Technique (Ink-Technique - working with color in permanent makeup with practical application), creator and developer of the color wheel system Khokhlova A. M. (color in permanent makeup)

The manifestation of vascular pathology on the lips is a sign of a disease of the vascular system of the body. The disease is diverse in its clinical manifestations.

There are several types of vascular dysplasia (vascular pathology): venular, venous, lymphatic, arteriovenous, mixed. Port-wine stains also refer to vascular pathology.

In modern medical cosmetology, many procedures are aimed at removing unwanted vessels. And, as described in previous articles, it is possible to deal with vascular pathology in a surgical or non-surgical way.

The surgical method is used in certain difficult situations, when this will be the only possible method of treatment. There are also alternative methods of correction used in cosmetology.

It is important for a permanent makeup master to understand that the appearance of vascular neoplasms is the first sign that attracts the client's attention long before the appearance of other symptoms of the disease. Our task is to timely identify the connection between skin changes and an imperceptibly developing somatic disease, which can actually be more dangerous than a cosmetic defect.

The sooner the true cause of the manifestation of vascular pathology on the lips (skin) is revealed as a result of the examination of the client, the sooner he will begin pathogenetic, rather than symptomatic treatment.

Man at the reception: how it was

A young man turned to MILLECENTA STUDIO before a consultation at the medical center.

The man wanted to do permanent lip makeup and, if possible, trichopigmentation of the chin in some areas. The neoplasm that we observe on the right above the upper lip of our client caused discomfort.

History taking: a typical variant of venular dysplasia.

A speck appeared on the face as a result of mechanical damage to the skin during shaving. After three months, it acquired a pronounced outline.

The formation occurred as a result of blood overfilling of defective capillaries, overstretching and rupture of their walls with the formation of cavities and hemorrhages (hematomas). The blood in these cavities, due to the slow current, formed small clots, blood clots. Hematomas and thrombotic masses sprouted with connective tissue fibers. As a result, connective tissue partitions were formed.

It is important to note that the mechanical impact on the site of the neoplasm (during shaving) led to significant bleeding and discomfort to the client.

The color of the presented neoplasm (as in the photo) can have a color from red to blue-violet. In some cases, there may be lesions that are the color of healthy skin (the deeper the vascular tumor is laid, the lighter its color).

Treatment

As we know, progress in the treatment of vascular neoplasms has been achieved through the use of laser therapy .

For the treatment of diseases, you can use such devices as carbon dioxide (CO2), argon (wavelength 488 nm), krypton (568 nm), pulsed dye (585 nm), argon-pumped (585–690 nm), semiconductor (800 nm ), Nd:YAG (1060 nm).

In our case, a 595 nm yellow dye laser (PDL - 585–595 nm) was used to treat venous ectasia above the lip surface of a client.

PDL is a vascular laser that uses hemoglobin as a target (chromophore) present in red blood cells circulating in the blood vessels and acting predominantly through photothermal effects. Hemoglobin exhibits absorption peaks in the blue, green, and yellow bands (414, 542, and 577 nm) as well as a peak in the near-infrared region of the electromagnetic spectrum (700 to 1,100 nm).

Modern laser systems that are used in the treatment of vascular pathologies emit wavelengths around these peaks, but the depth of penetration is also important here. For example, 414 nm has a surface penetration depth, therefore, it is not used in practice in the treatment of blood vessels.

Green laser light emitted at a wavelength of 532 nm is used in clinical practice, but it also has a slightly shallower penetration compared to the PDL laser (585–595 nm).

595 nm penetrates deeper than 585 nm but requires more density due to relatively low absorption compared to 585 nm. As a result, when switching between these two wavelengths, it is important to consider the energy density to control the increase in absorbance at 595 compared to 585 nm.

As for the Nd:YAG laser (1064 nm), it is long-pulse, it is used most often for deep vessels (mainly on the legs or large blue vessels on the face) due to the advantageous penetration depth compared to the PDL laser. At the same time, the 1064 nm Nd:YAG laser energy is absorbed almost ten times worse than the 595 nm dye laser (PDL), an indication that higher energy densities are required.

In the settings of equipment for the treatment of vascular pathology, the size of the spot, the duration of the pulse and the energy density are important. Spot size is important for both coverage area and penetration depth. A smaller spot size will have more light scattering and less penetration compared to a larger spot size for a given energy density. This is important in vascular treatment, as the chosen spot size should correlate with the depth of the vessel.

Conclusion . Our client was treated with a PDL laser, which was developed and used as a vascular laser. The emitted wavelength is in the yellow band between 580–600 nm, used in dermatology. It is also used to treat port-wine stains. Unfortunately, one of the limitations of this equipment is the relatively small maximum penetration depth (maximum 1.5 mm at a spot size of 10 mm), so it is not used to treat large and deep vessels of the lower extremities.

The number of procedures - 3 with a frequency of 1-1.5 months.

After the treatment, the client signed up for permanent lip makeup and chin trichopigmentation.

Photo of a client after three sessions of laser therapy

Technique for performing lips PM and chin trichopigmentation

Stage 1. A clear contour of the upper and lower lips. Sketch fixing.

The procedure for permanent makeup is carried out as follows - we apply application anesthesia only on the surface of the lips. We do not affect the tricopigentation area and the area after laser treatment.

Spot camouflage (see photo after treatment): use 4 mixes of HANAMI pigments - 2 warm tones, 2 cold. Mixes should match as much as possible with four skin tones on the client's face.

We pay attention to the skin color of the cheekbones, eyelids, upper lip under different lighting conditions.

We carry out the work with a wide beam needle RS 5, 6, 7. We gradually introduce the pigment at an angle of 90 degrees strictly perpendicular to the skin.

In work, we use moistened cotton swabs and wet wipes to remove pigment residues. We make camouflage mixes in 2-3 passes. Time for camouflage - 20-30 minutes maximum.

Stage 2. Permanent makeup for men's lips.

A mix was previously prepared based on HANAMI pigments: СHILI (after healing, a light red-pink color, the intensity depends on the technique of the master and the laying of the pigment), DIRTY PINK (dirty pink).

My task in the process of work was the following: the client's lips should acquire a soft outline visually along the contour and a slight uniformity of color over the surface.

The goal that I set for myself as a master is to create visually even male lips of a rich shade and without a strict contour, using light camouflage technologies in the field of vascular pathology and tricopigmentation.

Stage 3. Tricopigmentation MAKSINUS male chin.

Used pigments HAMAMI APEOLA BROWN - 5, Black Coffee, Golden Brown. Needles: texture 0.25, 0.3. Apparatus: tattoo machine Cheyenne HAWK PEN .

Tricopigmentation was performed without anesthesia. Imitation of hairs was created by layer-by-layer application of pigment. The client did not experience discomfort and was satisfied with the result of one procedure.

Photo of the client after healing work

An additional permanent makeup service was not provided to the client. Men's permanent makeup and trichopigmentation should look natural and masculinely seductive.

In our practice, it is sometimes important to seek help from doctors and cosmetologists. And I appeal to the masters of permanent makeup: if you encounter such diseases in your practice, in no case try to fix the client's problem without a specialist's opinion, since damage to the vascular pathology is fraught with consequences. Take care of your clients!

I wish that the information you have read be useful in the field of permanent makeup. I wish you all positive clients, success and career growth.

PS ​Additional information for permanent makeup masters

Venous hemangioma before and after laser coagulation

An example of an arachnid hemangioma

An example of a port-wine stain on a client's skin

The photographs are additional examples of venular dysplasia (vascular disease) in clients successfully treated with laser treatments.

Further - only the professionalism of the master.

With love for the art of permanent makeup,

Millecenta (Alesya Khokhlova)