Elective Excision of Permanent Eyeliner

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Abstract
To the Editor. —Permanent eyeliner is applied with a single or triple tattoo needle that implants pigment in the dermis of the lids along the lash border.1 Recommended techniques for the removal of permanent eyeliner include surgical excision, bleaching the pigment by applying alcohol with the tattoo needle,2 applying a lighter pigment over the existing eyeliner, and scraping the pigment off with a chalazion curette. We herein present our technique for the elective excision of permanent eyeliner. Report of a Case. —A 40-year-old woman was unhappy with the appearance of her lower lids two months after having blepharopigmentation of all four lids (Fig 1). We elected to first observe the patient to determine whether the pigment would fade with time. After six months, there was no apparent change. The various techniques for removing the pigment were discussed with the patient. The patient preferred excision, despite the risks of

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