Manual Dermasanding – The Delicate Touch in Facial Resurfacing

The idea of abrading skin to improve appearance is nothing new. Dermabrasion, a surgical skin planing technique using a high-speed rotary abrasive instrument, has enjoyed popularity for more than fifty years. More recently, however, manual dermasanding or gentle skin “buffing,” with or without the addition of a mild chemical peeling agent, has in many instances replaced the earlier rotary abrasive method for treating a wide variety of scars, wrinkles, and complexion and pigment problems. The sanding action improves contour irregularities when a new layer of skin replaces the abraded skin. The result is a smoother, fresher, and more lustrous appearance.

Manual buffing has proven especially useful for treating the delicate skin around the eyes, nose and lips, areas much more difficult to treat with conventional high-speed rotary dermabrasion. There is also no blood splatter, which is typical of the latter procedure, significantly reducing the concern about possible spread of HIV and hepatitis infections. Buf-peels should not be confused with microdermabrasion, which is a much more superficial form of skin sanding. Although far less expensive than laser resurfacing, and with a generally shorter recuperation time, buf-peels can offer a reasonable alternative and often yield results that can be equally gratifying.

Uses of Buf-Peels

When dermabrasion was first developed, it was used predominantly to improve acne scars, pock marks, and scars resulting from accidents or disease. Today, skin sanding methods are routinely used to treat tattoos, age (liver) spots, wrinkles, “frown” and “worry” lines, as well as certain other types of skin lesions.

As with other resurfacing techniques, conditions for which dermasanding would not be effective include the presence of congenital skin defects, certain types of moles or pigmented birthmarks, and scars from burns.

What’s Involved

Buffing is an office-based procedure. Medication to relax the patient may be given prior to surgery and supplemented with the use of topical or local anesthesia to numb the treatment sites. Then a sterilized abrasive material is used to gently buff or abrade the upper layers of the skin to improve the surface irregularities. In “buff-peeling,” the buffing is either preceded or followed by the application of a chemical peeling agent, usually a low concentration of trichloroacetic acid, to further enhance skin smoothing.

What To Expect Afterward

For a few days, the skin feels as though it has been overly sun-burned, and medications may be prescribed for discomfort, such as Lida Mantle cream or Lida Mantle HC cream. Healing usually occurs within seven days for buffed skin and seven to ten days for buf-peeled areas.

Newly formed skin, which is pink and slightly swollen at first, gradually develops a normal appearance. In the majority of cases, the pinkness fades by six to eight weeks. Regular make-up can be used as a cover-up as soon as the crusts are off. Most people can resume their normal work or social routines in seven to fourteen days. Individuals are instructed to avoid unnecessary direct and indirect sunlight for three to six months after the procedure and to use a sunscreen on a regular basis when outdooors.

Possible Complications

In certain skin types, there is a risk of developing a temporary or permanent color change in the skin. Taking birth control pills, pregnancy, or a family history of brownish discoloration on the face may increase the possibility of developing abnormal pigmentation.

Although low, there is a risk of scarring in certain areas of the face and particular individuals may be more prone to scarring. If scarring does occur, it can usually be treated with good results.

Limitations of Buffing and Buff-Peeling

Buffing and buff-peeling cannot significantly tighten loose or sagging skin and are not intended to replace face lift, brow lift, or eye lift procedures.

Buffing will not remove certain deep scars. Punch grafting, punch elevation, scar excision, dermaspacing or soft tissue fillers may be much more effective either alone or in combination with buff-peeling.

Finally, buffing and buff-peeling may not necessarily change pore size in all cases, nor can they predictably remove broken blood vessels on the face. However, they may improve the appearance of these conditions.