Being born with a cleft palate has not been the easiest ride, let me tell you. From cleft surgery to gum surgery, to jaw surgery, teeth implant surgery and so many more, my poor mouth has been cut up again and again in an attempt to make my smile appear straighter and less disfigured.
Yes, my cleft palate journey has been a painful one, but it pales in comparison to those who were also born with a cleft lip. Unlike my own facial deformity — a physical trait that’s hard for most people to notice since I wasn’t born with a cleft lip — those born with a cleft lip must display their facial deformity every day, sometimes with pride, other times with shame.
If you ask anyone born with a cleft lip and/or cleft palate, most folks would tell you they wouldn’t change a thing about growing up with a deformity, since it’s become a huge factor in shaping them into the person they are today. A cleft lip scar is a beautiful battle wound that many cleft-lipped people wear with pleasure and pride — sometimes, though, they just want to look like everyone else, too.
Both permanent makeup (also called medical tattooing) and lip filler are being used to reshape the appearance of those with cleft lips in a noninvasive way. Karen Betts, a renowned UK-based permanent makeup artist, has been offering lip tattoo services to clients for over 18 years, including those born with a cleft lip. “I feel incredibly lucky to be able to provide such life-changing treatments to my wonderful clients—helping others to feel great about themselves is the best feeling in the world,” says Betts. “I’ve had many clients cry happy tears upon seeing their new lips for the first time, and it’s an incredible feeling for me to know that what I’m doing is making a huge difference in their lives. I love the moment when I hold out the mirror for my clients to see their reflection and take in the look of absolute disbelief and joy on their faces.”
Getting permanent makeup over your lips or brows can be a nice bonus for your everyday client, but for those born with a cleft lip, it can be life-changing. “I decided that I wanted to do permanent makeup when I was overlining my right lip every day,” explains Kyra, a Switzerland-based woman born with a cleft lip. “I wanted to feel confident without makeup as well—swimming, sports, eating, or any activity that left me without the guarantee of my makeup lasting made my self-esteem really low because I would be constantly checking if the makeup was still in place. I wanted a solution that helped me not worry about it, and permanent makeup seemed great. Also, the doctors suggested it to me after having my operation to correct the lip shape.”
The process of tattooing permanent makeup over a cleft lip is similar to how it’s normally done, but it takes a certain level of skill to achieve natural-looking results when tattooing a cleft lip. “During the initial consultation, the most important thing is to set expectations — I take the time to talk to my clients about the results they would like to achieve in detail and make any recommendations to them on how I feel we can get the best results,” explains Betts. “Once I have a thorough understanding of what my client wants to achieve, I will draw the lip contour and color on with a natural makeup pencil. Together, my client and I will agree on the final shape and color of the lips before any tattooing takes place.”
Once the client is happy with the path they’re taking, Betts goes in with the fill. “It’s so important to understand color theory and how pigments will settle and show through different skin types,” says Betts. “We work on what is called the Fitzpatrick scale, which is a numerical classification scheme for human skin color. Once I decide what Fitzpatrick skin type my client is, plus the density of color in their natural lip tone, I can begin to consider the pigment.”
Betts uses her own line of permanent makeup pigments to create the perfect combination of colors for her clients. Through years of learning and studying how different skin tones react, Betts is able to mix a custom color for her clients depending on their requirements — sometimes they want to match the color to their favorite lipstick, other times they want Betts to create a shade that’s as close to their natural lip color as possible.
The treatment for permanent makeup usually takes around 90 minutes to complete, but this can vary from person to person, depending on the requirements, according to Betts. In her office, Betts and her artists use numbing techniques to make treatments as comfortable as possible. “If you can imagine the sensation of an electric toothbrush against your skin, you will have some idea of what a cosmetic tattoo machine feels like during treatment,” explains Betts. “You will certainly feel the vibration, but we work with our clients closely to make sure any discomfort is kept to a minimum.”
Unfortunately, a pain-free appointment isn’t the norm for everyone, including Kyra. “The experience of having it done was a painful one, and there had to be multiple sessions done to ensure the scar tissue would actually take the ink in,” she says. “However, [the experience] was not too unpleasant, because, for people who endured multiple surgeries [from a cleft lip and/or palate], this was just a tiny sting.”
Permanent tattooing over a cleft lip is a three-part process that is usually completed over two appointments: the initial consultation and first treatment, followed by a retouch appointment 4-12 weeks later. According to Betts, a treatment can last anywhere from one to three years—it really depends on the individual. “There are many factors that can cause permanent makeup to fade faster over time, such as sun exposure,” says Betts. “All of our clients are given thorough aftercare advice to help them to take the very best care of their new permanent makeup and get longer-lasting results.”
Permanent tattooing over a cleft lip is a three-part process that is usually completed over two appointments: the initial consultation and first treatment, followed by a retouch appointment 4-12 weeks later.
Another factor that might prevent permanent tattooing from staying put is if the color does not hold in the scar areas over the cleft lip. In that case, additional sessions would need to be done 4-12 weeks later. This was the case for Danielle O’Pray, an Australia-based woman born with a cleft lip. “I have had the tattooing done about four or five times, but the color, unfortunately, didn’t take to my skin where we were trying to even out my lips,” she says. “Even though the color didn’t stick for me personally, I’d still recommend others giving [permanent makeup] a go because I know my results aren’t typical of everyone.”
Some folks with cleft lips are trying out lip fillers to even out the shape of their lips temporarily. According to Katrina Riley, MSN, APRN-C, a nurse practitioner and co-owner of ÈLAN Aesthetics in Tampa, FL, the initial consultation for lip filler involves getting to know the client and discussing possible options and expectations. “The client is usually in our office for about an hour in total and the actual treatment itself takes about 30 minutes — we will place anesthetic cream on the area for 30 minutes prior to the procedure and wait for the complete numbing to take effect,” says Riley. “In some cases, we will give a nerve block or ‘dental’ block to ensure complete comfort to the client during the procedure.”
Stephanie Heintz, an NYC-based woman born with a cleft lip, has been getting filler into her lips for 15 years, and when she first started getting the treatment, she had to get a dental block in addition to numbing cream because of how sensitive she was in that area. “Another concern for cleft lip patients when getting filler is that you need to show your injector the scar tissue on the inside of your lip so you can be certain that it doesn’t get injected by accident—unfortunately, I’ve learned the hard way,” says Heintz.
Lip filler is a really great option for those wanting to even out the shape of their lips and can last anywhere from 8-12 months. “In some cases, we will recommend the client return in one to two months post-procedure for a ‘touch up’ to add a touch more of filler, like ‘icing on the cake,’ to ensure an aesthetically pleasing result,” says Riley.
