The very thing that we have equated with a healthy look, has, in fact, had the opposite effect. We now know harmful UV rays are the cause of premature wrinkles, uneven skin coloration, and pre-cancerous growths.
More and more women and men look to their dermatologists for skin revitalization and resurfacing to regain a fresher, more healthy and young-looking complexion. Dermabrasion, one such revitalizing treatment, can reverse the outward signs of aging as well as improve the appearance of acne scars and remove pre-cancerous keratoses. In addition, dermabrasion is useful in treating skin problems such as unwanted tattoos, scars caused by chicken pox or accidents, and other disfiguring conditions.
During dermabrasion surgery, the dermatologist uses a high speed rotating abrasive brush or diamond-impregnated burr (kind of like a mini-sander) to remove the outermost layers of damaged skin. The doctor controls how much skin will be removed and determines how deeply to penetrate the skin layers depending upon the degree of wrinkling or scarring. This abrasive or planing action evens out the skin, and a new layer of smoother, fresh skin will emerge.
Dermaplaning is a deeper planing of the skin often indicated when scars are very deep and/or crater-like. The surgeon uses a dermatome, an instrument which has an oscillating blade, to evenly skim off layers of skin to make the scarred area more even with the surrounding skin. Dermaplaning might be used in conjunction with dermabrasion, or other procedures such as face lift or chemical peel.
Your dermabrasion or dermaplaning may take place in a dermatologic surgeon’s office, an outpatient surgery center, or possibly a hospital.
Dermabrasion and dermaplaning are fairly quick procedures, usually taking from a few minutes to an hour or so—it’s highly individual depending upon how extensive the correction. The doctor may recommend that the procedure is repeated or done in stages, especially when scarring is deep or a large area of skin is involved.
The procedure is usually performed under local anesthesia. You’ll be given a sedative that will relax you and make you drowsy, but you’ll be awake. Your skin will be thoroughly cleansed with an antiseptic and it may be sprayed with a freezing agent to numb your skin. The surgeon will then begin the procedure to remove the necessary layers of skin.
At the completion of the procedure, your skin may be dressed with a soothing ointment, a wet or waxy dressing, dry treatment, or some combination of these.
Who Is a Candidate?
People who are in good health and want to rejuvenate aging skin and erase the marks of sun damage look at dermabrasion (or dermaplaning) as a way for more youthful appearing and glowing skin. Age is not a limiting factor in most cases, however it is important to recognize that older people heal more slowly.
Knowing what to expect and what dermabrasion can and can’t do before you undergo the procedure is important. If your goals are realistic—that is, you want to improve the appearance of your skin but don’t expect perfection, you’ll probably be a good candidate for the procedure and end up happy with the results.
Your skin type and color, ethnic background and age will be factors your doctor will evaluate to determine if dermabrasion or dermaplaning are appropriate skin-resurfacing treatments for you. Darker skin poses special considerations due to increased risk of undesirable skin pigmentation changes. Black skin, Asian skin, and other dark complexions may become permanently discolored or blotchy after a skin-refinishing treatment. If you are experiencing acne in an active stage, you may not be able to undergo the procedure due to a greater risk of infection.
Preparing for Surgery
Dermabrasion or dermaplaning, as with any other surgical procedure, requires you to be in good health. Discuss any health concerns and problems that you may have with your doctor.
Before your surgical procedure, your doctor will take your health history and conduct a routine physical exam. You will be advised of any special things to avoid or things to do.
Here are a few general guidelines that you’ll probably be asked to follow:
- Don’t take aspirin or anti-inflammatories (such as ibuprofen) or any drugs containing these for at least two weeks before surgery. They can interfere with normal blood clotting.
- Don’t eat or drink anything after midnight the night before surgery. Your stomach needs to be completely empty when undergoing anesthesia or sedation.
- Avoid drinking alcohol a few days prior to surgery.
- If you smoke, stop smoking at least a week before your procedure and for at least a week afterward. Smoking decreases blood circulation in the skin and impedes healing.
- Wear something loose that opens in the front. You don’t want to put on anything that goes over your head after the procedure.
- Arrange for someone to drive you home. If your procedure has been fairly extensive, you may want to have a friend or relative care for you for 24 hours. You will be sore and prescription pain medication often has a groggy effect.
Pain
For a few days following dermabrasion or dermaplaning, your skin will look and feel like you’ve experienced a really bad sunburn. Swelling and crusting of the skin is to be expected. It may be uncomfortable to move the muscles of your face (talking, eating) and a soft diet will be best. The initial discomfort you feel should be helped with prescribed pain medication. Your doctor will also want you to apply an emollient-type ointment which will help your skin heal faster and keep it supple. Healing usually occurs within 10 days. The redness of the skin will fade in about four weeks.
Recovery
In one to two weeks after surgery, the newly formed skin, which is pink at first, gradually develops a normal appearance. In most cases, the pinkness will largely fade by eight to 12 weeks.
When can you resume normal activities? You can expect to be back at work in about two weeks, in some cases, in less time. You can use makeup as soon as the skin has healed. Strenuous activity that might result in a bump to your face should be avoided for at least six weeks. You should not swim in chlorinated water for a month or more.
It is important that you avoid unprotected exposure to the sun for several months—it can be up to a year—after the procedure to protect the newly formed layers of skin as it forms pigment. Using a sunblock is essential. Your skin will appear lighter for weeks or even months after the procedure, but as the pigment is restored, your skin color will look more normal.
- It is crucial that you follow the post-operative instructions from your dermatologist completely.
- Call your dermatologist right away if you experience any increase in redness or itching in the days after surgery.
Risks
Dermabrasion and dermaplaning are relatively straightforward procedures in the hands of a qualified dermatologist, but there are some risks and uncertainties. Possible complications include:
- Change in skin pigmentation. Either lighter or blotchy skin, or darkening of the skin, usually caused by exposure to the sun in the days or months following surgery, is possible. Black skin, Asian skin, and other dark complexions are at additional risk for discoloration.
- Infection and scarring are rare but possible. Excessive scar tissue (keloid or hypertrophic scars) can develop in some individuals. These can be treated with injections or cortisone creams.
- Recurring fever blisters (herpes simplex).
Costs
Procedures that are considered elective or cosmetic are, in most cases, not covered by insurance, which means you’ll probably have to pay for it yourself. In some cases dermabrasion and dermaplaning may be covered when performed to remove precancerous skin growths or extensive scars. Surgery to correct or improve major deformities or accidental skin injuries may be covered in whole or part. Study your insurance coverage or call your insurance carrier to be sure. Average surgeon fees range from $1100 to $1900 for dermabrasion.
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