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Periorbital Phenol-Croton Oil Chemical Peel in Conjunction with Blepharoplasty: An Evolving Technique for Periorbital Facial Rejuvenation
Joshua Waltzman MD MBA, Susan Orra BA, Karolina Mlynek MD MBA, Eliana Duraes, MD, Neil Kundu MD, James E. Zins MD
Cleveland Clinic Lerner College of Medicine of Case Western Reserve University
2015-03-13
Presenter: Joshua Waltzman
Affidavit:
This abstract has not been previously published in any scientific journal or previously presented at a major meeting. The work on this project represents the original work of all authors.
Director Name: Steven Bernard, MD
Author Category: Medical Student
Presentation Category: Clinical
Abstract Category: Aesthetics
Introduction: There is little literature describing the effectiveness of phenol-croton oil peels (PCOP) at rejuvenating the periorbita in conjunction with blepharoplasty. We present a series of patients who underwent PCOP alone, or combined with blepharoplasty, for periorbital rejuvenation. The authors describe their surgical method and complications of this technique.
Methods: Retrospective chart review identified patients who underwent PCOP performed by a single surgeon (J.E.Z) from 2003-2014. Treatment sequences included: 1) peel alone to treat hyperpigmentation, 2) peel alone to treat fine lines, 3) peel at time of transconjunctival or pinch blepharoplasty, or 4) peel secondarily after cutaneous blepharoplasty. Standard concentrations of 27.5% phenol and 0.105% croton oil were used. Patient age, blepharoplasty type, and complications were obtained.
Results: We identified 82 patients (81 females, 1 male) who underwent blepharoplasty and PCOP, or PCOP alone. Average age was 58.66 ± 8.05 years. Indications for PCOP were hyperpigmentation (n=26) and/or fine rhytids (n=63). Twenty-five (30.4%) of these patients underwent PCOP combined with blepharoplasty. Blepharoplasty included: upper lid blepharoplasty (n=20), lower lid pinch blepharoplasty (n=8), and/or transconjunctival lower lid blepharoplasty (n=6). Complications of peeling included: residual hyperpigmentation (n=4), prolonged erythema (n=4), and telangectasias (n=2). Twelve patients (14.6%) underwent a second peel for residual rhytids.
Conclusion: Judicious use of PCOP in the periorbita can be successfully performed with minimal to no complications. It can be applied alone, or as a complement to blepharoplasty. When these techniques are combined there is significant improvement in upper and lower lid laxity, hyperpigmentation, and reduction of fine rhytids.
