health
Cosmetic tattoos bring eyebrows back
May 9, 2011
Valerie Hauch
STAFF REPORTER
At the end of the day, Cristina Alexa would sometimes have one eyebrow trailing down her face.
“It was embarrassing,” says Alexa, 42, who has lost all her hair, eyebrows and eyelashes to a rare condition called alopecia universalis (see sidebar). She started losing her hair in March of 2010 and by fall, every hair on her body was gone. She would draw her eyebrows on in the morning, but never knew when one might smear accidentally.
Alexa has a collection of six wigs and is now used to being bald. “I’m at peace with it,” she says, adding that she will sometimes go bald by choice in the summer because it’s cooler than wearing a wig.
But being without eyebrows and eyelashes, which give eyes definition, was getting her down, so she decided to get brows and eyeliner tattooed in February this year.
Alexa chose Yorkville’s Permanent Make-Up Artistry, whose owner, Dorothy Kizoff, has 20 years of experience tattooing everything from eyeliner and eyebrows to areolas for women who’ve had breast reconstruction following cancer.
Kizoff says about 10 to 15 per cent of her clients come for tattooing related to illness, medical conditions or scars and birthmarks. Recently she helped camouflage a man’s port wine stain — a vascular birthmark like the one on former Soviet leader Mikhail Gorbachev’s forehead.
Kizoff, 62, apprenticed for a year with a tattooist in Quebec before she started doing cosmetic tattoos here. Two decades ago, it was still a relatively little-known procedure. When Kizoff, who also has aesthetician training, told people back then what she did for a living, “they’d look at me like I had two heads ... I used to pray for three clients a month.”
Now she does five procedures a day and is booked months in advance. The cost for alopecia eyebrows, which usually involve two visits, is about $850 (it’s $695 for purely cosmetic brows).
Kizoff says she gets huge satisfaction helping people with medical conditions who have lost their confidence along with their eyebrows. “It’s the best thing I’ve done,” says Alexa, who was in Kizoff’s studio for about three hours.
To ensure proper placement on Alexa’s face, measurements were made and the brows were pencilled on first. When the final artwork was approved, pigment was implanted hair by hair with a powerful, hand-held machine using a sterilized, fine needle that creates a vacuum and draws pigment into the skin.
Kizoff uses a topical numbing cream for touch-ups, but initial tattoo creations are generally done with an injectable anesthetic (Xylocaine) after consulting with the client and getting a medical history. (Tattoo artists are one of the groups exempted from a provincial prohibition against administering a substance by injection.) To get the best final result, it’s important that the client doesn’t move due to pain.
Basma Hameed knows about pain all too well. When she was only 2 years old and living in Iraq, an accident in her home with hot oil left her with third-degree burns to 40 per cent of her face and scalp.
Now 24, she doesn’t remember much about what happened, except that she was rushed to hospital and that one eye was “glued shut” from the heat of the oil.
Luckily, doctors were able to “open” the eye and save her vision. While in Iraq, Hameed had skin grafts done, and after living in Jordan for several years the family moved to Canada when she was about 10.
In Toronto, she had a successful procedure to fix her scalp and now has a full head of ebony, waist-length hair. But two hair transplants to try and fix one burned eyebrow using hair from her head met with failure. After the second operation, 15-year-old Hameed, who had been doing her own Internet research on options for burn victims, asked her doctor about the possibility of using permanent makeup — pigmentation tattooing — to fix her eyebrow.
“They said it was the worst thing I could do,” she recalls. She was advised to try one more transplant, and agreed. It, too, failed. “I was in high school — that’s the hardest time,” says Hameed of her self-image and self-confidence.
Thankfully, she had a very positive circle of friends and supportive parents. “My parents always said, ‘It’s what’s on the inside that counts,’ ” says Hameed, who took that to heart.
She wore makeup foundation, but it wasn’t very effective. “I felt good on the inside but the foundation didn’t do much on the outside.”
She has had skin grafts and many sessions of laser therapy over the years. The latter helped flatten the scar, but it left the skin discoloured and red. Doctors told her that the skin colour would change, but she says that hasn’t happened. “If a little bit of sun hits it, it turns blood red,” says Hameed, who always wears a little foundation makeup with sunscreen.
At age 16, with her parents onside, she met with Kizoff. Although only one eyebrow was burned, she got both eyebrows done so they would match well and also had one session of scar camouflage.
“I saw the change — I was so excited,” Hameed says.
She was so inspired that she asked Kizoff if she could do an apprenticeship with her. “She thought I was really young but she saw the passion ... she knew I was very driven and with my history I was perfect for this,” says Hameed.
At age 17, she started shadowing Kizoff four times a week after school, watching everything she did. This continued for three years through high school and a post-secondary two-year George Brown aesthetician diploma course.
Hameed also performed follow-up camouflage scar sessions during this period on her own face. Because scar tissue does not take colour as well as regular skin, Hameed says repeat sessions were needed. The nerve endings in the scar tissue are mostly gone, so she didn’t feel pain.
At age 18, Kizoff gave Hameed permanent eyeliner, which remedied a “droopy” look to one eye, as well as lip colour.
Kizoff hired Hameed after her three-year apprenticeship, and in 2009 Hameed decided to start her own cosmetic tattooing business, Fabulosity Beauty Clinic, working out of Kizoff’s clinic in the evenings and on weekends, concentrating mostly on scar camouflage and areolas for women who’ve had breast reconstruction (an areola can cost about $550). She also hopes to get into a fall nursing program while continuing her business.
One person who sometimes refers breast reconstruction patients to Hameed for areola tattoos is Dr. Tim Sproule, a plastic and cosmetic surgeon at Scarborough General Hospital who did work on Hameed and has known her for years.
He has been very impressed with the micro-pigmentation camouflage she’s done on her face. “It’s tough to get it to look natural,” he says, but Hameed’s skill on her own face “is an example of how good it can be.”
Breast reconstruction, including the creating of nipples and areola tattoos, is covered by OHIP when done by doctors. Sproule does areola tattooing himself, but admits that his skills in this area are not as good as a professional tattooist like Hameed. “They do it better. There’s no question we don’t know how to do it as well. I’m trained as a plastic surgeon, I’m not a tattoo artist.”
THE ROOTS OF ALOPECIA
Like Kizoff, Toronto cosmetic tattooist Tina Davies of Natural Effects Permanent Makeup deals regularly with clients who have alopecia (she charges $600 for eyebrows; the entire procedure takes about 1.5 hours). The Canadian Alopecia Areata Foundation estimates that about 1 to 2 per cent of the population has some form of alopecia, which happens when the body’s immune system attacks hair follicles, causing hair to fall out. There are various forms and degrees of alopecia, and different triggers that can set off the immune system malfunction, such as toxins, malfunctioning thyroid, burns and more. But sometimes, as in Cristina Alexa’s case, the trigger is unknown.