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W. Bushong, Ph.D., LMFT Richard A. Martin, Jr., M.D., FACEP Kimberly L. Westwood, CPE, CCE et al. |
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Specialists in the Medical & Psychological Aspects of Transgender Health Care |
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Dermabrasion and Dermaplaning
Dermabrasion and dermaplaning improve the skin's appearance by removing the skin's top layers through a method of controlled surgical scraping. The treatments soften the sharp edges of surface irregularities, giving the skin a smoother appearance. Dermabrasion is most often used to improve the look of facial skin left scarred by accidents, previous surgery, or electrolysis damage. Surgical scraping will also smooth out fine facial wrinkles, such as those around the mouth. It's also sometimes used to remove the pre-cancerous growths called keratoses. Dermaplaning is commonly used to treat deep acne scars. Both dermabrasion and dermaplaning can be performed on small areas of skin or on the entire face. They can be used alone, or in conjunction with other procedures such as facelift, scar removal or revision, or chemical peel.
Alternatives and Combination of Procedures If you are planning surface repairs on your face, you may also be considering chemical peel, an alternative method of surgically removing the top layer of skin. Dermabrasion and dermaplaning use surgical instruments to remove the affected skin layers, while chemical peel uses a caustic solution such as phenol (an acid). Many plastic surgeons perform all three procedures, selecting one or a combination of procedures to suit the individual patient and the problem. Others prefer one technique for all surface repairs. In general, chemical peel is used more often to treat fine wrinkles, and dermabrasion and dermaplaning for deeper imperfections such as scars. A non-chemical approach may also be preferred for individuals with slightly darker skin, especially when treating limited areas of the face, since dermabrasion and dermaplaning are less likely to produce extreme changes and contrasts in skin color. Dermabrasion and dermaplaning can smooth scars left by acne, accidents, electrolysis damage, or previous surgery, as well as fine facial wrinkles, especially those around the mouth. But neither treatment will remove all scars and flaws. Dermabrasion and Dermaplaning These procedures are usually done on an outpatient basis, but if you are undergoing extensive work, you may be admitted to the hospital. Dermabrasion and dermaplaning may be performed under local anesthesia, which numbs the area, combined with a sedative to make you drowsy. Sometimes a numbing spray, such a freon, is used along with or instead of local anesthesia. In more severe cases, your surgeon may prefer to use general anesthesia. The procedures usually take from a few minutes to an hour and a half, depending on how large an area of skin is involved. It's not uncommon for the procedure to be performed more than once, or in stages, especially when scarring is deep or a large area of skin is involved. In dermabrasion, the surgeon scrapes away the top layers of skin using an electrically operated instrument with a rough wire brush or diamond impregnated burr. The surgeon scrapes away the outermost layer of skin with a rough wire brush, or a burr containing diamond particles, attached to a motorized handle. The scraping continues until the surgeon reaches the safest level that will make the scar or wrinkle less visible. In dermaplaning, the surgeon uses a hand-held instrument called a dermatome. Resembling an electric razor, the dermatome has an oscillating blade that moves back and forth to evenly skim off the surface layers of skin that surround the craters or other facial defects. This skimming continues until the lowest point of the scar becomes more even with the surrounding skin. Afterwards, the surgeon may then treat the skin in a number of ways, including ointment, a wet or waxy dressing, dry treatment, or some combination of these. Recovery Following the procedure, your skin will be quite red and swollen, and eating and talking may be difficult. You'll probably feel some tingling, burning, or aching; any pain you feel can be controlled with medications. The swelling will begin to subside in a few days to a week. A scab or crust will form over the treated area as it begins to heal. This will fall off as a new layer of tight, pink skin forms underneath. Your face may itch as new skin starts to grow, and you may be provided with an ointment to make you more comfortable. If ointment is applied immediately after surgery, little or no scab will form. In any case, you will be given detailed instructions to care for your skin after surgery. If you still have facial hair remaining, you will need to delay hair removal for a while. It is very important that you understand your surgeon's instructions and follow them exactly, to ensure the best possible healing. The treated skin will be a bit swollen, sensitive, and bright pink for several weeks, but you can expect to be back at work in about two weeks. The pinkness of your skin will take about three months to fade. In the meantime, you'll probably want to wear non-allergenic makeup when you go out. Also, it is very important to protect your skin from the sun until the pigment has completely returned, which can be as long as six to twelve months following treatment. Skin resurfacing will take some time before you see the final results. Several months after your procedure, much of the pigmentation has returned and the skin is much smoother than before. Other Considerations Although older people heal more slowly, more important factors are your skin type, coloring, and medical history. For example, black skin, asian skin, and other dark complexions may become permanently discolored or blotchy after a skin-refinishing treatment. People who develop allergic rashes or other skin reactions, or who get frequent fever blisters or cold sores, may experience a flare-up. If you have freckles, they may disappear in the treated area. The most common risk is a change in skin pigmentation. Permanent darkening of the skin, usually caused by exposure to the sun in the days or months following surgery, may occur in some patients. On the other hand, some patients find the treated skin remains a little lighter or blotchy in appearance. You may develop tiny whiteheads after surgery. These usually disappear on their own, or with the use of an abrasive pad or soap; occasionally, the surgeon may have to remove them. You may also develop enlarged skin pores; these usually shrink to near normal size once the swelling has subsided. While infection and scarring are rare with skin resurfacing treatments, they are possible. Some individuals develop excessive scar tissue (keloid or hypertrophic scars); these are usually treated with the application or injection of steroid medications to soften the scar.
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This Site may also be accessed via www.tgcare.com Transgender
Care Health Information Archive
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Dermabrasion
and dermaplaning are methods of skin resurfacing. Other methods
discussed elsewhere include chemical peeling and laser resurfacing,
which work in similar ways. These methods rely on the top layer of the
skin being removed, and as the new skin grows, changes take place in the
remaining skin. A new layer of collagen forms just below the epidermis.
This is called the grenz zone. The older damaged collagen is pushed
further from the surface and deeper into the dermis. This results in
tightening of the skin and a decrease in the depth of the wrinkles. The
resurfacing of the skin comes from cells found deep around the base of
the hair follicles, but these hair growing cells are typically not
destroyed. 
