| Skin resurfacing or peeling
This procedure was frequently used by plastic surgeons
a few decades ago and then it seemed to be forgotten for a few years until
now, with new techniques it starts becoming popular again. It is done
with chemical substances and tools such as the Dermoabrasive, Laser, Radiofrequency,
etc).
Many factors should be taken into consideration in the initial consultation
such as:
a) skin irregularity caused by acne, pox, light scar, b) ethnical group
: dark skinned people tend to develop more spots after this type of surgery;
c) profession of patiet; c) local factors that may interfere (irritable
beard, active acne, deep skin irregularity, spots or dischromalies or
unaesthetic scars; e) patient’s motivation.
The dermoabrastion, peeling or resurfacing can be recommended
for one or more sessions (when recommended for more than one session there
must be an interval between the sessions depending on the skin characteristics
and technique used). It can be done with local or general anesthesia or
even sedation (chemical peel). During the first phases (eritema phase)
the patient cannot be exposed to sunlight so as to avoid spots on the
skin and this procedure can be done simultaneously with other procedures
such as mouth, wrinkles around the eyes or total face.
Since this procedure uses different substances and techniques the patient
should ask all questions in the first consultation and be aware of risks
involved with doctor.
History
In 1500 A.C in anciebt Egypt, there is reference to skin filing to remove
spots and scars. Salt has also been used as abrasive substance. From the
70’s on new tools and files with diamond points were used. The skin
can be filed until a certain depth, next to the glands which will be necessary
for a good regeneration of the skin.
Technique
One of the most frequently used techniques is the mechanical
peeling to remove scars produced by acne or spots, stimulating the cell
regenation in a physiological way. Peelings can be superficial, medium
or deep.
Indications
Acne scars
The dermoabration is a type of peeling use by both men and women and it
consists of peeling superficially (or medium) the skin with acne or marks
caused by exposition to ultraviolet rays. A high rotation tool is used
with local anesthesia (for small areas) removing the skin layers with
files made with diamonds or water. Manual peeling can be made with water
concomitantly with plastic facial surgery to promote cell renovation for
senile or marked skin.
Senile seratosis and spots
In seniles spots and premaligne lesions, this method
has a precise indication for it promotes the regeneration obeyin the normal
physiology of healing. The treatment can be made in more than one session
with intervals no smaller than six months.
Rinophima
The exagerated growth of subskin, skin and glands represents
a good indication for this technique which enables skin renovation and
immediately after the procedure, the skin and glands proliferate.
Patients with bad healing such as tendency for cheloyds, spots, scar stretching
may not be recommended to undergo this procedure. An ointment for reconstruction
is applied right after the procedure. The patient should avoid sunlight
for 15 days and after that period should use sunscreen for 3 months. Normal
lights, both at home and at work also emit radiation and so the skin should
be protected in these places as well.
After three weeks the skin is fully reconstructed but its normal aspect
will only be seen after the third month. Pancake or powder should be applied
over the sunscreen. AS you peel, the new skin will have a better aspect,
looking healthier and younger.
Wrinkles
The lip wrinkles represent indication for facial surgery
through abration. When the wrinkles are too deep there may be hipopigmentation
areas (white spots) which can be easily corrected with an adequate corrective
base makeup. After 30 days the lip can be filled and then the patient
will have a much younger and better look.
Post accident scars can be treated with abration and
the results can be obtained right after one or two sessions. The skin
treatment, whatever the technique used (laser, chemical or dermoabration)
will promote skin rejuvenation and cell renovation.
Cheloyds
They can be treated with this technique as soon as there
is epitelization, use silicon plates for tow to three months as well as
associate the treatment of infiltrations and massages with special creams.
In extreme cases these scars can be associated with betatherapy (special
superficial radiotherapy) 24 hours after procedure.
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