Aesthetic Surgery

Aesthetic Surgery - Periorbital Phenol-Croton Oil Chemical Peel in Conjunction With Blepharoplasty: An Evolving Technique for Periorbital Facial Rejuvenation

A retrospective chart review identified 82 patients who underwent phenol-croton oil peel (PCOP) performed by a single surgeon at Cleveland Clinic from 2003–2014. The purpose of this study was to examine institutional experience with patients who were treated with PCOP alone or PCOP combined with blepharoplasty for periorbital rejuvenation.

Treatment sequences included:

· peel alone to treat hyperpigmentation

· peel alone to treat fine lines

· peel at time of transconjunctival or pinch blepharoplasty

· peel secondarily after cutaneous blepharoplasty

Standard concentrations of 27.5% phenol and 0.105% croton oil were used, as described by Hetter.¹ Patient age, blepharoplasty type, and complications were obtained.

Eighty-one females and 1 male underwent blepharoplasty and PCOP or PCOP alone. Average age was 58.66 ± 8.05 years. Ten patients (12.2%) underwent a second peel for residual rhytids.

Judicious use of PCOP in the periorbita can be successfully performed with minimal to no complications, whether applied alone, or as a complement to blepharoplasty. The combined technique allows for substantial improvement in upper and lower lid laxity, hyperpigmentation, and reduction of fine rhytids.

A 51-year-old female before surgery
Two weeks after bilateral upper lid blepharoplasty, lower lid pinch blepharoplasty, and phenol-croton oil peel of the lower lids. There is improvement in both fine lines and hyperpigmentation.
Details of Chemical Peels and Procedures Performed (N = 82)

2003 - 2014

  1. Hetter GP. An examination of the phenol-croton oil peel: part IV. Face peel results with different concentrations of phenol and croton oil. Plast Reconstr Surg. 2000 Mar;105(3):1061-1083.