This patient came to us for a consultation looking for somewhere she could get help covering her scars, but also somewhere where she wouldn’t feel like she was being judged. It’s often very hard for self-harm patients to talk about their problem with anyone and many manage to keep their scars hidden from friends and family for decades. This patient underwent a very successful skin graft procedure by a surgeon to cover self-harm scars to the forearms. Surgery was performed two years prior to having cosmetic tattooing. In my experience, medical tattooing can generally be done one year after having a skin graft however, depending on the case, it may take up to two years.
Very tight scar tissue meant that the medical tattooing procedure had to be done very slowly using a fine needle, to implant pigment into the skin with a pointillism method, where you hold the needle directly above the skin to create microdots through the whole scar. This technique also helps to break down and loosen the tight scar tissue due to the penetration. Four different shades of pigment were used on this patient, two for the freckled appearance, to create more depth, and the other two shades were used over the whole area that was being treated, to match the patient’s skin color.
The freckles were done unevenly, in both small and large sizes, to mimic the appearance of true freckles. Pointillism for the freckles could have created too dense a color tone, so we used a shading needle in small, circular movements to create different sized freckles and used it to push out the pigment in some areas, so not to create a freckle that was too rounded. This allowed the freckles to blend in better with the rest of the skin. The patient was delighted with the result which took almost four hours to achieve. There was no follow up on this particular procedure as the patient was due to work abroad soon after, otherwise the patient would have come in for a follow up procedure to check the result, which can last up to five years. Complications are highly unlikely; however, the patient may have poor pigment retention which would mean that they may need to have more sessions. If the healing is delayed or the area required medical attention, I would advise the patient to visit her general practitioner.
The patients that were included in both these case studies reported a confidence boost and a sense of liberation after receiving these life-changing treatments. It is important for aesthetic practitioners to consider the possibilities of medical tattooing for their patients and, in circumstances where practitioners may not be able to treat the patient but where medical tattooing may be an option, there should be the opportunity to refer them to professionals