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Dermabrasion
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.
 Dr. Cruise's philosophy regarding Dermabrasion
 As pointed out in benefits section the best purpose for dermabrasion is to smooth down irregular skin problems. It is true it can be used for facial rejuvenation but, in general, I prefer chemical peeling or laser skin resurfacing for this.
Dermabrasion is probably the best modality for smoothing out deeply pitted acne scars. It will not get rid of the scar completely but it certainly will improve it and it can be repeated if necessary. If an acne scar is very deep it is best to surgically cut it out and meticulously suture back the normal margins. Then, at a later date dermabrade the entire area for the best result.
An exciting advance in depressed scar repair is the combination of fat transplantation to pop the scar up and then to dermabrade the entire area. This, in combination, is the best treatment modality.
Sometimes, the best way to correct unfavorable scars is to cut them out and repair them as meticulously as possible. Then, if necessary, dermabrade the entire area. A consultation is necessary to see what treatment is best for you.
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.
Possible complications
Dr. Cruise has extensive experience with dermabrasion through his work with treating burn victims. Still, complications 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. Dr. Cruise will discuss possible complications with you during your consultation.
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.
Do's
and Dont's prior to surgery
Dermabrasion, by itself, does not require
significant preoperative planning. Dr. Cruise, however, does
have a skin treatment protocol he uses prior to dermabrasion
much like he uses prior to chemical peeling and laser skin
resurfacing. 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. Dr. Cruise 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. Dr. Cruise and ICRS are both
well trained and experienced. Excessive worrying can
actually be detrimental and you should discuss this with
Dr. Cruise prior to surgery so that something can be prescribed
to make sure you remain calm.
Anesthesia
ICRS only uses
board certified anesthesiologists to make sure you have the
best anesthesia possible. 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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