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MANUAL DERMABRASION

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SUMMARY

  • Dermabrasion resurfaces skin, improving texture and contour irregularity.

  • Manual dermabrasion is performed using sandpaper, drywall sanding screen, or a cautery scratch pad, and is a useful technique for treating smaller areas.

  • Electrobrasion may provide similar outcomes to manual dermabrasion for discrete areas, possibly with less risk of milia formation.

image Beginner Tips

  • Manual dermabrasion requires only minimal instrumentation, while electrobrasion utilizes electrosurgical devices generally found in any dermatologic surgeon’s office.

  • Regardless of technique, dermabrasion should be continued to the depth of the papillary-reticular dermis interface.

image Expert Tips

  • Traditional mechanical dermabrasion is useful for treating larger areas.

  • Manual dermabrasion or electrobrasion should be performed 6 to 8 weeks postoperatively for scar revision.

image Don’t Forget!

  • Personal protective devices are of vital importance, particularly when performing traditional dermabrasion, as a significant amount of blood and body fluids may become aerosolized.

  • Continuing dermabrasion to a level deeper than the papillary-reticular dermis interface increases the risk of scarring.

image Pitfalls and Cautions

  • Dermabrasion is relatively contraindicated for patients currently using isotretinoin or those that have used isotretinoin within 6 to 12 months.

  • Infection postprocedure may lead to significant scarring; preoperative history taking and diligent postoperative monitoring or education are very important.

image Patient Education Points

  • Patients should be highly motivated to care for their wounds in the postoperative period.

  • It is important to educate patients regarding the immediate postoperative appearance of a dermabraded area and regarding the importance of diligent wound care and sun protection.

image Billing Pearls

  • Dermabrasion should be coded with the 15780 series codes, and dermabrasion for purely cosmetic reasons is generally not covered by insurance.

  • Since postoperative dermabrasion is usually performed 6 to 8 weeks postsurgery, it cannot be billed for in the case of flaps and grafts as they have 90-day global periods.

INTRODUCTION

Dermabrasion is a technique designed to resurface skin by improving texture and contour irregularity. Traditional dermabrasion involves the use of a handheld motor-driven rotary device, mounted with a diamond fraise, wire brush, or serrated wheel.1 A topical refrigerant may be used for anesthesia and to make the skin surface rigid for mechanical abrasion.2 Typically, the level of abrasion is to the level of the papillary or superficial reticular dermis.3 Dermabrasion has been used to treat a wide variety of skin conditions, ranging from spot treatment of postoperative scars to full facial rejuvenation.4 Manual dermabrasion is performed using sandpaper, drywall sanding screen, or a cautery scratch pad, and is a useful technique for treating smaller areas.5 Different grades of sandpaper can be used to achieve multiple depths of ablation.6 Electrobrasion utilizes an electrosurgical device to ablate the skin with the added advantage of hemostasis intraoperatively, and is most suited for treatment of a focused skin area.7 In electrobrasion, machine power settings and distance ...

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