Dermabrasion for Free Flap Aesthetic Enhancement

Inclusion criteria

• Adults aged 18 years or older.
• History of successful free flap reconstruction with a cutaneous skin paddle in the head and neck region.
• Patients with benign (eg. osteoradionecrosis, trauma) or malignant (eg. squamous cell carcinoma) diagnoses requiring free flap reconstruction.
• Benign free flap patients must be a minimum 3 months post-operative to ensure flap maturity. Malignant free flap patients must be a minimum of 3 months post-operative or post-radiation with no further cancer treatment (eg. radiation, surgery, chemotherapy) planned at that time.
• Flap skin paddle must be of sufficient size and external to allow for split-treatment design (minimum 4 cm in diameter). Donor site scar must also be sufficient size (minimum 6 cm in length)
• Patients must have ability to provide informed consent.
• Willingness and ability to comply with the treatment and follow-up schedule.

Exclusion criteria

• Inability to give informed consent.
• Evidence of active flap or radiation skin complications (e.g., infection, partial necrosis, wound breakdown).
• Completion of head and neck radiation therapy within 3 months of first dermabrasion treatment date.
• Uncontrolled diabetes mellitus (HbA1c > 8.0%).
• Current antibiotic use or known immunocompromised state.
• History of keloid formation or hypertrophic scarring.
• Fitzpatrick skin type VI or higher (due to increased risk of pigmentary changes).
• Use of isotretinoin medication within the past 3 month (known to induce photosensitivity).
• Current use of blood thinners that cannot be safely paused.
• Known photosensitivity disorders.
• Active malignancy requiring ongoing treatment.
• Inability or unwillingness to avoid sun exposure during the treatment period.
• Inability to perform or adhere to prescribed wound care.
• Inability or unwillingness to attend follow-up visits.