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DERMABRASION

Skin that has a rough texture as a result of acne scarring or injury can sometimes be satisfactorily treated with dermabrasion, a technique which is similar to sanding a scratch out of a piece of fine furniture. Dermabrasion is a surgical preparation technique where abrasion is performed to reveal the dermal layer of the skin.

Dermabrasion can be the ideal procedure to remove wrinkles of the lips and around the mouth. Often, I may advise a "perioral" dermabrasion to be done at the time of a facelift to correct these wrinkles.

Procedure

Dermabrasion is completed by taking the high areas of the skin down to the low spots, or pits, and in order to eradicate the shadows that form in the depressed area when light strikes the face from the side. Normally, shallow scratches can be sanded effectively, whereas deeper ones need to be effaced. In the case of a deeper scar, a preliminary surgery, like punch excision, elevation or grafting, may be suggested and may take place four to eight weeks prior to the dermabrasion procedure. When the skin texture is rough from excessive scarring, a second dermabrasion may be recommended and may take place anywhere from three to twelve months following the initial procedure. Dermabrasion adds improvement to the skin surface when it is completed.

During the procedure, we will use either the "twilight" anesthesia technique with local anesthetic and a freezing spray on the affected area to block any sensation or a complete general anesthetic. The patient will experience little, if any, pain.

Following Surgery

Immediately following surgery, a special gauze dressing may be placed over the abraded skin and is allowed to adhere to the raw surface overnight. Upon your immediate follow-up visit, you will be given instructions on how to care for this area. The gauze-covered area is kept moisturized daily until it falls off, usually within five to seven days. Alternatively, the dermabraded area may be treated "open" during the entire postoperative period. Within seven to ten days, the face will demonstrate a deep red color, which will fade in the ensuing days to pink, and then vanish within eight weeks. The new skin results may vary in tone and texture from the facial skin which was not treated.

Female patients can usually begin to use make-up after ten days, and most patients can resume their normal routine of school, work, and social activities at this point. However, during this time, special consideration must be given to the new skin which was resulted from the procedure, as it is just as sensitive as the skin of a newborn infant. Direct sunlight must be avoided without the use of sunscreen products. Normal outdoor activities, including golf and tennis, are acceptable using sunscreen products. Also, one should not ingest hormones that contain Estrogen, or birth control pills, as they slightly increase the risk of irregular coloration within the dermabraded areas, which may result in blotchiness. If, however, the hormones are required for relief of "hot flashes", it is not necessary to discontinue their use, unless brown blotchiness actually occurs.

For Acne Patients

I do not recommend dermabrasion as the sole treatment for patients currently suffering from acne, although I have seen considerable improvement following the procedure. Because there are products available, like Accutane™, it may be better to follow that method of treatment first.

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