Techniques for Dermabrasion to the Face
Steven M. Levine
Daniel C. Baker
DEFINITION
Surgery is the standard to address descent and laxity in the aging face.
Resurfacing is important to treat textural and other surface changes related to aging and environmental damage.
Dermabrasion is a highly effective, reliable, and low-cost method to facial resurfacing.
It is particularly useful for vertical perioral rhytides.
ANATOMY
Dermabrasion can be performed on the entire face and neck or can be isolated to specific aesthetic units such as the glabella or perioral region.
The perimeter of any area being treated should be “feathered” to minimize the creation of a transition between dermabraded and nondermabraded tissue.
PATIENT HISTORY AND PHYSICAL FINDINGS
Indications for dermabrasion are broad and can include desire to improve skin texture, reduce visible fine lines, or reduction in age spots (such as solar keratosis).
It is important to elicit a history of oral herpes so that these patients can be pretreated with antiviral medication.
Skin type is important to note.
SURGICAL MANAGEMENT
Dermabrasion can be performed as a stand-alone procedure or in combination with a face and necklift.
Preoperative Planning
The primary consideration for preoperative planning is the patient’s skin tone. The more pigmentation in the skin, the higher the chance for postdermabrasion complications such as postinflammatory hyperpigmentation or areas of hypopigmentation.
Some providers choose to pretreat patients with a retinol or bleaching agent for 4 to 6 weeks prior to dermabrasion.
The authors do not use pretreatment.
A marker is used preoperatively to stain the fine lines for which the dermabrasion is targeting.
Positioning
The patient is supine on the procedure table.
Usually the head of bed is slightly elevated.
The provider should be sitting for maximum stability.
Approach
The approach can be accomplished using a variety of techniques that yield a controlled, reproducible distribution of mechanical resurfacing to the skin.
TECHNIQUES
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