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03/31/2014 08:55 EDT | Updated 05/31/2014 05:59 EDT

Twerk All You Want, Just Don't Get a Lip Tattoo Like Miley's

2012-05-28-GermGuyBanner.jpg When it comes to the climb of pop stardom, Miley Cyrus has proven she can't be tamed. Earlier this month, the singer posted a photo showing a new tattoo in a rather unlikely place: her lower lip. Unlike the other maneuvers, which may have social consequences, this one could lead to medical problems.

When it comes to the climb of pop stardom, Miley Cyrus has proven she can't be tamed. No matter what the reaction might be to her party in the USA ways, she has proven time and time again that we can't stop her wrecking ball behaviour. Now, she's showing the people who adore her who own her heart using not song, but imagery.

Earlier this month, the singer posted a photo showing a new tattoo in a rather unlikely place: her lower lip. But unlike the traditional simplicity of a letter or short phrase, Cyrus chose a complex Japanese pictograph -- better known as an emoji. The result: a yellow sad kitty.

The move of bringing an unusual act into the mainstream seems to fit her current antics. In the last year, she has brought the titillation of twerking to the international stage, managed to redefine a certain construction-related activity, and shown a new use for the human tongue. In the meantime, thousands if not millions, have tried to mimic her ways to show their allegiance to her.

But this latest exploit may lead to a number of consequences for those hoping to brandish a similar design seen only by a protruding pout. Unlike the other maneuvers, which may have social consequences, this one could lead to medical problems. Tattoos carry a risk of infection and this could be heightened when performed in the oral cavity, a place known to house millions of bacteria.

To get a better idea about the complications, both socially and microbiologically, I reached out to Lizzie Renaud, owner of the Toronto-based Speakeasy Tattoo and experienced tattoo artist. Before we discussed infections, she made it clear a lower lip tattoo is a decision that should be considered carefully although many don't do that ahead of time.

"People come in all the time and want something they've never seen before. It's an impulse. And, because it's fast -- you just get in there, do the tattoo and get out -- people don't realize the potential for problems. Worse, it's a one-shot deal. It's relatively unfixable."

Normally, when an injury occurs anywhere on the body, the healing process follows a particular mechanism involving a number of repair-focused molecules such as growth factors, proteins, and cellular glues known as integrins. As these experts do their job, the immune system stands by like sentries. When pathogenic bacteria or viruses arrive with the intent to take advantage of the weakened area; the immune cells attack in the hopes of ridding the area of these intruders. The fight can lead not only to inflammation but also scarring.

But since the mouth is so rich in bacteria, these defenders have developed a fascinating ability to recognize the difference between a normal oral bacterium -- a commensal -- and one that poses a threat: a pathogen. This phenomenon, known as tolerance ensures no unnecessary fighting happens and the skin heals without scarring. This process happens every time we encounter a wound, such as a bitten cheek, toothbrush nicked gums, and the lower lip tattoo.

Where Renaud's advice becomes relevant is through preventing the introduction of potential pathogens or by messing with the good bacteria in the mouth. Smoking has been known to disrupt the levels of commensals in the mouth and alcohol interferes with the wound repair process. As for staying away from sugar, which helps to prevent pathogenic bacteria from growing, Renaud says this goes against earlier protocols. "Sucking on a Popsicle was the traditional way to care for a lip tattoo. That usually led to placing all sorts of good sugar in a fresh wound. We know now that is obviously not a good thing and should be avoided."

Even with the microbiologically sound advice, Renaud says there are still a host of other problems that could interfere with a dream tattoo, particularly in the mouth. "I would still advise people it's a very bad idea. Even with the low risk for infection, the reason you don't see it is because it isn't effective. The nature of a lip tattoo is such you are assured it will eventually come out. It's not as permanent as on other parts of the skin. The other thing is that typically, lower lip tattoos are small designs, such as a letter or a heart. They are rarely as intricate as Miley's emoji."

But perhaps Renaud's final reason is the one that should remind Mileyphiles about thinking twice before following their role model's behaviour. "If you are dead set on getting one, make sure you know what you are going to get. If it's not done well or heals poorly due to infection, you may end up with something that looks more like a mushy piece of pizza -- or an E. coli bacterium -- than a cat. And, as I said before, you're stuck with it for life."

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