Dermabrasion in Seattle
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General Information:
Dermabrasion is a technique that is used to improve the look of uneven or acne-scarred skin. Uneven fine lines around the mouth and pre-cancerous sunspots can also be removed. Dermabrasion is used to treat deep acne pit scars and "ice pick scars" from deep cystic acne. Dermabrasion can be done as a single procedure or in conjunction with other procedures. Dermabrasion can be done on a single spot, a specific area or the entire face.

Patients from all ages can benefit from dermabrasion. Those individuals with a fairly light complexion do best with this procedure. Those with dark complexions, olive, or black skin may have some unpredictability of color of the skin after healing.

Other procedures such as chemical peels and laser resurfacing have the same goal as dermabrasion - remove the outer layer of the skin. The dermabrasion involves a mechanical sanding of the skin to smooth down the outer layers.

On initial consultation, Dr. Portuese will ask the patient about their goals and expectations. He will review the patient's medical history. Acne must be under control before performing dermabrasion. Accutane must not have been used for at least 12-18 months prior to the procedure.

The most common risk associated with dermabrasion is skin pigmentation. The skin can heal either too dark, which is most common, or too light. If the skin heals too dark, a bleaching agent can always be prescribed to bleach the skin to its normal coloration. This is usually a temporary problem. On a rare occasion, a patient can develop excessive scar tissue, called keloids or hypertrophic scarring, which is treated with cortisone injections.

The Decision:
When patients decide to have dermabrasion, Dr. Portuese will explain the techniques involved with the procedure.

Dr. Portuese will give the patient specific instructions on how and when to prepare for their surgery. This will include preoperative and postoperative care, avoiding aspirin or other products which will cause bleeding during or after surgery.

Following these instructions will help the patient recover from surgery more smoothly. All surgery is performed on an outpatient basis in our Medicare-certified ambulatory surgery suite.

The Procedure:
Dermabrasion is a mechanical sanding of the skin to smooth out the outer layers of the skin. Dermabrasion can be repeated two to three times over the course of a year to give a full effect.

Most patients will have approximately a 30-40% improvement after all the procedures are complete. The area will be slightly red and crusty immediately after the procedure and may have a slight amount of bleeding.

If you have further questions about Dermabrasion, please feel free to contact our office.

Dermabrasion can be done under local anesthesia for small areas or intravenous sedation for large areas.

We have board certified physician anesthesiologists who will be present to monitor the anesthesia and the patient's vital signs while Dr. Portuese performs the surgery. Patients must have transportation arrangements and someone to take care of them for the first twenty-four hours.

If a small area is to be done, patients may choose to have a local anesthetic, which will anesthetize the area and surrounding tissue. If the procedure is done under local anesthesia, the patient will be able to care for themselves after the procedure.

Postoperative Course:
The postoperative course for dermabrasion surgery is usually uneventful. Complications are minor and infrequent. These include reaction to the general anesthesia or a bacterial or viral infection. If patients choose to have the procedure around the mouth, an antiviral agent will be prescribed for the patient to begin prior to the procedure. This will help prevent fever blisters.

During the postoperative course, some patients will experience some swelling and weeping from the site. The first week the skin must be kept moist with an ointment at all times. A&D ointment is recommended because of low incidence of allergic reaction. Dermabrasion is not painful.

Many patients report a mild burning or stinging sensation. Patients are given a prescription for pain medication for the postoperative period. Cold compresses to the area will help the discomfort. Patients will experience swelling around the area for the first week.

It is important that patients keep their head elevated for the first several days after the surgery. The skin typically will develop a scab for approximately one week after surgery and then when the scab falls off, the skin is pink. This pinkness fades over a course of a month or two.

It is important that patients keep their physical activities to a minimum for the first two weeks after surgery. This will keep the blood pressure down and optimize the healing process.

It is extremely important that sun exposure be strictly avoided for four months following the procedure. Sunblock must be used in this time period to prevent a dark hyperpigmentation to the areas that have had dermabrasion.

Most patients can return to work or school within a week to ten days following surgery. Once the scabs have diminished, patients can wear makeup to diminish the pinkness.

Typically, postoperative visits to Dr. Portuese office are performed within the first week after the surgery, and at 1 month, 6 months and 1 year.

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