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Diminishing Facial Scars

Scars on the face are hard to cover and hide. Using a “sanding” mechanism such as dermabrasion these scars can be smoothed, explains Sydney plastic surgeon DR DARRYL HODGKINSON.

Skin resurfacing is used by plastic surgeons and dermatologists to repair visible skin damage, including facial scarring. There are 3 types of resurfacing procedures available:

  • Skin Peeling with various acids (i.e. Trichloroacetic acid or Phenol)
  • Laser Resurfacing with Carbon Dioxide or the Erbium Laser
  • Dermabrasion or Skin Sanding

Dermabrasion or skin sanding is particularly useful for facial scarring secondary to trauma or surgery, but most commonly for acne scarring or the scarring that is left after the treatment of acne. This treatment is used for teenage and adult acne.

Before and after breast Dermabrasion by 
Dr Hodgkinson for acne scarring

Dermabrasion in the 1990s utilises a high speed, air-driven, rotating diamond burr of which there are many different sizes and shapes to get into various nooks and crannies of the face. There is a variation in the depth of diamond chips in the burrs, just as there are different grades of sandpaper.

The skin surface (epidermis) is first removed, and then the other layers of skin under the epidermis can be removed if required.

It is within the deeper skin layers that scars often lie. The smooth skin heals from beneath (called re-epithelialisation) and the dermis regenerates new collagen.

Extreme care needs to be taken by the surgeon, and extensive experience is necessary to avoid dermabrading too deeply, exacerbating scarring or not deeply enough, which would not produce an effective result. Dermabrasion has re-emerged as a very reliable technique for eradicating deep wrinkles around the mouth (often called smoker’s lines).