Plastic Surgery/Care after dermabrasion
Three days ago, I had dermabrasion to remove minor lines above my lips and a scar there that looked like a deep line. I got more than I'd bargained on; the chin and the area all around my mouth were also dermabraded (perhaps this is standard?). Anyway, I really expected the plastic surgeon to send me home with a handout detailing what I should and shouldn't do in aftercare. I didn't get that, and I've already called twice with questions, so I really don't want to call again. I understood the doctor as saying that I needed to continue putting gauze over the Polysporin dressing the area and change it a couple times a day. But even though I used ample Polysporin, it still hurt when I removed the gauze, so I called to ask if I could use a bandage of plastic or some other material that isn't permeable. What I was told in the phone call with the nurse is that I was supposed to keep the gauze on only that day, and that she had told me to leave it open to the air, but covered with Polysporin, after that. That's not true, and my driver, who was there during the conversation at the office, verifies that. And I see that some Internet sites strongly suggest keeping dermabraded areas bandaged as the wet environment supposedly speeds the healing process. Anyway, I'm now wondering if I should in any way encourage the peeling process (the gauze over the dried areas encouraged it a bit too much for my comfort, but I'm wondering if I should do anything gentler). Or just leave all hands and washcloths off and stick to the regimen of standing under a body-temperature shower and soaking my face a couple times a day? Anything you can say about aftercare or lifestyle would help. I've checked various Internet sites, but much of the advice seems contradictory.
Other information: No meds prescribed other than a painkiller, which I haven't needed today. Doctor favors Polysporin, which I understand to be a good call. No followup visit for a week. I just want to do everything right until then. And by the way, I knew next to nothing about dermabrasion when I went to the plastic surgeon. I went in thinking that I wanted fillers, but he said they wouldn't be sufficient and would be very temporary anyway. I'm not unhappy with this doctor, but for $1,500, it really seems I should have gotten a piece of paper with clear instructions on it.
I'm obviously sorry for any problems you're having. I've listed below my GENERAL recommendations for the aftercare for a dermabrasion. However, it is extremely important that you receive ongoing care from a provider who can see and monitor you in person. It would typically be the PS who performed the procedure on you, or one of his or her assistants or associates, but it can be anyone and if for any reason you are not receiving, or do not think you are receiving, appropriate care from one doctor then you need to find another one who can help you. While dermabrasion is, conceptually, a simple procedure (the skin is scraped mechanically and when it heals the superficial layers are typically smoother than they were before), controlling the depth of the procedure is of paramount importance. The first part of that is the surgery itself, but if the wound become infected or the level of the scraping deepens, further complications can ensue, including a prolonged recovery, continued infection, and/or scarring. For that reason, this type of procedure requires particularly close monitoring.
There are different ways of treating the dermabraded skin. Occlusive dressings would be one approach but another is to leave the areas open but keep them moist with a plain ointment, such as Aquaphor or even Vaseline. I would not normally advise the continued use of Polysporin (or Neospoin) as contact dermatitis can result from that. A non-adherent dressing, such as Xeroform or Telfa, can be used initially, but the daily application and removal of these is not normally recommended (I can't say that 100%). After the first day or so, daily showers with reapplication of an ointment should be adequate.
While dermabrasion is an extremely effective treatment and is of historical significance, it has become less popular recently due to its relatively messy post-operative care regimen, the mechanical nature of the treatment itself, and its supposed replacement with chemical peels and laser treatments. Despite all of those, dermabrasion is a time-tested and effective treatment modality. It does, however, require an active post-operative regimen and care, and I'm concerned that you may not be getting that.
You should speak with your PS, make sure things are proceeding well and to your understanding, regardless of what it takes to accomplish that and, in the absence of satisfaction in that regards, see another plastic surgeon near you.
I hope that this helps and good luck,