The two types of permanent eye makeup (blepharopigmentation) are permanent brows and permanent eyeliner. The procedure involves cosmetic tattooing of high-quality pigment into the dermis, or second layer of the skin, using sterile needles. Application can be done with a special vibrating machine or by hand using a multi-pronged needle resembling a tiny flea comb.

Permanent brows (photo) have become especially popular in the Asian community due to naturally sparse brow hair density in many people as well as spotty hair loss from frequent plucking. The tattoos look more natural when applied to skin with at least some existing hair.

While originally a medical procedure, most applications today are performed by trained non-medical technicians and certified aestheticians at beauty salons or medical spas. Design and execution by an experienced operator usually produces excellent results. The color can be applied as closely-spaced dots, lines, or even strokes. It is not uncommon for the work to be completed over several sessions and require a touch-up or two.

Application of brow tattoos feels much like hair being plucked, while the more sensitive eyelash area can hurt a little more. A gentle touch helps, as do mild numbing solutions.

Pigment colors vary but some have proven problematic. Deep black tends to look artificial. Titanium dioxide, a white pigment present in many preparations, can slowly change into an odd purple-blue hue over time, while brown can eventually turn a light pink.

Full permanence of the tattoo is unusual. Most fade over time and some disappear completely after only several years, so "semi-permanent" is a more accurate name.

In cases where pigment application is too dark or shaped poorly, it may be possible to remove most but usually not all of the pigment by employing various treatments ranging from salt water injection to special laser techniques performed by a physician. Eyeliner is more difficult to remove than brow pigment.

A newer variation on brow tattooing is called eyebrow embroidery. Pigment is intentionally placed more superficially with the understanding that it will only last for a few years if even that. Some claim that the tattoo looks more natural and the color never really has a chance to change into unwanted tones.

While generally considered safe in the hands of an experienced operator, permanent makeup can be complicated by problems such as intense bruising and swelling immediately after treatment, infection, poor aesthetic execution, and permanent loss of eyelashes.