Dermabrasion:
Dermabrasion is a method to improve the contour of the skin. It penetrates deeper layers of the skin than microdermabrasion, and can be quite effective in removing facial wrinkles, especially wrinkles around the mouth.
How It's Done:
Dermabrasion is performed with a dermabrader. A dermabrader is a handheld, motor-driven device with a diamond-shaped head. Different-shaped tips can be used, known as burrs. Pressure is applied by the operator of the dermabrader (usually a plastic surgeon) to the skin. The amount of pressure and type of burr applied affects how deep the dermabrasion goes. Because scarring can occur with dermabrasion, it is important that an experienced provider performs dermabrasion. The deeper the dermabrasion, the greater the risk for adverse scarring.
Where Dermabrasion Is Performed:
Dermabrasion should be done in a medical setting, such as a hospital or a surgical center. Dermabrasion should only be done by a surgeon, as severe injury can occur due to the more invasive nature of the procedure. Additionally, it is important for dermabrasion to be done in a sterile environment. Why? Because the top layers of skin have been removed with dermabrasion, there is an increased risk of infection.
How Often It Can Be Done:
Unlike microdermabrasion, which takes six to 12 treatments to obtain a good result, one session of dermabrasion can yield a very good result. The more invasive/deeper nature of the procedure is the reason for this difference.
How Dermabrasion Improves Your Skin:
Dermabrasion removes the top layers of the skin. The removal of the top skin layers improves skin texture by:
- tightening the skin
- generating the production of new collagen
- decreasing the appearance of acne scarring or scarring that has occurred from an injury
- improving skin discolorations such as age spots, sun spots, and discolorations from acne
Anesthesia Needed for Dermabrasion:
Because dermabrasion reaches deep into the skin, there will be pain without some type of anesthetic. It does not need to be a general anesthetic. However, if you are already under general anesthesia because you are having another procedure done at the same time, then you are covered. Otherwise, intravenous sedation alone or in combination with an injection of a local anesthetic or the application of a cryoanesthetic (freezing the skin with a spray) will also suffice when general anesthesia is not used.
The Downtime for Dermabrasion:
If you have dermabrasion, count on having a red or pink appearance to the face with some crusting for approximately two to four weeks. The pinkness/redness will be improving in this time period, but you may feel self-conscious out in public. While you heal, your plastic surgeon will have you apply either a thin layer of ointment (antibiotic ointment ,or Vitamin A and D ointment) or a burn cream to the dermabraded areas. In some cases, your surgeon may apply a thin layer of medicated sheeting to your face while you heal. The ointments and sheeting are used to keep in moisture and prevent crusting while you heal. Crusting can cause scarring.
The Possible Complications of Dermabrasion:
Complications are not common, but can include infection, scarring, blotchy skin, hyperpigmentation (darkening of the skin), and hypopigmentation (lightening of the skin). In people of color, permanent hyperpigmentation can occur. Thus, dermabrasion is not recommended for people with darker skin (black skin, brown skin, Asian skin, and other dark complexions). Hypopigmentation, when it occurs, is usually in people with white skin.
How Dermabrasion Compares to Other Methods of Skin Resurfacing:
Compared to the other methods of skin resurfacing, such as chemical peels, lasers, and microdermabrasion, dermabrasion has one distinct advantage. Because the depth of penetration into the skin is manually controlled, it is more precise. The plastic surgeon controls the depth of the dermabrasion. On the other hand, a disadvantage is that the result is indeed based on the technique of the surgeon. Too shallow and you’ll see limited results. Too deep, and you may get awful scarring. However, when it is done right, which is the majority of the time, you will see significant improvement in the lines and wrinkles of the face.
Sources:
Kryger ZB. Dermabrasion. In: Kryger ZB, Sisco M, eds. Practical Plastic Surgery. Austin, TX: Landes Bioscience, 2007.
Obaid SI, Burns JL. Nonoperative Facial Rejuvenation. In: Janis JE ed. Essentials of Plastic Surgery, 1st Ed. Philadelphia: Elsevier, Inc, 2006.
Perrotti JA. Cutaneous Resurfacing: Chemical Peeling, Dermabrasion, and Laser Resurfacing. In: Thorne CH, Beasley RW, Aston SJ, Bartlett SP, Gurtner GC, Spear SL. Grabb and Smith’s Plastic Surgery. Philadelphia, PA: Lippincott Williams and Wiilkins, 2007.
