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From the beginning of time, people suffering from
the disfigurement of facial scarring have searched for ways to improve
these imperfections. There are a variety of dermatologic surgical
techniques which are safe and effective. Although dermabrasion has
been performed in one form or another for many years, refinements
in technique, equipment, and pre- and post-operative care have enhanced
its popularity.
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28-year
old female with
traumatic scar of 10 years |
After dermabrasion with
almost no trace of the scar |
Dermabrasion, or surgical skin planing, is a surgical procedure
in which Dr. Rapaport removes or "sands" the skin with
a rotary abrasive instrument which improves its contour and gives
it a smoother appearance.
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| 35-year-old female with ice
pick acne scarring |
6 months after a series of
punch grafts with the donor skin taken from behind the ear.
The grafts are then blended in by dermabrasion of the cheek |
When dermabrasion was first developed, it was used predominantly
to improve scars resulting from acne, chicken pox, and accidents.
Today it is also used to treat other types of skin conditions such
as tattoos, age "liver" spots, and changes caused by chronic
sun damage such as wrinkling and precancerous degeneration.
Before surgery, a medical history is taken and a careful examination
is conducted in order to evaluate the condition of the patient's
skin. During the consultation, Dr. Rapaport describes the types
of anesthesia to be used, the procedure, and realistic results that
can be expected. The doctor also reviews alternative treatments
and possible risks and complications are explained.
Photographs are frequently taken before and after surgery to help
evaluate the amount of improvement. Printed pre-operative and post-operative
instructions are often given to the patient. Medication to prevent
activation of fever blisters (herpes simplex) may be given.
Dermabrasion is performed in Dr. Rapaport's in-office surgical
facility. Medication to relax the patient may be given prior to
surgery. The area is thoroughly cleansed with an antiseptic cleansing
agent before application of a spray that freezes and numbs the skin.
Alternatively, the skin may be swollen or "tumesced" with
an anesthetic solution. A high-speed rotary instrument with an abrasive
wheel or brush removes or abrades the upper layers of the skin and
improves irregularities in the skin surface. In some cases, abrasive
paper may be used and soothin ointments and dressings are then applied.
For a few days, the skin feels as though it has been severely sunburned.
Medications may be prescribed to alleviate any discomfort the patient
may have, but most people do not experience severe pain. Special
dressings and the application of emollients help speed the skin's
recovery. Healing usually occurs within 10 days.
The newly formed skin is pink at first and gradually returns to
its normal appearance by eight to twelve weeks. Make-up can be used
as a cover-up when the skin is healed, and people can resume their
normal activities in seven to ten days. Patients are instructed
to use a sunscreen daily and to avoid unnecessary direct and indirect
exposure to sunlight for three to six months.
Everyone's skin heals differently. Some individuals have a tendency
to develop light or dark areas after skin injuries. This can also
occur after dermabrasion treatment. Your dermatologist can usually
treat increased pigmentation with the use of bleaching creams, but
decreased pigmentation may be permanent.
Some people may develop thickened skin in certain areas after dermabrasion
similar to keloids. Several therapies, such as cortisone creams
and injections, can be administered to treat this problem and help
the skin return to normal.
Patients with clotting disorders or bleeding, keloidal scarring,
immunosuppression, or patients on 13-cis-retinoic acid (isotretinoin)
should tell their dermatologist.
Dermabrasion cannot be expected to eliminate or improve all scars
in all patients. Some scars require the use of other procedures
to obtain the best results. These include careful surgical removal
of the scars followed by small skin grafts or suturing. Dermabrasion
is then used to smooth over these fresh scars six to eight weeks
later.
Other patients may benefit from the use of filling substances in
conjunction with dermabrasion. These include injectable collagen
or fat which are used to elevate depressed scars. Some patients
may benefit from repeat touch-up dermabrasion of areas that have
not been sufficiently improved after the initial procedure.
Dr. Rapaport can advise you as to the likelihood of the need for
additional treatments, depending on the specific condition of your
skin.
For a consultation call (201) 227-1555 or send us an email
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