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The woman that did my eyebrows did them by hand instead of using an electric tattoo needle because it gives her much more control. Also she is really good at matching color with skin type. I met her when I went with a friend who was getting the scars on her areolas from breast implants tattooed to help hide them. She spent about 30 minutes just getting the color right and after everything healed you couldn't see any color difference between the scar and her skin.
With permanent makeup it is very important that the person knows what the color will end up with your skin type.
The downside of having someone doing tattoos by hand is it takes a lot longer and basically you have someone jabbing you with a small knife for a few hours.
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