Cosmetic Procedures

CONSIDERING ALTERNATIVE PROCEDURES

If you're planning "surface repairs" on your face, you may also be considering chemical peel, an alternative method of surgically removing the top layer of skin. However, dermabrasion and dermaplaning use surgical instruments to remove the affected skin layers, while chemical peel uses a caustic solution.

Many 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 acne 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.

THE BEST CANDIDATES FOR DERMABRASION

Dermabrasion and dermaplaning can enhance your appearance and your self-confidence, but neither treatment will remove all scars and flaws or prevent aging. Before you decide to have a skin-refinishing treatment, think carefully about your expectations and discuss them with your surgeon.

Men and women of all ages, from young people to older adults, can benefit from dermabrasion and dermaplaning. 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.

In addition, most surgeons won't perform treatment during the active stages of acne because of a greater risk of infection. The same may be true if you've had radiation treatments, a bad skin burn, or a previous chemical peel.

ALL SURGERY CARRIES SOME UNCERTAINTY AND RISK

Dermabrasion and dermaplaning are normally safe when they're performed by a qualified, experienced physician. 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-refinishing 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.

PLANNING YOUR SURGERY

Because these treatments have sometimes been offered by inadequately trained practitioners, it's especially important that you find a doctor who is trained and experienced in the procedure. After all, dermabrasion and dermaplaning usually involve the most visible part of your body-your face.

In your initial consultation, be open in discussing your expectations with your surgeon, and don't hesitate to ask any questions or express any concerns you may have. Your surgeon should be equally open with you, explaining the factors that could influence the procedure and the results-such as your age, skin condition, and previous plastic surgeries.

The surgeon will discuss your medical history, conduct a routine examination, and photograph your face. He or she should explain the procedure in detail, along with its risks and benefits, the recovery period, and the costs. Insurance usually doesn't cover cosmetic procedures, however, it may cover dermabrasion or dermaplaning when performed to remove precancerous skin growths or extensive scars. Check your policy or call your carrier to be sure.

PREPARING FOR YOUR SURGERY

Your surgeon will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, and on avoiding aspirin and other medications that affect blood clotting. You may also be given special instructions regarding the care and treatment of your skin prior to surgery. If you smoke, you'll probably be asked to stop for a week or two before and after surgery, since smoking decreases blood circulation in the skin and impedes healing.

While you're making preparations, be sure to arrange for someone to drive you home after your surgery, and to help you out for a day or two if needed.

WHERE YOUR SURGERY WILL BE PERFORMED

Your treatment may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, for cost containment and convenience. However, if you're undergoing extensive work, you may be admitted to the hospital.

TYPES OF ANESTHESIA

Dermabrasion and dermaplaning may be performed under local anesthesia, which numbs the area, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort. Sometimes a numbing spray, such a freon, is used along with or instead of local anesthesia. Or, in more severe cases, your surgeon may prefer to use general anesthesia, in which case you'll sleep through the procedure.

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