Skin smoothing surgery

Alternative names
Dermabrasion

Definition
Surgical removal of the top layers of the skin.

Description
Dermabrasion is usually performed on an awake patient using local anesthesia. Extensive procedures, however, may require sedation or general anesthesia. A surgical instrument is used to gently and carefully “sand” the surface of the skin down to normal, healthy skin. The healing tissue is treated with ointments (such as petroleum jelly or antibiotic ointments) to reduce scab formation (crusting) and therefore reduce scar formation.

Dermabrasion is helpful in reducing scars and fine skin creases (wrinkles).

Indications
Dermabrasion may be offered to patients with:

     
  • facial scars from       o acne       o accidents       o previous surgery  
  • fine facial wrinkles, such as around the mouth  
  • precancerous growths (keratoses)

For many of these conditions, alternative treatments exist. Always discuss your options with your physician.

Risks
The risks for any anesthesia are:

     
  • reactions to medications  
  • infrequent but potentially severe heart or breathing problems

The risks for any surgery are:

     
  • bleeding  
  • infection  
  • scarring

Additional risks include:

     
  • permanent skin discoloration, either lighter, darker, or pinker

Expectations after surgery
You will likely be given antibiotic pills to prevent a viral infection (severe cold sores). The skin may be treated with ointment and a wet or waxy dressing. The skin will be quite red and swollen, and eating and talking may be difficult. There may be some aching, tingling, or burning for a while after surgery. Pain can be controlled with medications. The swelling will subside within two to three weeks. The skin will itch as new skin starts to grow. The freckles sometimes disappear in the treated area, but may return.

The dermabraded skin may develop whiteheads (milia) after dermabrasion which usually disappear. Enlarged skin pores may also develop but usually shrink to normal size once the swelling has subsided.

If the treated skin remains red, elevated, and itches after healing has started, this may be a sign that abnormal scars are beginning to form. The surgeon will provide treatment which can be started early.

Convalescence
For men, shaving will be delayed, then an electric razor is used at first.

For several weeks, the new skin layer will be a bit swollen, sensitive, and bright pink. Normal activities may be resumed and the patient can be back at work in about two weeks. Avoid any activity that could cause a bump to the treated area for at least 2 weeks; ball sports are to be avoided for 4 to 6 weeks. Stick to indoor pools to avoid sun and wind, and keep the face out of chlorinated water for at least 4 weeks. For 3 to 4 weeks the patient will experience a red flush with alcohol consumption.

It is important to protect the skin from the sun for 6 to 12 months until the pigment has completely returned. The skin pinkness will take about 3 months to fade. Hypo-allergenic make-up may be worn to conceal the scar. When full repigmentation occurs, the color should closely match the surrounding skin, making the procedure virtually undetectable.

Johns Hopkins patient information

Last revised: December 8, 2012
by Armen E. Martirosyan, M.D.

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All ArmMed Media material is provided for information only and is neither advice nor a substitute for proper medical care. Consult a qualified healthcare professional who understands your particular history for individual concerns.