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Skin Rejuvenation

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Microdermabrasion
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Micro-dermabrasion is a non-surgical approach for removing the outer layer of the skin. This results in rejuvenation of aged skin and improvement in the appearance of fine lines, wrinkles, sun damage, hyper pigmentation and scars. This procedure may be applied to any part of the body.

The procedure involves the use of small crystals that are sprayed with a precise amount of force over the surface of the skin. The crystals are then vacuumed off along with the accumulation of dead skin cells, resulting in the disappearance of an otherwise dull or sallow look. The Parisian Peel® machine is a medical grade device that can only be used by physicians to deliver finer crystals at a higher speed, which results in a more effective result.


If You Are Considering Microdermabrasion

Dermabrasion and microdermabrasion "refinish" the skin's top layers through a method of controlled surgical scraping. The treatments soften the sharp edges of surface irregularities, giving the skin a smoother appearance.

Dermabrasion is most often used to improve the look of facial skin left scarred by accidents or previous surgery, or to smooth out fine facial wrinkles, such as those around the mouth. It's also sometimes used to remove the pre-cancerous growths called keratoses. Dermaplaning is another form of dermabrasion and is commonly used to treat deep acne scars.

Both dermabrasion and microdermabrasion can be performed on small areas of skin or on the entire face. They can be used alone, or in conjunction with other procedures such as facelift, scar removal or revision, or chemical peel.

If you're considering a procedure to refinish the skin, this information will give you a basic understanding of the procedure - when it can help, how it's performed, and what results you can expect. It can't answer all of your questions, since a lot depends on your individual circumstances. Please ask Dr. Freedland if there is anything about the procedure you do not understand.

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Considering Alternative Procedures

If you're planning "surface repairs" on your face, you may also be considering chemical peel or laser resurfacing, alternative methods of surgically removing the top layer of skin. However, dermabrasion uses surgical instruments to remove the affected skin layers, while chemical peel and laser resurfacing use different methods to accomplish a similar effect.

Dr. Freedland performs all of these procedures, selecting one or a combination of procedures to suit the individual patient and the problem. Other surgeons prefer one technique for all surface repairs. In general, microdermabrasion and chemical peels are used more often to treat fine wrinkles, while dermabrasion and laser resurfacing are used for deeper imperfections such as acne scars. Dermabrasion may be preferred for individuals with slightly darker skin, especially when treating limited areas of the face, since dermabrasion is less likely to produce extreme changes and contrasts in skin color.

If you'd like more information on chemical peel, ask Dr. Freedland for the ASPS brochure on that topic.

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The Best Candidates For Dermabrasion

Dermabrasion and microdermabrasion can enhance your appearance and your self-confidence, but these treatments will not remove all scars and flaws or prevent aging. Before you decide to have a skin-refinishing treatment, think carefully about your expectations and discuss them with Dr. Freedland.

Men and women of all ages, from young people to older adults, can benefit from dermabrasion. Although older people heal more slowly, more important factors are your skin type, coloring, and medical history. For example, black skin, Asian skin, and other patients of color may become permanently discolored or blotchy after a skin-refinishing treatment. People who develop allergic rashes or other skin reactions, or who get frequent fever blisters or cold sores, may experience a flare-up. If you have freckles, they may disappear in the treated area.

In addition, most surgeons won't perform treatment during the active stages of acne because of a greater risk of infection. The same may be true if you've had radiation treatments, a bad skin burn, or a previous chemical peel.

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All Surgery Carries Some Uncertainty And Risk

Thousands of these procedures are performed successfully each year. When done by a qualified plastic surgeon, the results are generally quite positive. Nevertheless, there are always risks associated with surgery and specific complications associated with this procedure.

Post-operative complications such as infection and blood clots are rare, but can occur. Infection can be treated with drainage and antibiotics, but will prolong your hospital stay. You can minimize the risk of blood clots by moving around as soon after the surgery as possible.

Poor healing, which results in conspicuous scars, may necessitate a second operation. Smokers should be advised to stop, as smoking may increase the risk of complications and delay healing. Often there is temporary loss of sensation, which may last up to a year after surgery.

You can reduce your risk of complications by closely following Dr. Freedland's instructions before and after the surgery, especially with regard to when and how you should resume physical activity.

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Planning Your Treatment

Because inadequately trained practitioners have sometimes offered these treatments, it's especially important that you find a doctor (generally a plastic surgeon or a dermatologist) who is trained and experienced in the procedure. After all, dermabrasion usually involves the most visible part of your body - your face.

In your initial consultation, be open in discussing your expectations with Dr. Freedland, and don't hesitate to ask any questions or express any concerns you may have. Dr. Freedland will be equally open with you, explaining the factors that could influence the procedure and the results-such as your age, skin condition, and previous plastic surgeries.

Dr. Freedland will discuss your medical history, conduct a routine examination, and photograph your face. He will explain the procedure in detail, along with its risks and benefits, the recovery period, and the costs. Insurance usually does not cover cosmetic procedures, however, it may cover dermabrasion or microdermabrasion when performed to remove pre-cancerous skin growths or extensive scars. Check your policy or call your carrier to be sure.

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Getting The Answers You Need

Individuals considering dermabrasion or microdermabrasion often feel a bit overwhelmed by the number of options and techniques being promoted today. However, Dr. Freedland and his staff can help. In deciding which is the right treatment approach for you, they will consider effectiveness, safety, cost and appropriateness for your needs. This is called surgical judgment, a skill that is developed through surgical training and experience. Dr. Freedland also uses this judgment to prevent complications; to handle unexpected occurrences during surgery; and to treat complications when they occur.

Dr. Freedland's education and training, which he received at the University of Michigan, has helped to form his surgical judgment. Patients are encouraged to consider a doctor certified by the American Board of Plastic Surgery ("ABPS"). By choosing a plastic surgeon who is certified by the ABPS, a patient can be assured that the doctor has graduated from an accredited medical school and completed at least five years of additional residency - usually three years of general surgery (or its equivalent) and two years of plastic surgery. To be certified by the ABPS, a doctor must also practice surgery for two years and pass comprehensive written and oral exams.

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Preparing For Your Treatment

Dr. Freedland will give you specific instructions on how to prepare for surgery, including guidelines on eating and drinking, smoking, and taking or avoiding vitamins, iron tablets and certain medications. If you develop a cold or an infection of any kind, especially a skin infection, Dr. Freedland may have to postpone your surgery.

If you smoke, plan to quit at least two weeks before your surgery and not to resume for at least two weeks after your surgery. Avoid overexposure to the sun before surgery and do not go on a stringent diet, as both can inhibit your ability to heal. Though it is rarely necessary, Dr. Freedland may recommend that you have blood drawn ahead of time in case it is needed during surgery.

Whether your surgery is done on an outpatient or inpatient basis, you should arrange for someone to drive you home after your surgery, and to help you out for a day or two after you leave the hospital.

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Where Your Treatment Will Be Performed

Dermabrasion typically requires sedation. This treatment may be performed in a surgeon's office-based facility, an outpatient surgery center, or a hospital. It's usually done on an outpatient basis, for cost containment and convenience. Dr. Freedland feels a hospital provides the safest environment for your surgery and therefore performs almost all of his procedures at a JCAHO accredited hospital. However, if you're undergoing extensive work, you may be admitted to the hospital.

On the other hand, microdermabrasion is usually performed in an office because it is far less invasive and does not require any sedation.

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Types Of Anesthesia

Dermabrasion may be performed under local anesthesia, which numbs the area, combined with a sedative to make you drowsy. You'll be awake but relaxed, and will feel minimal discomfort. Sometimes a numbing spray, such a Freon, is used along with or instead of local anesthesia. Or, in more severe cases, Dr. Freedland may prefer to use general anesthesia, in which case you'll sleep through the procedure.

Microdermabrasion rarely requires any kind of anesthesia.

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The Treatment

Dermabrasion and microdermabrasion can be performed fairly quickly. The procedures usually take from a few minutes to an hour and a half, depending on how large an area of skin is involved. It's not uncommon for the procedure to be performed more than once, or in stages, especially when scarring is deep or a large area of skin is involved.

In dermabrasion, the surgeon scrapes away the outermost layer of skin with a rough wire brush, or a burr containing diamond particles, attached to a motorized handle. The scraping continues until the surgeon reaches the safest level that will make the scar or wrinkle less visible.

In dermaplaning, the surgeon uses a hand-held instrument called a dermatome. Resembling an electric razor, the dermatome has an oscillating blade that moves back and forth to evenly "skim" off the surface layers of skin that surround the craters or other facial defects. This skimming continues until the lowest point of the acne scar becomes more even with the surrounding skin.

In microdermabrasion, a precision hand piece is used to direct a stream of very fine crystals onto the face. Mile suction is applied to the skin to remove the crystals. This process can be directed only to those areas of the skin, which need treatment most. The gentle abrasive action of the crystals combines with the suction to remove the dead outer layer of your skin while bringing smoother, softer skin to the surface. It can be utilized on all colors of skin.

The surgeon may then treat the skin in a number of ways, including ointment, a wet or waxy dressing, dry treatment, or some combination of these. Dr. Freedland prefers Oxy-Mist. Oxy-Mist uses medical grade oxygen to deliver numerous amino acids, trace minerals, electrolytes and Vitamin E to the treated areas to hasten the recovery time.

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After Your Treatment

Right after dermabrasion, your skin will be quite red and swollen. Eating and talking may be difficult. You'll probably feel some tingling, burning, or aching; any pain you feel can be controlled with medications prescribed by Dr. Freedland. The swelling will begin to subside in a few days to a week.

If you remember the scrapes you got when you fell down as a child, you'll have an idea of what to expect from this type of surgery. A scab or crust will form over the treated area as it begins to heal. This will fall off as a new layer of tight, pink skin forms underneath. Your face may itch as new skin starts to grow, and Dr. Freedland may recommend an ointment to make you more comfortable. If ointment is applied immediately after surgery, little or no scab will form.

Dr. Freedland will give you detailed instructions to care for your skin after surgery. For men, this will include delaying shaving for a while, then using an electric razor at first. It's very important that you understand Dr. Freedland's instructions and follow them exactly, to ensure the best possible outcome.

If you notice the treated area beginning to get worse instead of better-for example, if it becomes increasingly red, raised, and itchy after it has started to heal-it may be a sign that abnormal scars are beginning to form, call Dr. Freedland as soon as possible, so that treatment may begin early.

Microdermabrasion has a more mild after treatment course. You may be red for just a few hours afterwards, or not at all. Often microdermabrasion is performed in conjunction with a chemical peel. In this case, the redness will last longer and is dependent on the strength of the chemical being used. Dr. Freedland can explain to you the different types of chemical peels as well as their respective recoveries.

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Getting Back To Normal

After dermabrasion, your new skin will be slightly swollen, sensitive, and bright pink for several weeks. During this time, you may gradually begin resuming your normal activities.

You can expect to be back at work in about two weeks. Dr. Freedland will probably advise you to avoid any activity that could cause a bump to your face for at least two weeks. More active sports-especially ball sports-should be avoided for four to six weeks. If you swim, stick to indoor pools to avoid sun and wind, and keep your face out of chlorinated water for at least four weeks. It will be at least three to four weeks before you can drink alcohol without experiencing a flush of redness.

After microdermabrasion, you will be able to go back to work almost immediately. Again, if a chemical peel is performed in conjunction with microdermabrasion, then you may have redness and peeling for up to two weeks.

Above all, it's important to protect your skin from the sun until the pigment has completely returned to your skin- as long as six to twelve months. Dr. Freedland will instruct you on skin care products that can help make your scars less visible.

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Your New Look

Refinishing treatments can offer dramatic improvements in the surface of your skin, but it will take some time before you see the final results.

The pinkness of your skin will take about three months to fade in the case of the deep dermabrasion. In the meantime, you'll probably want to wear non-allergenic makeup when you go out (for tips on hiding your condition while it heals, ask Dr. Freedland for the ASPS brochure on camouflage cosmetics). When your new skin is fully re-pigmented, the color should closely match the surrounding skin, making the procedure virtually undetectable.

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