Dermabrasion for fine lip lines

Many a woman present with the lines around the mouth following years of sun exposure and smoking. Whilst it is possible to correct early wrinkles if the patient is in her 40s, it can sometimes be difficult to correct extensive deep lines of the upper and lower lip. Dermabrasion is an excellent ancillary treatment for facial rejuvenation.

One of the major reasons skin ages is due to the chronic exposure to ultra violet radiation. Race, ethnicity, eye and hair colour and freckles all contribute to early onset of skin ageing. Damage is keener to from the first day of exposure until death. 50% of a person's exposure to ultraviolet radiation occurs before the age of 18 years. From the first moment are babies taken outdoors, all subsequent outdoor activities will increase his or her likely radiation exposure. The working environment also influences exposure potential. Exposure decreases for people who work in an indoor environment. Occupations that require outdoor exposure will increase the photo ageing process, particularly in unprotected skin. The key to diminishing this damage is education and the use of some blocks.

Environmental factors such as heat, wind, humidity, pollutants, cloud cover, the season, time of day and reflected sunlight from the sand or snow also play a major role in radiation exposure.

The Evolution of the Technique
Removal of the upper layer of skin for improvement in surface texture probably be gained in Egypt in 1500 BC when a type of sandpaper was used by Egyptian surgeons to smooth out scars. In 1905 a German dermatologist used a motorised dermabrader. In 1947 and American plastic surgeon applied sandpaper abrasion for acne scars and traumatic tattoos. The current dermabrasion technique employs a small hand-held electrically powered instrument that it takes a diamond fraise at speeds of 15,000 to 30,000 rpm. This procedure is performed either under sedation with local anaesthetics or general anaesthesia for more extensive procedures.

In the past decade, incorporating some of the concepts of traditional dermabrasion, the new technique of Microdermabrasion has been advocated. Microdermabrasion can improve certain types of scars from aged and sun-damaged skin while avoiding many of the problems that are seen with traditional dermabrasion. The technique uses a fine beam of aluminium oxide microcrystals to precisely and superficially peel the skin surface. Its advantages are that it is gentle and requires no significant change in the patient's normal routine all activities. However, multiple treatment sessions are needed for optimal improvement.

In the treatment of postacne scarring it is very important to appreciate the scarring from acne is permanent and that dermabrasion can only improve the amount of light and shadow that falls on the craters of the skin, which create shadows. Dermabrasion will produce a more undulating surface as opposed to a rocky, craggy type dermis. Scars, although they are improved, will not be removed and patients can never expect to have the skin was scarred restored to the soft smooth texture of infancy. It is important to appreciate that two or three procedures are necessary for maximum improvement and it is an improvement but not a cure.

Patients taking isotretinoin (Roaccutane) or those who have recently completed a course should not undergo any skin resurfacing procedures for at least six months after the completion of the therapy. It is preferable to wait for at least a year before doing a dermabrasion.

Healing of the Dermabrasion Wound
In the case of deep wrinkles around the mouth it is important to do a deep dermabrasion which has the effect of laying down a layer of collagen which creates the improvement. Healing is expected in seven to 10 days.

Healing of the dermabraded areas is similar to that of a " roastie ". Initially there is an outpouring of serum from the wound and combined with the dressing that is applied this forms a soft crust. The healing of the skin then takes place below this layout. The new collagen that is laid down can last for three to four years following dermabrasion. Moisturisers are recommended to keep the new skin hydrated and sunblock is mandatory to diminish the possibility of hyperpigmentation.

It is not unusual for milia to form and these are small white headed cysts arising from the hair follicles, sebaceous gland ducts and sweat ducts. They usually appear with the first month following the procedure and can be treated with an exfoliating buffing pad or a mild abrasive facial scrubs to unroof the blocked ducts.

Only by the end of seven or eight days the patient can apply makeup and can be seen in public. It is very important that the sunblock must be worn as the first application on the skin each morning before makeup is applied all before leaving the house.

Potential complications

Hyperpigmentation and hypopigmentation
Patients who generally have a fairer complexion will do much better than patients with an olive or dark complexion. If you should have a complexion like this, be very careful about undertaking dermabrasion. Hypopigmentation can occur when a very deep dermabrasion has been performed in the instance of deep wrinkles around the mouth.

Milia
These are like tiny little rice seeds and are tiny little white cysts in the skin which can be removed by means of an abrasive sponge.

Residual wrinkles
Very deep lines are difficult to eradicate completely and it may be necessary that a filler materials might be indicated once all the wounds have healed.

Scarring
This can occur when the dermabrasion is too deep or when infection has occurred postoperatively. This is usually treated by steroid injections. If the dermabrasion is confined to the face there is usually a low risk of scarring occurring.

Infection
Infection is extremely rare because most patients receive perioperative antibiotics and antiviral medications.