Chemical Peels in Plastic Surgery Workup

Author: Gregory Caputy, MD, PhD, FICS; Chief Editor: Jorge I de la Torre, MD, FACS more...

Updated: Mar 1, 2012

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Laboratory Studies
Other Tests
Histologic Findings
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Laboratory Studies

Workup is dictated by the patient's underlying health status and the type of sedation considered necessary for the procedure.

Other Tests

If an extensive area is to be peeled with phenol, perform a preoperative ECG and intraoperative monitoring.

Histologic Findings

With deep chemical peels, a grenz zone of essentially scar tissue is found within the deep layer of the skin, with superficial healthy new skin laid down following the procedure.

Proceed to Treatment & Management

Contributor Information and Disclosures

Author

Gregory Caputy, MD, PhD, FICS Chief Surgeon, Aesthetica Plastic and Laser Surgery Center, Inc

Gregory Caputy, MD, PhD, FICS is a member of the following medical societies: American Society for Laser Medicine and Surgery, Canadian Medical Association, International College of Surgeons, International College of Surgeons US Section, Pan-Pacific Surgical Association, and Wound Healing Society

Disclosure: Syneron Corporation Salary Speaking and teaching

Specialty Editor Board

Tolbert Wilkinson, MD Consulting Staff, Department of Surgery, Southwest Texas Methodist Hospital

Tolbert Wilkinson, MD is a member of the following medical societies: American College of Surgeons, American Society for Aesthetic Plastic Surgery, Phi Beta Kappa, and Texas Medical Association

Disclosure: Nothing to disclose.

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

Wayne Karl Stadelmann, MD Stadelmann Plastic Surgery, PC

Wayne Karl Stadelmann, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Surgeons, American Society of Plastic Surgeons, New Hampshire Medical Society, Northeastern Society of Plastic Surgeons, and Phi Beta Kappa

Disclosure: Nothing to disclose.

Nicolas (Nick) G Slenkovich, MD Director, Colorado Plastic Surgery Center

Nicolas (Nick) G Slenkovich, MD is a member of the following medical societies: American Academy of Otolaryngology-Head and Neck Surgery, American College of Surgeons, American Medical Association, American Society of Aesthetic Plastic Surgery, American Society of Plastic Surgeons, and Colorado Medical Society

Disclosure: Nothing to disclose.

Chief Editor

Jorge I de la Torre, MD, FACS Professor of Surgery and Physical Medicine and Rehabilitation, Chief, Division of Plastic Surgery, Residency Program Director, University of Alabama at Birmingham School of Medicine; Director, Center for Advanced Surgical Aesthetics

Jorge I de la Torre, MD, FACS is a member of the following medical societies: American Association of Plastic Surgeons, American Burn Association, American College of Surgeons, American Medical Association, American Society for Laser Medicine and Surgery, American Society for Reconstructive Microsurgery, American Society of Maxillofacial Surgeons, American Society of Plastic Surgeons, Association for Academic Surgery, and Medical Association of the State of Alabama

Disclosure: Nothing to disclose.

References

Litton C. Chemical face lifting. Plast Reconstr Surg Transplant Bull. Apr 1962;29:371-80. [Medline].
Baker TJ. The ablation of rhitides by chemical means. A preliminary report. J Fla Med Assoc. Nov 1961;48:451-4. [Medline].
Baker TJ. Chemical face peeling and rhytidectomy. A combined approach for facial rejuvenation. Plast Reconstr Surg Transplant Bull. Feb 1962;29:199-207. [Medline].
Hetter GP. An examination of the phenol-croton oil peel: Part I. Dissecting the formula. Plast Reconstr Surg. Jan 2000;105(1):227-39; discussion 249-51. [Medline].
Hetter GP. An examination of the phenol-croton oil peel: Part II. The lay peelers and their croton oil formulas. Plast Reconstr Surg. Jan 2000;105(1):240-8; discussion 249-51. [Medline].
Hetter GP. An examination of the phenol-croton oil peel: Part III. The plastic surgeons' role. Plast Reconstr Surg. Feb 2000;105(2):752-63. [Medline].
Alexiasdes-Armenakas, Macrene. Fractional Laser Resurfacing. J Drugs Dermatol. July/2007.
Brown AM, Gordon HL, Brown ME. Phenol-induced histological skin changes: hazards, technique, and uses. Br J Plast Surg. Jul 1960;13:158-69. [Medline].

Preoperative view of patient with severe panfacial acne scarring, multiple seborrheic keratoses, nevi, and panfacial actinic skin damage.

Postoperative view (6 mo) after full-face carbon dioxide laser resurfacing with up to 8 passes used in some areas.

View of the infraorbital area of an African American patient. Although a mid face lift was offered to correct the deep nasojugal groove, this was declined, and the patient wanted mere removal of bags and a less tired appearance.

Additional view of the infraorbital area of patient in Image 3. This African American patient wanted mere removal of bags and a less tired appearance, although a mid face lift was offered to correct the deep nasojugal groove.

Additional view of the infraorbital area of patient in Images 3-4. This African American patient wanted mere removal of bags and a less tired appearance, although a mid face lift was offered to correct the deep nasojugal groove.

Postoperative view (3 mo) after transconjunctival lower eyelid blepharoplasties and carbon dioxide laser resurfacing of the lower eyelids. Note the slight redness that remains, but essentially no change in pigmentation has occurred.

Additional postoperative view (3 mo) of patient in Image 6 after transconjunctival lower eyelid blepharoplasties and carbon dioxide laser resurfacing of the lower eyelids. Note the slight redness that remains, but essentially no change in pigmentation has occurred.

Additional postoperative view (3 mo) of patient in Images 6-7 after transconjunctival lower eyelid blepharoplasties and carbon dioxide laser resurfacing of the lower eyelids. Note the slight redness that remains, but essentially no change in pigmentation has occurred.

Patient in Images 6-8 2 years postoperatively after transconjunctival lower eyelid blepharoplasties and carbon dioxide laser resurfacing of the lower eyelids.

Additional view of patient in Images 6-9, 2 years postoperatively after transconjunctival lower eyelid blepharoplasties and carbon dioxide laser resurfacing of the lower eyelids.

Patient's neck area after preparation with 20% methanol.

Patient 2 minutes after application of 40% trichloroacetic acid (TCA) solution.

Patient 8 minutes after application of additional trichloroacetic acid (TCA) to even the peeled surface.

Patient following completion of the chemical peel at 10 minutes and after neutralization with water.

Patient after completion of the chemical peel and a single pass with a carbon dioxide laser on the face. This patient had a 35% trichloroacetic acid (TCA) peel performed on the face 2 months previously but desired a deeper peel.

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