Throughout history, people who have been distressed and embarrassed by disfigurement of their facial skin have searched for ways to improve these imperfections. Today, because of modern technology, there are several excellent procedures available to improve facial scarring, one of which is dermabrasion. This technique, first introduced in the 1940′s, has been perfected over the last few decades. Used on both men and women, facial dermabrasion is a surgical procedure in which skin, scarred from acne, pox or other causes, is “sanded” with a rotary abrasive instrument. The abrasive or planing action evens out the skin to give it a smoother, more pleasing contour. When the technique of dermabrasion was first developed, it was used primarily to improve acne, pox marks and scars resulting from accidents or disease. Today, it is used to treat other conditions as well. These include tattoos, age (liver) spots, wrinkles, and certain kinds of skin lesions.
Dermabrasion can be done successfully on patients with active acne. It is better, of course, to obtain the greatest amount of acne control prior to the surgery, but more extensive damage can occur if the procedure is delayed.
Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. A careful examination is also conducted. The physician describes the type of anesthesia to be used, the procedure, what results might realistically be expected and possible risks and complications. Photographs are taken before and after surgery to evaluate the amount of improvement. Preoperative instructions may include the elimination of certain drugs which contain aspirin in order to minimize the possibility of excess bleeding. Antibiotics may be prescribed to prevent infection. The patient may be advised to cleanse the face and hair with an antiseptic soap the day before surgery.
Dermabrasion can be performed in a physician’s office, an outpatient surgical facility, or a hospital, depending upon the physician’s and patient’s preference. Medication to relax the patient may be administered prior to surgery. The face is thoroughly cleansed with an antiseptic cleansing agent. Eyes and hair are covered, and the area to be treated is sprayed with a spray that freezes the skin. Cold packs to numb the area may be applied before it is sprayed.
Superficial skin is then “sanded” with an abrasive wire brush or other appliance attached to a high speed rotary instrument. (Fig. A&B) Some patients require bandaging after treatment, others do not. The procedure lasts from thirty to sixty minutes, depending upon the condition of the skin and extent of the area involved.
FIG. A FIG.B
Following SurgerFor a few days, the skin feels as though it has been severely sunburned. Medication alleviates any discomfort the patient may have. Antibiotics may be prescribed to prevent infection.
If bandages are used, they are removed within a few days. Some swelling is to be expected 24 to 48 hours after surgery. Swelling can be reduced by keeping the head in a slightly elevated position when reclining.
A crust which loosens and falls off in several days begins to form a few days after dermabrasion. At this time, the planed area is moist. The patient may be instructed to wash the crust with a mild soap and tap water but is cautioned not to pull off crusts that tightly adhere to the skin as this can result in scarring.
After the crusts fall off, the skin appears quite pink, but this coloration fades in three to six weeks. During this period, special soaps and cosmetics may be recommended and men are allowed to shave with mild shaving creams. Patients are instructed to avoid medicated or scented cosmetics and hair sprays which might be harmful to the skin.
For several weeks following dermabrasion, pimples resembling acne may appear. These disappear in time. Directed and reflected sunlight must be avoided for several weeks, and sunscreen should always be worn when outdoors. Strenuous activities should be avoided for ten days to two weeks following surgery. The physician advises when normal activities can be resumed.
Thousands of patients who undergo dermabrasion each year are delighted with the results. Occasionally, hyperpigmentation or deepening of skin color occurs, but this can be treated. Infection of the treated area is rare, as is scarring. Additional planings may be necessary. Although complications are rare, there are certain inherent risks connected with every surgical procedure which should be thoroughly discussed with the physician. Patients can minimize complications by carefully following directions given by the physician.
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