Permanent makeup and botulinum therapy: combinations of procedures

Lyubov Malysh, dermatocosmetologist, specialist in hardware and injection techniques for face and body correction, leading specialist in exclusive hardware techniques (France) of the BIDC clinic, member of the Association of Cosmetologists and Aromologists of Ukraine

Often, in an effort to look younger and more beautiful, our clients turn not only to us, but also to injection cosmetologists, which, of course, is rational and justified. But who should be the first to work with the face: a doctor of aesthetic medicine or a PM master, so that the result pleases everyone? Let's figure it out

Sometimes women are ready to take any risks, including combining and alternating various complex procedures, just to preserve beauty and prolong youth. One of the most common such combinations in cosmetology practice is the combination of permanent makeup on the face with botulinum toxin injections. Is it possible to combine these procedures, is there any need for an interval between them, what to do first and in what areas can we combine these two, certainly popular and beautiful services? What are the consequences and how it will affect the appearance? So, botulinum therapy, and then tattooing, or vice versa?

Botulinum therapy and PM: nuances

Let's see what botulinum therapy is. The botulinum toxin injection procedure involves the use of a dangerous poison, a weakened and highly purified botulinum toxin, which the doctor injects into small muscle fibers. As a result of the injection of the drug, the muscles relax and become inactive, the eyebrows after injections can remain blocked for 7⎼14 days. The effect of eliminating wrinkles due to the cessation of muscle contraction lasts for an average of six months, the procedures can be repeated 2-3 times a year.

The procedure of permanent makeup is carried out inside the skin and, like botulinum therapy, involves a small surgical intervention, leading to traumatization of the skin with a mandatory rehabilitation period and careful care. The effect of the micropigmentation procedure lasts from one to three years.

It is necessary to combine these procedures in the areas of the upper and lower thirds of the face.

The zone of the upper third of the face, in which, in fact, the zones between the eyebrows and forehead are located, despite its rather small mobility compared to the lower third of the face, is the first to experience the results of gravitational omission of soft tissues. Indirectly, this area can be attributed to the correction of the arrow on the upper eyelid, together with injections of botulinum toxin to relax mimic wrinkles around the eyes, as well as to relax the muscle wrinkling the nose (“rabbit wrinkles”). In the lower third of the face, micropigmentation of the lips and botulinum therapy are most often combined into "purse-string" wrinkles above the upper lip and into the muscle that lowers the corners of the mouth.

The effect of combining with good craftsmanship is colossal! Imagine a smooth forehead without a single wrinkle and expertly executed eyebrows or a high-quality lip tattoo and smoothed vertical wrinkles above the upper lip, beautifully raised corners of the mouth and straightened labio-chin furrows in an older lady. Just minus ten years!

However, both procedures are quite specific, and each has its own characteristics and stages, without immediately giving the final result. Micropigmentation, as noted above, requires rehabilitation, elimination of edema, rejection of crusts and residual color manifestation, while taking into account possible additional correction. The effect of botulinum toxin is also not immediately apparent. On average, on the 14th day, we can observe muscle relaxation, wrinkle smoothing and judge the final result. Therefore, both cosmetologists and PM masters advise to observe an interval of three to four weeks between the injection of botulinum toxin and permanent makeup. As for the sequence of procedures, opinions differ up to the opposite. All the pros and cons depend on the experience of the master. A key role, of course, should be played by an individual approach to the client.

PM ⎼ Botox

There is a common rule in cosmetology: first, what lasts longer is done. Following this rule, permanent makeup must be done before the injection. It should be noted that with the introduction of botulinum toxin, the beautician can slightly raise or lower the eyebrows (usually this is the client’s desire). If you do micropigmentation after Botox injections, then as soon as the drug is removed and the eyebrows fall into place, it is likely that permanent makeup will look strange.

PM masters often correct asymmetry by making the shape of the eyebrows taking into account the facial expressions of the client. True facial expressions can be adequately assessed only without preliminary injections of botulinum toxin in the area between the eyebrows and forehead. And to carry out the tattooing procedure without fear of changes that may occur after the restoration of innervation and mobility of facial muscles.

Botox ⎼ PM

The opposite opinion: "freezing" facial expressions of the forehead often leads to the correction of the asymmetry of the eyebrows. It is more logical to first introduce a botulinum toxin preparation, and then, after 3⎼4 weeks, when the preparation “gets up”, you can proceed to permanent makeup. This sequence is suitable, for example, in the case of severe deep forehead wrinkles, which can move the eyebrows to the bridge of the nose. If pigmentation is done first, then after injections of botulinum toxin, the muscles will evenly relax, which can lead to asymmetry. If you first introduce botulinum toxin preparations, and then make pigmentation, an unaesthetic result can be avoided. If forehead wrinkles are weakly expressed or appear only when frowning, then any combination of procedures is possible.

As for wrinkles around the eyes, preference should also be given to botulinum therapy, since a tightened eyelid will provide a clear contour of the inter-ciliary line and facilitate the work of the master.

Let's now look at the work on the lips. The circular muscle of the mouth, being in hypertonicity, deforms the shape of the lips, forming vertical wrinkles that literally cut into their border, make the contour of the lips blurry and fuzzy, and also reduce their volume. What decision the master will make depends on his approach and experience. It is preferable, again, to first do the botulinum therapy procedure, and then, after the elimination of wrinkles, to carry out micropigmentation. In addition, in this case it is easier to eliminate a slight congenital asymmetry of the lips.

It should also be noted that the nasolabial area and the lips themselves are most often subjected to contour correction (filler injection). When performing lip tattooing, PM masters should take into account the injection sites of the filler and the shape of the lips in the future: perhaps it is necessary to abandon the correction of lip asymmetry with tattooing, and make it with a filler. Of course, with this approach, it is necessary to take into account the condition of the teeth, the correct bite and the client's plans for treatment at the dentist (prosthetics, bite correction, braces, etc.). All these moments greatly affect the state of the nasolabial and labio-chin zone.

Fillers and tattoo

And a few words regarding the question: what comes first - filler or tattoo? First - tattoo, then filler. Unlike botulinum toxin, which relaxes the muscles and works deep, the filler acts more superficially, as it is injected into the dermis, causing an intense accumulation of moisture. This improves skin turgor and its resistance, so the pigment may be poorly administered. In addition, the installation of the filler provokes the intensity of metabolic processes in the dermis, which will entail the rapid removal of the pigment. Lip tattooing in this case should be done one and a half to two months after contouring. If the client contacted you after the filler was placed, you should warn her about it. Otherwise, she will not be satisfied with the result, since the presence of edema, which will be much greater than usual, as well as a temporary inflammatory process in the tissues, which means increased microcirculation of lymph and blood, can lead to mutual neutralization of the effect of both procedures.

Such a complex and step-by-step approach to aesthetic cosmetology requires serious knowledge and experience, as well as close cooperation with colleagues who own techniques that you may not own. Learn, improve your skills and knowledge! The results are worth it!