Complications of blepharopigmentation.

Blepharopigmentation is a commonly performed procedure with a very low rate of reported complications. We present three complications of the permanent eyeliner procedure: two cases of longlasting pigment fanning, and one case of eyelid margin necrosis with cilia loss and secondary cicatricial entropion. These complications may be related to placement of the pigment too deeply, or to overapplication with tissue maceration. Care should be taken to avoid through-and-through eyelid margin penetration, and to limit the number of needle penetrations to no more than is necessary at each application site.