While it would be preferable to undergo any kind of surgical lifting before facial tattooing especially if significant alteration is expected, properly placed permanent makeup will maintain their position with respect to the brows, eyes and lips.
Injectible fillers used to increase lip volume, for example, typically should not affect tattoo position either and could be performed before or after tattooing.
Ablative resurfacing (removal of the epidermis and portions of the dermis by dermabrasion, carbon dioxide or Er:YAG laser, or chemical peeling agents) causes significant inflammation which will decrease a tattoo's color intensity, if not allow much of the pigment to eliminate through the abraded surface of the skin. While non-ablative laser resurfacing (creating a dermal injury while leaving the epidermis intact) has not been reported to cause problems with cosmetic tattoos, vigorous treatment can result in inflammation lasting hours or days and might theoretically lead to some pigment removal. Q-switched lasers (alexandrite, ruby, or Nd:YAG) are well known to cause permanent pigment darkening reactions in titanium and iron oxides commonly used in tattoo pigments. Therefore it is exceedingly important to inform the physician using a Q-switched laser the existence of any cosmetic tattoos. Laser hair removal, which employs alexandrite, diode, and Nd:YAG lasers, deposits light over a longer pulse duration than their Q-switched counterparts and is not known to cause tattoo pigment darkening. Still, significant inflammation can occur and the multiple treatments required for successful laser hair removal might lighten cosmetic tattoos. Finally, topical photodynamic therapy using aminolevulinic acid (ALA) and intense pulsed light (IPL) or pulsed dye laser can cause prolonged inflammation in the skin and therefore lead to significant removal of tattoo pigment.
