Aging for the older women in the 21st century is more than medical issues. In this study, 62 women (ages 51-81+) obtained a total of 97 permanent makeup procedures. Procurement cues included self-improvement and friend's appearance, consistent with internal, external, and appearance perspectives of body image. Poor eyesight was also of concern (14/23%). Actual benefits included saving makeup time and money (external), while achieving personal goals (internal). This study seems to confirm that for these older women, body image remains important, especially qualities of the face. They did not shed their internal, external, nor appearance concerns associated with body image, as they aged.