Perioral Dermabrasion

Perioral Dermabrasion is a type of cosmetic procedure used to smooth out deep wrinkles around the upper lip and the chin area. It is one of the oldest techniques in facial rejuvenation but it still gives effective results. During this procedure, a handheld rotary device with a very coarse tip diamond fraise is used to sand off deep wrinkles and smooth the skin. Because of this, the procedure is often referred to as dermaplaning of the top layers of the skin.

CANDIDACY

The potential candidate for this procedure is generally someone who is much older and has very prominent lines around the upper lip area and just between the chin and lower lip. Generally, these intense wrinkles have been accumulating for many years due to smoking and are normally very profound. Furthermore, the ideal patient for this procedure is someone who wants an aggressive treatment for this specific area and is willing to sustain a lengthy downtime. It is also important to understand that perioral dermabrasion is recommended for Caucasians and other people with fair skin tones. It is not suggested for people with darker skin due to the fact that skin pigmentation and scarring will leave a darker skinned person with a much lighter skin color in the treated areas.

HOW IT WORKS

The stainless steel wheel on the rotary tool has tiny chips of diamonds bonded to it. The diamond chips are a mixture of coarseness and roughness. As the high speed wheel spins around, the tiny diamond chips shave off the top layer of skin called the epidermis. The powerful rotation sands off the skin all the way down to the top layer of the dermis. The name of this procedure is derived from the word "oral" meaning mouth with "perioral" meaning the specific area around the moustache. "Derma" comes from the word dermabrasion which means the dermis layer of skin. This procedure is similar to sanding down a rough piece of wood to make it smoother.

COMPARISONS

Microdermabrasion is different from perioral dermabrasion because it is a much less invasive procedure which very gently resurfaces the most superficial layers of skin.  The purpose of Microdermabrasion is to create an even, controlled shedding of top layers of damaged skin cells so you are left with a new fresh layer of skin with a more even texture and color. Cosmetic physicians may recommend microdermabrasion to patients with finer wrinkles or age spots.  Microdermabrasion is not designed for deep wrinkles in the perio-oral region.   Other treatments include lasers laser and micro-needling procedures.  Most of these procedures are done with machines which limit the depth and energy used. These machines have standard settings to give a uniform result each time. There are no set setting or standards for perioral dermabrasion procedures.  The doctors controls the depth of the treatment by the pressure of his or her hand.   Chemical peels have standard formulas where the chemicals are applied and they generate a chemical reaction that peels a specific depth of skin and allows for new smoother skin to grow.  

LIMITATIONS

Perioral dermabrasion can be so aggressive that it is not recommended for other areas of the face which are too delicate for this procedure. However, laser procedures can be done on most areas of the face. However, perioral dermabrasion can be used in conjunction with a face lift if the patient is already under anesthesia. A patient must be sure that the physician is trained and experienced with this type of procedure.

RISKS

Perioral dermabrasion is an older technique that is operator dependent which means that the pressure a physician uses determines how aggressive the treatment becomes. It can be difficult for a physician to control the depth at which the device sands away the layers of skin. The associated risks for perioral dermabrasion can be sanding the skin layers too deep and leaving the skin extremely raw which could create deep and discolored scarring. Furthermore, discoloration of the treated area could result in a patient needing make-up for the rest of their life. In fact, some people have such discoloration they actually look like they have a white mustache area.

RECOVERY

The recovery process is fairly extensive for this procedure and it starts with seven to ten days of painful, raw skin around the lip area. Ointments and non-adhesive dressings will be administered during that time. Make-up will not be tolerated until after the skin begins to heal at about a week or two. Therefore, many patients prefer to sit at home and recover during that time. The area will appear pink or reddish for a period of six to twelve weeks. Sometimes, the skin can become extremely red with inflammation which can lead to hyperpigmentation. Often, doctors will use bleaching creams to tone down the darkness.     

RESULTS

Although there will be some discoloration in the treated area, the skin will be much smoother. Perioral dermabrasion is a powerful procedure which should last a lifetime given that most patients with these prominent lines are already of an older generation. Therefore, it is basically a permanent procedure.

FINAL THOUGHTS 

Although there is not a large number of doctors who specialize in this type of procedure, perioral dermabrasion may be the most aggressive and effective procedure for a middle age Caucasian who specifically wants to treat deep lines around the lip area and has plenty of downtime to spare. Patients should do proper Internet research to find a doctor in their area that specializes in perioral dermabrasion. An experienced doctor can determine if a patient is an ideal candidate for the procedure.

Written by Cosmetic Town Editorial Team - SP

Based on an exclusive interview with Dan Yamini, MD in West Hollywood, CA