Dr. Dirk Lazarus

Plastic, Reconstructive & Cosmetic Surgeon

MBChB (UCT), FCS (SA) Plast & Recon Surg

The top 3 before and after pictures are not of my own patients. They demonstrate the results obtainable with Dermapen.

The bottom picture is my patient. Before and 4 months after Botox and treatment with medical needling.

Skin Resurfacing

Skin resurfacing is a minor procedure to improve the appearance of fine wrinkles. The principle behind all resurfacing is to damage the deeper layer of the skin, the dermis, which then heals with new, refreshed and more orderly arranged collagen fibres. This new dermis has a rejuvenated and smoother appearance. Resurfacing is sometimes an option for fine crepe lines which typically occur around the mouth and eyes and elsewhere on the face.

Traditional resurfacing techniques – dermabrasion, chemical peel and laser – remove the outer layer of skin and have a longer recovery time. Lasers can be associated with prolonged redness and even burns. Modern resurfacing techniques use various techniques to make multiple small puncture holes in the skin to cause the dermal damage. This can be done with Fraxel laser or with some form of skin needling, either with a roller or with a Dermapen.

The Dermapen is a device like a medical tattoo gun. It has multiple needles (12) which are very fine and which penetrate the skin to a depth of 0.5-2 mm depending on the setting. The needles vibrate up and down causing multiple penetrations every second. The procedure is performed after the application of topical anaesthetic to the face. This makes the face numb enough so that the needle penetrations are not painful. Currently I have a nurse in my practice who performs these Dermapen treatments. The process is a walk in walk out procedure and takes about 90 minutes with the application of the cream and leaving it time to work. Redness lasts a few days and is usually not severe. Some swelling and bruising can occur. Usually 3 treatments are recommended about 6 weeks apart, but the regimen can be varied according to patient needs.

Sometimes, with facelift, I will do a peri-oral chemical peel (around the mouth). The Dermapen is unsuitable as I make ink marks on the face for the surgery and I don’t want to cause the ink to penetrate the skin. I use dilute trichloracetic acid (TCA) which I paint on until the skin frosts (turns white). With healing the skin will go red and peel similar to a sunburn after which you will be left with a smoother, better quality skin.


This email comes late as I have purposed to do this since the beginning of the year. I came to you in January 2009 to have reconstructive surgery for a scar on my face. For many people it did not seem a big deal but somehow, I had failed to accept as I could not even look at my face because of it.

You did an excellent job. With the limitations you explained to me, the scar has now healed with a year of plaster/ tape. I still see where the scar originally was but it is now almost unnoticeable that I hardly take notice of it.

I now go about confidently, never hiding my face with my hand as I used to do in the past.

Also, you were so gracious to let me use the coach house at only a fraction of the price. You will never know how truly grateful I am. I will always have fond memories of Cape Town.

Thank you so much. Please extend my thanks to your team also.

God bless you,