Dermabrasion

Dermabrasion
is a surgical procedure to improve or minimize the appearance
of scars, restore function and correct disfigurement resulting
from an injury. Dermabrasion is used to smooth scar tissue by
shaving or scraping off the top layers or the skin. Though
Dermabrasion smoothes the surface of the scar it will not
remove the scar. Scars are permanent but their appearance will
improve over time. The procedure may be performed in a
dermatological surgeon's office or in an outpatient surgical
facility.

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Once
the surgery is completed the skin will be treated with an
ointment, a wet or waxy dressing, dry treatment or a
combination of these. You can expect the skin to be red and
swollen following surgery. The swelling will go down within 2
to 3 weeks. Patients will experience some aching, itching,
tingling, or burning after surgery as new skin begins to grow.
A crust will form over the area as it begins to heal, however,
if ointment is applied to the area immediately following
surgery, there will be little or no crust formation. As
healing continues, the crust will fall away revealing a new
layer of tight pink skin.
If the area remains red, swollen and itches after healing
has started this may be a sign that abnormal scars are
forming. Inform your surgeon if you are experiencing these
symptoms.
Following the operation, you can expect to return to your
normal activities such as work in about two weeks. You will
want to avoid any activity that could cause a bump to the
treated area for about two weeks. Sports should be avoided for
4 to 6 weeks following surgery. It is important to protect the
skin for 6 to 12 months until the pigment has completely
returned. The skin pinkness will take about 3 months to fade.
When full re-pigmentation has returned the skin should closely
match the surrounding skin.
Overview
Dermabrasion is the process of mechanically
scraping off the top layers of skin in order to smooth out
skin irregularities and force the skin to regrow healthier,
thicker collagen. When the top layer of the skin is removed
it tends to regrow collagen more equally throughout, resulting
in a smoother appearance.
The strength of dermabrasion is to help
smooth out skin, but it also does a very good job of creating
a healthier, glowing skin. The reason for this is that when
the skin is reforming it grows back with a better blood supply.
Babies have a tremendous blood supply to their skin. This
is why their skin appears so healthy.
A further advantage of dermabrasion is
that it tends to shrink pore size. This may be due to realignment
of the collagen fibers within the dermis.
Dermabrasion is usually performed on
the face and often combined with other procedures but can
be done alone. It is helpful to transplant fat underneath
the scar to efface the scar and then dermabrade over it.
This is the best treatment we have for acne scar treatment.
Another use of dermabrasion with or without a fat transplantation
is to reduce the wrinkles around the mouth seen primarily
with aging.
Benefits
The most significant benefit of dermabrasion
is that it allows the plastic surgeon the ability to mechanically
smooth out the face of someone with skin irregularities. Here
is a summary:
- Creates
smoother, healthier skin.
- The new skin is better vascularized
and has a more youthful glow.
- Very helpful with acne scars and deep
pitting scars.
- Very useful to flatten out old scars
that are either depressed or elevated.
- Improves sun damaged skin.
- Can be done in conjunction with other
cosmetic procedures.
Are
you a good candidate?
The best candidates
for dermabrasion are people who have skin irregularities either
from acne, healed cuts, or any other process that has left
a mark on the skin that is either sunken in or elevated.
Dermabrasion also has many positive effects
on skin rejuvenation but it is probably not the modality of
choice. Chemical
peeling and laser
are used more extensively for this purpose.
You must understand if you are considering
dermabrasion that the area dermabraded will look quite unpresentable
until it heals, which will take 7 to 14 days. Even after
it heals it will be quite red for a about another 6 weeks.
It may take up to 1 year before the pinkness is completely
gone
People who have been on the drug Accutane
should not have dermabrasion within a two-year period of taking
the medication. This drug can cause serious healing problems
associated with dermabrasion.
Possible
complications
Complications are rare but still must be discussed. The most
common complication after dermabrasion is inadequate improvement
of the scar. One must be realistic about what dermabrasion
can do. It is not likely to completely remove the scar but
it will improve it. Other possible complications are permanent
scarring if the abrasion is done too deep. Also possible
are hyper- and hypopigmentation, prolonged redness, and possibly
of reactivation of herpes if you had that in the past. Your
doctor will discuss possible complications with you during
your consultation.
Do's
and Don'ts prior to surgery
Dermabrasion, by itself, does not require
significant preoperative planning. However, some doctors will use preoperative protocl. This protocol involves Retin-A, glycolic acid,
and the use of Valtrex. This will be discussed prior to the
procedure.
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Medications.
Certain medications thin your blood and should not be
taken within 3 weeks of surgery. The most notable is
aspirin and aspirin containing products. Vitamin E and
many herbal products also thin the blood and should not
be used within 3 weeks of surgery. Your doctor will go
over this more thoroughly prior to the procedure.
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Washing.
It is a good idea to wash the area to be dermabraded thoroughly
the morning of the procedure. Do not apply makeup and
style your hair so that it stays back and out of the way.
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State of mind.
Remember, this should be a happy and exciting time. A
certain amount of nervousness is normal but you should
not be overly concerned. Excessive worrying can actually
be detrimental and you should discuss this with your doctor
prior to surgery so that something can be prescribed to
make sure you remain calm.
Anesthesia
The anesthesiologist
will discuss with you what type of anesthesia is best for
you. He/she will take into consideration your medical history,
the procedure, and your personal wishes.
Dermabrasion can be done under either
local or general anesthesia.
After
the procedure
The procedure itself will take about
1 hour.
Immediately.
Right after dermabrasion the local anesthesia will provide
excellent pain management. You can go home immediately.
Keep in mind, however, that your face will look quite unpresentable
for approximately 1 week. Keep your head elevated to reduce
swelling. It is important that someone else drives you home
and that you wear a hat to protect your face from sunlight.
An antibiotic cream will be applied to the dermabraded area.
It is important that you keep reapplying this so that the
skin does not dry out. Apply only a thin layer.
First
48 hours. You can shower, eat, and do just
about whatever you would like as long as you keep your head
elevated and away from sunlight and dirt. Keep reapplying
the antibiotic cream as necessary.
First
week. And about 7 to 10 days after the procedure
your skin will have repaired itself revealing the new skin
underneath. Your face will be pink for at least 6 weeks with
the first 2 weeks being more red than pink.
Recovery
time
Typically, patients return to work within 10 to 14 days.
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