Wendy Lewis, dubbed “the Knife Coach” for her impartial advice on the best aesthetic treatments, says her favorite facialist in New York is Denise DeGiulio at Enhanced Image, 130 West 57th Street, New York 10019; 212-957-0777 — she gives a professional-grade facial and peelings and is very experienced in all manner of cosmetic treatments.

The Art of Micropigmentation

The demand for micropigmentation procedures has increased greatly because consumers have become more aware of the benefits of permanent cosmetics. Many nurses and skin-care professionals are seeking formal training in these techniques. Well-done micropigmentation is definitely an art, and the best technicians tend to have a good eye for aesthetics and a sense of facial balance and proportion.

The key advantage of micropigmentation is that a woman can wake up every morning with some color and definition to her face, without having to bother with a time-consuming makeup application. Micropigmentation can be worn alone or with additional cosmetics; for example, lipstick or lip gloss can be applied over permanent lip color, if desired.

Says Denise DeGiulio, aesthetic director of Enhanced Image Inc in New York City and a course instructor for PMT/Permark, “Micropigmentation can be performed using various methods, including the traditional coil machines, the pen or rotary machine, and the hand method.

“The process includes a consultation, the application of pigment, and at least one follow-up visit to adjust the shape and color or density of the pigment as needed. Colors will appear darker immediately following the procedure but will soften during the first 10 days.”

Micropigmentation is considered “permanent” or “semipermanent” because the color is implanted into the upper reticular dermis and cannot be simply washed off. However, some fading does occur over time, and color retouching is required after 2 to 4 years.

Most people experience some discomfort, and the methods used for pain management are similar to the ones used for botulinum toxin Type A injections,filler injections, and nonablative laser treaments. They include topical anesthetic ointments, local anesthetics, and nerve blocks.

For conditions such as alopecia areata, permanent cosmetics can be used to replace lost eyebrows and eyelashes. Permanent cosmetics administered in fine individual strokes are also used to fill in areas of the scalp to camouflage hair loss.

Nipple areola repigmentation is another common technique used by plastic surgeons after breast reconstruction. Hypo­pig­mented scars from aesthetic surgery or traumatic injury may also benefit from repigmentation with permanent cosmetics.

It is mandatory to follow proper sterilization procedures and work in a clean environment. As DeGiulio explains, “We treat micropigmentation like a medical procedure. All needles used should be new and sterile for each client, some machine parts are disposable and should be disposed of in a sanitary manner, and all other parts should be autoclaved.”

I have a disorder called trichotillomania, or compulsive hair pulling, and it has left me with virtually no eyelashes or eyebrows. People who have this disorder pull out their own hair and/or eyelashes and/or eyebrows. I’m beginning to tire of the difficulty, expense and time required to conceal my condition each day, and am considering tattooing, what do you think?

Thanks for sharing the details of your condition. I know there are others who experience the same compulsion and might be considering similar options, so it’s good that you’ve brought it to light.
* First, though, if you haven’t seen a dermatologist, I strongly suggest you do so, just for a definitive diagnosis. And you should to make sure the area of your brow isn’t bruised under the skin, extrasensitive or in any way traumatized as a result of the hair pulling.
* If indeed the doctor says it’s okay, I wholeheartedly recommend a tattoo, but only if it’s done in an aesthetically pleasing way by a trained artisan, medical aesthetician or doctor.
* I recommend having a light pigment done, over which you can enhance with a bit of brow makeup. This way, you can still manipulate and enhance the brow area yourself. And because shape and color are paramount, I also recommend consulting with a makeup artist as well as a tattoo professional. As a general rule, the most flattering brow color is one shade to one and a half shades lighter than your hair color, and the arch is key. (*See my column on eyebrows.)
* Start by making an appointment with a professional makeup artist. If you live in the New York City area, please contact me and I’ll personally help you create an appropriate and flattering shape, one that suits your face, doesn’t interfere with your overall qualities and compliments your eyes, skin and hair tones.
* After you’ve agreed upon a shape and tone, you’ll be ready to to see the tattoo professional, also known as a micropigmentation professional, to discuss tints and characteristic of design. At this time, you’ll also make sure that she or he is licensed and accredited, and that you feel comfortable.
* You’ll need to reserve two appointments with the makeup artist and two with the tattoo professional — one for initial consultations, and one for the procedure.(I recommend bringing the makeup artist with you to help draw the intended shape.)

I discussed and consulted with New York City professional micropigmentation experts whom I comfortably recommend:

* Denise DeGiulio is a medical esthetician, who owns and runs Enhanced Image Inc. in New York City. She’s also the East Coast trainer for Permark, the company that makes the pigments used by micropigmentation professionals. Denise creates eyebrows using a very delicate touch in fine hairline strokes, utilizing the same lowlight and highlights techniques as fine hair colorists.

Medical Aesthetic Specialist, Denise DeGiulio of Enhanced Image, Inc.

There is a certain sense of strength that comes from taking care of yourself. Denise DeGiulio of Enhanced Image does simply that. She provides a number of procedures to help you enhance your own image and feel better about yourself. Treatments include facials, rapid exfoliation, camouflage therapy, manual lymphatic drainage, micropigmentation and basic make-up application. Denise takes time to individualize the treatment to match each client’s needs and ensure optimum results. Manual lymphatic drainage, camouflage therapy and micropigmentation are procedures often used in post-operative situations. Denise has acted as Program Director for the Skin Care Unit at Brooklyn Hospital Center. She is an active member of the Society of Plastic Surgical Skin Care Specialists, has been a Curriculum Instructor for Barbizon Modeling School and a participant in the American Cancer Society’s “Look Good, Feel Better” program. If you or someone you know would enjoy an image boost, contact Enhanced Image for an appointment or a beautifully wrapped gift certificate. Denise is available by appointment and is located in the same suite as Dr. Theirl.