Are You a Candidate for Dermabrasion?
Not everyone is a candidate for dermabrasion. If you are prone to keloids, hyper or hypo pigmentation or do not react well to burns or excessive scarring due to minor cuts and abrasions, dermabrasion is not such a good idea. The abrasive medium literally rubs off  the top layers of skin to reveal younger-looking, fresh skin beneath.  If you scar badly from abrasions, or scrapes, the results of dermabrasion could be disastrous. Also, if you have ethnicity (i.e. Greek, Italian, Asian or African-American, etc.) in your biological family, you may be prone to hyper or hypopigmentation resulting from any level of dermabrasion. 

If you have oral herpes.  You MUST gain the approval of your primary physician and seek a prescription for oral acyclovir , one brand name is Zovirax.  This is very important!  Zovirax (or equal) can significantly decrease your chances of a break out.  If you have a break out during your healing period, it can spread to your entire face and result in severe and permanent scarring.

Also, you should NOT have a dermabrasion treatment on the affected area if you have the following:

• Undiagnosed lesions

• Recent herpes outbreaks

• Warts

• Active, weeping acne (stages 3-4)

• Active Rosacea

• Unstable diabetes

• Auto-immune system disorders

• pigmentation problems

*source for the immediate above, Medscape Medical Journal (1999)

Communication is crucial in reaching one's goals.  You must be able to voice your desires to your surgeon if he/she is to understand what your desired results are.   Discuss you goals with your surgeon so that you may reach an understanding with what can realistically be achieved.

You must be mentally and emotionally stable to undergo an cosmetic procedure.  This is an operation which requires patience and stability in dealing with the healing period.   There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue.  Please consider this before committing to a procedure.

What to Expect at Your Consultation
After checking a few surgeons' backgrounds and credentials, you will make an appointment for a consultation. You will meet with these surgeons and discuss your goals and you will disclose all information regarding your health; if you smoke, what medications or vitamins you presently take, etc., this is very important. You really should consider smoking cessation as this can significantly decrease healing. Visit the Medication & Supplements List for more information. 

You will discuss your complaints and concerns and discuss the various levels which can be safely removed, thus the amount that can be improved, etc. Your surgeon will explain the technique or methods that may be most appropriate for you.  He or she should discuss the risks associated with dermabrasion with you, as well. 

You will also discuss the available anesthesia that will be used for your procedure.  Most dermabrasion procedures are performed under Light Sleep Sedation, Twilight or regional, sometimes even local with oral sedation.  However, some physicians may use General IV Sedation.  Either way, discuss this beforehand as many people are not aware of the risks of Anesthesia.  If you do go under Deep General, ascertain that the anesthesiologist is certified.  Please read the All About Anesthesia Page, the risks regarding anesthesia should be considered for a fully informed choice. 

If you would like more information on Consultations or a list of questions to ask your surgeon please visit the Consultation Help Page. If you should choose to book or reserve a surgery date you will usually give a deposit to hold your surgery date. Most times if you cancel a few days beforehand, this amount is non-refundable. After paying your deposit and scheduling a surgery date, you will also schedule a pre-operative appointment...

Your Preoperative Appointment
This appointment addresses more questions you may not have thought to ask at the initial consultation, such as more treatment details, concerns and even ascertaining that your surgeon is aware of what you desire from your procedure.  Just as your surgeon will make certain that you know what it realistically possible from this procedure.

You will also discuss your pre-operative instructions and speak about the recovery period instructions and what to expect in the months ahead. You will be given prescriptions for antibiotics, pain relievers, perhaps blood pressure medicines, prescription anti-inflammatory drugs.

Please do not hesitate to address any concerns that you may have during this time and even after your pre-operative appointment. If you remember something when you get home or the next day or even the day of treatment, don't be afraid to ask. 

Preparing for Your Treatment
You should be given an information packet that explains everything you should do and know before your treatment date.  For more  invasive procedures, the packet should include a list of all the medications you should not take starting usually at 2 weeks before your treatment. These medications will include, but are not limited to, aspirin containing products, stimulants, seratonin supplements, etc. Would you like to view a typical Medication & Supplements List?  Also, if your surgeon advised that you may take Arnica montana, Bromelain, Vitamin K, etc. for swelling and bruising you should either have this in your packet or begin shopping for your necessities.

It is quite possible that you will have blood work performed. This is normally an extra out-of-pocket expense that the patient must participate in to check your white and red blood cell count and check for disease or disorders beforehand. If you are a female they may take an extra vial for a pregnancy test. Some surgeons ask that you have physical. This can be yet another out of pocket expense so ask at your consultation what will be needed when you are quoted a price.

For less invasive or minimal correction procedures, the routine is much simpler, please discuss this aspect with your physician.

So many things to do... so little time. Your treatment will be here before you know it so visit the Preparing For Surgery page and relax. This section contains, printer-friendly pre-op lists, tips and advice as well as things you must do to prepare for your big day.

How These Treatments Are Performed
A dermabrasion procedure normally takes anywhere from 15 minutes to 2 hours to perform, depending upon the size of the area to be corrected.  For patients undergoing anesthesia for their procedure, first, you will have monitoring pads (electrodes) attached to you so that the surgical team can properly monitor your vital statistics before, during and after your operation.  When you are brought to the operating room, your electrodes will be connected to the monitoring equipment.  

Once you are on the operating room table, you will then be given your choice or your surgeon's preference in anesthesia as discussed prior to your surgery date.  If you had been given an oral sedative or valium prior you will have less anxiety.  They will more than likely insert an IV for a saline drip to keep you hydrated and have a vascular doorway for anesthesia, antibiotics, and other medications.  If you haven't been given a sedative, it is more stressful for some patients.  If you feel that you may experience anxiety inquire beforehand regarding an oral sedative.  Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time.  It's the initial placement of the IV that may sting a bit.  Some people get heir IV placed in the crook of the elbow, some the hand - it all depends upon your veins though.  So if your veins are not very prominent this can be a problem. You are then brought to the O.R. if you aren't on the table yet.  After the needle is injected into the vein it is pulled out and a little plastic tube is left in your vein.  This is called a catheter.  The  catheter is taped to your skin so it is not accidentally knocked or pulled out and is ready to be used as a sort of entryway for anything the surgical team deems necessary for your body.  This is usually done before you get into the actual O.R., by a nurse, and you have a saline bag hooked up to you.  The medications will usually be given with a drip system with this saline. As said before, the saline will keep you hydrated both during and post-operatively.  

If you have chosen an IV Liquid Sedative, they will insert a hypodermic into your tube that you are attached to or they attach the bag of it with a drip system to add a few drops every few seconds and when they spring open the stopper and it starts heading towards your body.  The the effects of the anesthesia are felt soon after injection or opening the stopper, a few seconds in fact.  It may feel similar to a sensation of heat entering your arm or hand at the catheter site.  It then feels as though it is creeping up your arm, then it jumps from your shoulder to a metallic-like taste under your tongue and then you are blissfully anesthetized.  The anesthesiologist or surgeon will then determine if you are sedated properly, your stats are stable and if you are ready for the surgery to begin.

You will be injected with a solution of Lidocaine for pain relief and epinephrine for vasoconstriction.  Vasoconstrictors impede your skin's ability to bleed excessively by narrowing the bore of the blood vessels.  This is usually necessary for dermabrasion during deeper resurfacing procedures.  However, not all procedures will need injections of epinephrine.  

Your surgeon will then begin to manually abrade your skin with a fine grit type of surgical sandpaper or with a sanding machine somewhat similar to a Dremel or acrylic nail sander.  Your surgeon may make several passes or one simple, yet deeper pass until the scar is at the same level as the surrounding skin.  Some scars are removed completely whereas some ice pick type scars may need additional procedures such as punch-grafting or injectable fillers.

After the skin resurfacing is complete, your surgeon will cover your face with either a thin film of Bacitracin or antibiotic burn cream like Silvadine. Some surgeons use a second synthetic breathable skin to protect the newly surfaced tissue during its healing process. There are several experimental coverings that are undergoing testing.  Some will even provide you with or suggest that you get a hydrogel-type masks or sheeting such as HydroGOLD by BioDermis.com

EXTRA! A relatively new and exciting burn bandage is made from cotton and purified chitin, called chitosan, (a polysaccharide), which is extracted from the exoskeletons of crustaceans (crab, shrimp and lobster shells). Incidentally, Chitosan is also an ingredient in controversial fat magnet pills and supplements.  Below is from Youngdeok Chitosan:

"Chitosan is a natural product derived from Chitin, a polysaccharide found in exoskeleton of crustaceans like crabs and shrimps, in the crusts of the insects like beetles, gold bugs, and grasshoppers, and in the cell wall of bacteria and fungi like molds and mushrooms.

Crab's shell consists of Chitin substance, Protein, Calcium carbonate which are all boned together very strongly to become a hard and stable crust.

Therefore, pure Chitin (acetylamino-polysaccharide) is extracted by removing protein and calcium carbonate from crab's shell. Through the process of deacetylization called purification, Chitosan (amino-polysaccharide) is obtained from Chitin by getting rid of acetyl radicals.

Chitosan-Oligosaccharide is obtained by an enzymatic hydrolysis of chitosan using chitosanase. Compared with Chitin and Chitosan that has poor solubility and absorbability into our body, Chitosan Oligosaccharide is absorbed perfectly. "  http://www.youngchito.co.kr/eng/default.asp 

Some bandages consists of several layers, the main layers consisting of the purified crab shells (chitosan) as well as a synthetic barrier that whisks away moisture and fluids from a weeping, healing wound. An outer layer of cotton gauze absorbs the fluids. The gauze pads can be changed but the synthetic skin and chitosan covering stays to protect the wound. The chitosan are actually absorbed harmlessly into the body and excreted. Miraculously, the crab shells have a superior antibacterial property unheard of in any relative substance. Reportedly, no known fungus or germ can adhere to it's surface. When the bandage is removed, perfect, flawless skin appears. 

You are then gently awakened and brought into the recovery room where the recovery nurse will monitor your vital stats until you are ready to be released. This is dependent upon the individual but may take up to two hours. Your face may feel tight and quite tender as the anesthesia wears off. You may even feel emotional or upset, this will depend upon your body's reaction to anesthesia. You may also experience rigors or shivering. This may feel uncontrollable and is usually from the medications, more than likely if epinephrine is used (a  vasoconstrictor). The recovery nurse usually has wrapped you in a warm blanket but if not, request one. It certainly makes things more tolerable.

The Road to Recovery
You may be groggy from the anesthetic and or oral medications and probably won't remember much of the first day or two if you were sedated. You will have to take it easy and sleep on two pillows to keep your head elevated for 7 to 14 days, or however long your surgeon suggests. When you wake up you will notice that your face may look even more swollen in the first 3 days. But, as the days go on the swelling will dissipate. There may be some bruising, but this will go away, as well. So make a mental note of this or you may be shocked into a depression. Bruising and swelling are a normal occurrence in most invasive procedures.  In dermabrasion, there is marked redness and weeping (wound seepage).

There will be redness and slight discomfort post-operatively. Your surgeon will have instructed you on the proper care of your treatment area as well as prescribed you the necessary antibiotics and pain medications to help alleviate your discomfort. Take your temperature on time and regularly. An elevated temperature could mean an infection. Take those antibiotics ON TIME. And don't forget if you are taking birth control that some antibiotics can interfere so in the event that you do have relations, use another form of protection as well. The swelling can be alleviated with ice packs. You may be instructed to apply ice (not directly on skin), gel masks and vinegar soaks on your treatment area for the first 48 hours. 

Your healing time totally depends upon the depth of your treatment.  You can expect to be down for at least 1 to 2 weeks, unless the treatment is very superficial.  Which in that case a light chemical peel would suffice. Your skin will feel like a wind or sun burn.  It may weep and need dressing changes and additional ointments which will be supplied by your doctor directly or by prescription. You may sometimes wear these bandages for about 5 to 7 days. You will more than likely have them removed by your doctor on day 5 but this could be longer if the penetration was pretty deep. After your bandages are removed your doctor will go over with you the proper care for your treatment area such as cleansing and applying ointment.  If you notice crusty formations; DO NOT PICK AT THEM OR PULL THEM OFF! You will scar as a result - probably more than before your treatment.  But, don't worry, they usually subside by day 10. 

You may be given a bovine mucalpolysacharide solution or wash, this is a cow-derived cartilage extract that has the anti-inflammatory properties of 1-2% hydrocortisone.  It accelerates epidermal healing.  The skin wash is like having a steroid application without the risk of steroid induced atrophy or telangiectasia formation.  Catrix is one brand, Correction Cream Wash, CX-10 Correction ointment and CX-5 Correction cream.

Post-operatively, you must use sun block faithfully!  Your skin is very susceptible to damage by UVA/UVB radiation (the sun).  This includes artificial sunlight like tanning beds as well as simply driving to the store or around town all day in your car.  Believe it or not you do get sun exposure when you drive around.  You should not use using AHA's, Vitamin A (Retin A) or exfoliants until your surgeon advises it is safe to do so.  Your skin is very fragile in its healing stage, which could last for months.

Your skin will heal and become very smooth and young looking. The pinkness will subside as will the tenderness. You may be pink for up to 5 months or more, depending on your skin's ability to bounce back and, of course, the depth of the abrasion. You must take care of your skin in order to keep it looking vibrant and fresh.  Although, no procedure can keep your skin from aging, it can give you a young, relaxed appearance and buy you some time.

At about 2 weeks or as soon as there is no weeping and no crusting (but please ask your doctor first) you can safely wear cosmetics to cover the redness.  There are special cosmetics one can buy to offset the redness or you can experiment on your own with what you have.  Physician's Formula is am inexpensive and effective camouflaging cosmetic line that can be bought in your local pharmacy or drug store.

Risks & Complications of Dermabrasion
Ascertain that your surgeon discusses all of the risks and complications with you at your consultation. There could be allergic reactions to the anesthetic. Just make sure that you disclose your medical history and this is very important, your nationality.  If you are susceptible to Keloid scarring or have active skin infections or afflictions such as herpes outbreaks, you may not be a good candidate for Dermabrasion. 

Very Important: If you have a history of cold sores, herpes or other viral infections please disclose this to your surgeon!  After dermabrasion treatments, chemical peels and and laser resurfacing - viral anomalies may spread and severely disfigure the treatment area.  You will be placed on anti-viral medications beforehand and continue during the healing phase.  Bacterial infections are also a severe risk and even water-borne or plant-borne bacterial infections can severely scar your treatment area if they are exposed to your treatment area.

If your skin is olive, black, brown and even yellow-toned, take care in your choice of resurfacing measures.  Dermabrasion, Laser resurfacing and chemical peels can cause noticeable damage to ethnic skins. You should request a spot test if you or your doctor are uncertain. You can never be too careful.

There is also the risk of bullae (blisters), milia (or small whiteheads), infection, thicker scar tissue of the treatment area and hypopigmentation as well as hyperpigmentation, as said before. You must also be very careful if you have taken Accutane within the past year and a half (12-18 months).  Accutane causes dermal thickening and can cause increased scarring.

* Please note the prices charged for surgeries represented in the documentations of the links above are representative of what an American doctor would normally charge. Of course, our fees are lower but our doctors are more experienced because more patients come to us due to the affordable prices. Thus, the doctors work on more cases (especially oriental patients and many Caucasians).