Dermabrasion Questions and Answers

Question:

I have about a dozen scars on my shins due to chemical burns (from Nair Hair removal cream) and electrical burns due to bad electrolysis. All of the scars are small (about pea sized) and shallow rather than raised, and are very discolored--brownish purple while I am very fair skinned. I've tried silicone sheets to reduce the scarring, but it hasn't worked at all. I REALLY want to get rid of the discoloration, and would love to get rid of the shallowness, also, but it's the discoloration that bothers me more. What type of surgery (dermabrasion?) could help with with these scars, and what's a rough estimate of the cost? I hope you can help me. I can't go another summer in pants every day, but I can't bear to wear shorts with all of these ugly scars. Thanks for any help you can give me. Carla

Answer:

Dear Carla, The pigmentation can be readily removed with lasers although that will do little for the textural skin changes. You may wish to have the larger ones surgically removed to leave a fine scar that is level. The former should not cost too much - I charge $20 per spot per treatment with about 3 or 4 treatments required to lighten the pigmentation. The surgery costs about $200 per scar.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

On july 10th I had moh's surgery under my left eye, it was quite extensive and I've been left w/ a diagonal scar under my left eye beginning 1/4 of an inch under my tear duct and going towards my left ear. The scar is approximately 2 inches in length and I am having dermabrasion on the 19 of Sept. I would like to know what to expect, will I be in any discomfort, will it swell, and how long does it generally take to heal. Thank you for your time. I have visited a website on dermabraision and did get some information but I guess I feel I just need a little more positive thoughts. Thanks again.

Answer:

Dear Margaret, I understand that you will be having dermabrasion on this scar. If the scar is narrow and not too depressed, this may help a little. In that area, dermabrasion is not the best treatment since the lower eyelid skin is very thin and fragile and does not lend itself well to mechanical abrasion. I would suggest that you visit with a plastic surgeon in order to explore the possibility of either scar revision if the scar is wide or thick and, if optimal from that viewpoint, laser resurfacing so that an adequate depth of resurfacing can be performed without danger to this very thin skin or your eye.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

A couple of months ago I had a real bad reaction to some makeup. I broke out with really bad acne. The acne has cleared, but some scars were left. What would you recommend to have these scars removed?

Answer:

Dear Marie, I wish it was easy to remove scars. It depends upon their character and depth. If they are very deep, they may need to be surgically removed. If more superficial, a type of deep resurfacing will improve them markedly and, if very superficial, a light treatment such as microdermabrasion performed a few times will make them much better. I would suggest that you visit with a dermatologist or plastic surgeon who offers all of the options in order to determine what is best for you.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Is dermabrasion the proper procedure for removal of lip lines and lines around the eyes?

Answer:

Dear Beverly, Many practitioners have used this for years around the mouth. It is dangerous on the lower eyelid and upper eyelid skin. Microdermabrasion is safer but not effective for all but the finest of lines. Most of us have taken to using lasers in this area for smoothing the skin with minimal risk of scarring. The only down side to this is the fact that it will be red for about one month to 6 weeks after the procedure. The choice of treatment should be based upon how severe the wrinkles are and not on the favourite procedure fo the surgeon.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hi, I'm a 17 year old single mother of a 6 month old son. During my pregnancy I developed horrible strech marks that completely cover my stomach and go in circles around my belly button. I was wondering what type of surgery would best get rid of my battle scars and an approximate price. I would love to show off my stomach in a bikini again!

Answer:

Dear Julie, If you have a lot of excess skin in addition to the stretch marks and plan on having no further children, a tummy tuck is still the best option. Despite the long, low scar, it is the best means of removing the stretch marks if a tummy tuck is needed for other reasons. If your skin is not loose and the muscle are still tight, successful treatment options are limited. Many have tried laser and microdermabrasion treatments with very limited success. New non-resurfacing lasers which stimulate collagen production may be useful but they have not yet been extensively tested.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I'm probably between minor and substantial in thew wrinkle department. Could you tell me what the other deeper procedure would be?

Answer:

Dear L. Studies with the N-lite and similar non-resurfacing lasers show a contraction of collagen of about 10% with slightly more benefit in deeper dermal layers. Mocrodermabrasion will usually improve your minor wrinkles by about 10 to 20%. Laser resurfacing, to a deeper level may improve textural wrinkles by as much as 70 to 80% but, that is with about 2 to 3 weeks of recovery and redness which may last up to 6 to 8 weeks. If your wrinkles are between minor and substantial, that may be too much for you in terms of recovery.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Can you tell me if the Laser procedure done with NLite has good results? Also is microdermabrasion a good alternative for wrinkle reduction?

Answer:

Dear L. The Nlite is a very superficial laser as is microdermabrasion. If your problems are minor, both would be of some help. I would suggest that a deeper procedure be performed if you have substantial wrinkling.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

I have had two dermabrasion treatments, and both hurt very much. My friend is doing the same treatments (at another center) and says it does not hurt. Will you provide me with more information, please? And is it supposed to hurt? My face usually stays red for several hours afterward and I can see every stroke the wand made. Thank you very much.

Answer 1:

I take it that you mean microdermabrasion treatments which are very different from dermabrasion. There are settings for varying the intensity of the suction and the flow of crystals on the various machines avaialable. If it hurts, it is likely delivering a deeper peel and you may get better results than your friend. If it bothers you too much, though, tell the operator and have them turn down the power.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Answer 2:

I WOULD NOT ASSUME ONE IS A MICORDERMABRASION AND ONE A DERMABRASION. ONE THING IS FOR SURE. IF IT HURTS, IT PROBABLY MEANS THAT THE DEPTH OF THE DERMABRASION IS DEEPER. REMEMBER, NO PAIN NO GAIN! YOU ARE PROBABLY PAYING A LOT FOR WHAT YOU WANT. MAKE SURE THAT YOU GET WHAT YOU WANT.. IT WOULD BE ADVISABLE TO DISCUSS THESE SIMILAR QUESTIONS WITH YOUR PLASTIC SURGEON. I AM SURE THAT HE/SHE WOULD BE HAPPY TO DISCUSS WHAT HAS BEEN DONE. GOOD LUCK JRBERMAN

Question:

I have a scar on my forearm (between elbow and wrist) as a result of a 2nd degree burn from an airbag - results of an auto accident. Everyone says that it shouldn't have scared at all, but it did and is quite noticable. The insurance adjuster is trying to tell me that I can have it removed with dermabrasion for about $1000. Is this true? Are there any side effects, pain, etc.? Thanks for your help!

Answer:

Dermabrasion and laser resurfacing can help the contour of scars but do little to the true scar tissue. If it is indeed a widespread scar with altered skin texture and appendages, often, other procedures such as scar excision or tissue expansion followed by scar excision need to be considered for optimal scar improvement. These procedures would be somewhat more costly than the sum that you mention.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

Hi. I'm a 30 year old African-American woman who has been battling acne and espcially hyperpigmentation associated with acne scarring since I was a teenager. I've been to dermatologists and aestheticians and received accutane, antibiotics and a couple of years worth of chemical peels and micro-dermabrasion with little results. I'm interested in getting rid of this problem once and for all! My question: Is a laser procedure a safe and viable option for Black skin with my condition and how much does such a treatment run? My complexion is medium-brown and I was told a couple of years ago that lasers were not recommended for my skin tone, so I'm wondering if the technology has improved since then. If not, what other options do I have?

Answer:

Dear Rae, Lasers procedures work very well on your skin color and I perform many. In my opinion, it is the best means of evening out your pigmentary problems as well as improving the scarring. The trouble is that not very many physicians have experience with non-white skin in laser resurfacing. I have presented my techniques at many national and international meetings and am currently publishing a paper on the matter. There is no question in my mind that you can be greatly improved with a laser resurfacing procedure.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

Question:

What is the best non-surgical way to get rid of deep stretch marks caused by rapid weight gain during pregnancy? Does plastic surgery for stretch marks work well?

Answer:

Dear Lea, If the stretch marks are red, they can be reduced with a laser. They tend to progress to white anyway and these are very poorly treated by laser, DermaPeel, dermabrasion, etc. If you have a lot of excess skin, a tummy tuck procedure can be performed to surgically remove the stretch marks. All other treatments, in my opinion, improve things, at best, 10 to 15%.

Gregory Caputy, MD, Chief Surgeon
Honolulu, HI

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