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Dermabrasion
Dermabrasion


Dermabrasion Dermabrasion has been used since 1905 when a German dermatologist used the technique for the treatment of post acne scars. The procedure is known to doctors as “surgical skin planning” and “non-chemical peel.” Currently, plastic surgeons use dermabrasion for the treatment of scarring related to acne, a condition known as “rhinophyma” (often referred to as the “W.C. Fields’ nose”) and for acne, rosacea, tattoos, chicken pox, scars, skin growths, multiple pigmented birthmarks, blotchy brown or liver spots, keloids and sun damaged skin.

The procedure is also often used to remove wrinkles around the chin and mouth. It produces smoother skin by removing the outer layer of skin (the epidermis) so that new tissue grows back to replace the old. The procedure is contraindicated (not used) for congenital skin defects, certain types of moles or pigmented birthmarks and scars from burns.

Benefits of Dermabrasion

"Modern life takes a heavy toll

on skin because we spend so much
time outdoors under the damaging effects of the sun."

Modern life takes a heavy toll on skin because we spend so much time outdoors under the damaging effects of the sun which rapidly age skin – unless precautions are taken. Smoking, stress and aging also take a toll. Dermabrasion usually creates a fresh, more youthful appearance in skin. Moreover, the skin that grows back is usually smoother than that which it replaces.
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How is Dermabrasion Performed?

The procedure is usually done on an outpatient basis. The surgeon will examine your skin to assess factors that could affect the outcome of the surgery and to determine the proper procedure for your condition. Many surgeons recommend pretreatment with Retin A, for several weeks before seeing the doctor. But before the procedure, a complete medical history is taken and examination is conducted to evaluate the general health of the patient. Skin type and color, ethnic background and age are important factors that should be discussed prior to surgery. Patients may expect to be photographed so a picture can be compared with one taken after the procedure. The procedure can be performed in the surgeon’s office or in an outpatient surgical facility. You maybe given some medication by mouth to better relax you before going ahead.

Some surgeons administer sedation before full face dermabrasions while others use local anesthesia if the area is limited to, for instance, just one scar.

First, the skin is cleansed with antiseptic agent. Many surgeons freeze the skin with ice packs or a spray that freezes the skin.

After that, the surgeon uses a hand-held high speed rotating dermabrasion machine -- about the size of a pencil -- with a small cone of sandpaper or a stiff brush on its end. That instrument sands down the outer layer of the old skin and leaves a scab which remains on the face for about a week. As the scab peels off, new skin appears and is very pink. Infection and excessive bleeding are easily controlled. Discoloration and swelling may occur for several months. During that time, hypoallergenic makeup is usually recommended. Most people can return to normal activities in seven to ten days while the new skin is largely healed by 12 weeks.

Acne scarring is currently the most common reason for having dermabrasion.
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Microdermabrasion

Instead of a small grinding tool, the surgeon uses an instrument that uses a blast of sterile grit and a vacuum in a closed loop system to remove the first layer of skin. Sometimes known as the “lunchtime” peel because a treatment can be completed in half an hour, microdermabrasion is done more quickly but does not produce effects that last as long as other dermabrasion. While each treatment costs about $150, according to the dermadoctor.com, the patient can usually return to her regular activities more quickly. The procedure is mildly invasive but the effects are usually smaller and anywhere from six to 16 treatments may be needed. Microdermabrasion does not require either a local or general anesthesia. Most patients say microdermabrasion feels like an emery board or sandpaper rubbing on their skin.

Microdermabrasion is usually used for hyperpigmentation, some stretch marks, uneven skin tone, reducing the dullness of aging skin and smoothing out fine wrinkle lines. It is not used for keloidal scaring, jagged ice-pick scars, skin cancers or skin growths.
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Laser Dermabrasion

Physicians who prefer lasers for dermabrasion say the instrument allows them to have more control and to be more precise. Types of lasers doctors use to remove the outer layer of skin include the YAG and carbon dioxide. Any laser burns the face to create the new skin surface which forms in about ten days. Lasers can smooth fine lines, acne scars, vaporize birthmarks and moles along with sun spots and facial hairs, spider veins, warts, tattoos. A laser will cause redness to last for about two months. Some physicians say laser resurfacing is most effective for shallow scars that can be stretched with the fingers. Patients can expect a 50 to 80 percent improvement but should allow 18 months for complete results. Laser treated patients should stay out of the sun for at least two months.

Black and Asian skin and other dark complexions may become permanently discolored or blotched after a skin refinishing treatment.
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How Much Pain is Associated with Dermabrasion?

After dermabrasion, the face feels raw and irritated, somewhat like a skinned knee. Some patients report feeling like they have a severe windburn or sunburn. A yellow, clear fluid drains from the sites and is normal and expected. The scabs are usually removed with moist wet packs which can help prevent any infection under the crust. If that infection occurs, the patient may suffer more severe scarring and a worse overall result. Doctors usually recommend wearing a heavy duty sunblock and staying out of the sun for three to six months. It often takes about eighteen days to effect a full healing and the appearance of the new glowing skin.

Laser dermabrasion may cause some oozing and crusting and most doctors recommend patients take some time off work. However, there is no bleeding and minimal trauma to the surrounding skin.
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What are the Risks and Limitations of Dermabrasion?

Sometimes, hyperpigmentation can occur after the operation if the patient has been exposed to the sun for any length of time. In patients with severe acne, dermabrasion should be postponed until the acne is less weepy. Otherwise, a serious infection can develop. Also, patients with a history of keloidal formation are at risk of developing severe scarring, postoperatively.

You should also let your doctor know if you get cold sores. If you have a history of those, you will probably be given antiviral pills before the procedure.

Moreover, some studies have shown that patients taking Accutaine may develop unusual scarring following standard or laser dermabrasion. Most patients can expect a 50 to 85 percent improvement. Results are usually long-lasting.

You should let your doctor know if you have persistent redness lasting for ten days after the procedure. That could be a sign a scar is forming. If so, the doctor will inject the area with cortisone or give you a cortisone ointment to apply to the area. Yellow crusting may indicate the beginning of an infection.

Another possible complication could be skin that looks darker or lighter than the surrounding skin. It can usually be treated but can be permanent.

Also, people who develop allergic rashes or other skin reactions or who get frequent fever blisters or cold sores may experience a fare-up. Freckles will disappear in the treatment area. And, it will be three to four weeks before you can drink alcohol without experiencing a flush of redness.
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What Are The Typical Costs Associated With Dermabrasion?

Full face laser resurfacing costs about $4000, depending on the overall economic conditions where you live. The American Academy of Facial Plastic and Reconstructive Surgery reports the national average for a microdermabrasion program is about $400 while standard dermabrasion averages about $150 per treatment.
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Ten Questions Every Patient Should Ask Their Surgeon

Before any dermabrasion procedures, a consultation should occur between the prospective patient and the providing surgeon. During that consultation the surgeon and patient discuss issues like the desired outcome, various options that are available, the procedure itself and risks and limitations. The surgeon provides information about anesthesia options, the location and description of where the procedure will be done -- in a hospital or office surgical suite -- and associated costs. The patient's medical history is taken, and the area to be treated is examined during the consultation.

To educate the patient about dermabrasion, and help form realistic expectations, it is recommended that the patient look at before and after photographs, speak with previous patients, and ask the following questions:

  1. Is what I described realistic?
  2. Where is the dermabrasion performed and how long will it take?
  3. In my case, what technique (standard, laser or microdermabrasion) is most appropriate?
  4. What kind of anesthesia will be used during the surgery?
  5. How much does microdermabrasion cost and what elements factor into that cost like hospital fees, anesthesia, and so on?
  6. What is the surgeon’s level of experience in performing dermabrasion?
  7. What percentage of patients experience complications with dermabrasion?
  8. What is the surgeon’s policy about correcting or repeating the procedure if the first dermabrasion does not meet agreed upon results?
  9. What should I expect, post-operatively, in terms of soreness, scaring, activity level, and soreness, scaring, activity level, etc?
  10. Have you ever had your malpractice insurance coverage denied, revoked or suspended?
Prospective patients should look at a selection of before and after photographs of recent patients who have had the same procedure from the surgeon. You can request the names and contact information of previous patients.

Patients should tell the surgeon about any allergies, serious medical conditions, or medications they may be taking.

This site provides information about plastic/cosmetic surgery and is designed to help users make decisions regarding their own treatment options. However, medical information is not the same as medical advice -- the application of medical treatment to an individual’s specific circumstances. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a qualified medical practitioner if you want professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.
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