Tattooed Ladies

Cleopatra, who must have spent hours rimming her eyes with kohl each morning, would no doubt have loved the latest gift of cosmetic surgery: tattooing a thin dark line along the upper and lower lids to augment or replace conventional eyeliner. Since the operation was introduced in the U.S. a year ago, about 15,000 of her modern-day sisters have scurried off to ophthalmologists, dermatologists and plastic surgeons in unblinking pursuit of a fuss-free made-up look. The operation appeals especially to athletic women who do not want to worry about runny eyeliner and to those with poor eyesight, arthritis or allergies who have trouble putting on or wearing eye makeup. The cost: usually $600 to $1,200.

Most doctors who offer the surgery maintain it is harmless, though they note that temporary tenderness, swelling and bruising can result. But last week at a meeting in San Francisco of the American Academy of Ophthalmology, physicians discussed other complications and cited three cases. In two, women lost some of their eyelashes after being tattooed. In the third, a woman suffered an allergic reaction, possibly to the pigment. Says Dr. David Tse of the University of Iowa: "I'm sure as people do more operations, more complications will be reported."

In the half-hour procedure, performed under local anesthesia, the physician uses a special needle-tipped device to inject rows of tiny dots of black or brown iron-oxide pigment 1 mm into the lids. It is a delicate undertaking, and pigment can inadvertently be put into hair follicles rather than under the skin. Another worry is that the pigment may migrate into the lymphatic system. J. Earl Rathbun, an ophthalmologist at the University of California, San Francisco, has a more mundane concern: "Making sure people know what they want and where they want it, because once it's put in, it's permanent." In short, no one should go into the operation with her eyes closed.