Adjunct Perioral Phenol-Croton Oil Peel Shortens Philtrum Length in Patients Undergoing Primary Facelift.

[BACKGROUND] Plastic surgeons have a variety of treatment options for perioral rejuvenation, including chemical peels, energy-based skin-tightening devices, microneedling, microcoring, fat grafting, fillers, neuromodulators, and surgical lip lifts.

[OBJECTIVES] The aim of the current study was to determine the effect of perioral phenol-croton oil peeling on philtrum length in patients undergoing primary facelift.

[METHODS] A retrospective cohort study was performed on Caucasian females undergoing primary facelift with perioral heavy formula phenol-croton oil peels (33% phenol, 1.1% croton oil). Propensity matching was performed with BMI and age for comparison to control patients undergoing facelift without adjunct peel. Mirror Medical Imaging Software was used to estimate pre- and postoperative philtrum length for each patient from the nadir of the cupid's bow to the subnasale. Mann-Whitney and independent t-tests were used to compare the percentage change in philtrum height amongst and between cohorts.

[RESULTS] The study cohort consisted of 100 female primary facelift patients (50 with perioral peel, 50 without perioral peel). The patients had a mean age of 67.0 years and a mean BMI of 24.6 kg/m2, and the mean [standard deviation] follow-up for first appointment at least 3 months postoperatively was 6.4 [3.3] months (range, 3.0-16.1 months). Peel patients had significantly shorter philtrum lengths postoperatively, with a mean shortening of 9.3% [4.6%] (P < .001). Control patients had no difference in philtrum length postoperatively (P > .05).

[CONCLUSIONS] Phenol-croton oil peeling is a powerful tool for tightening skin and softening rhytides in the perioral region. This study demonstrated an additional, previously unreported benefit of average philtrum length shortening of nearly 10%. These findings are gratifying because philtrum lengthening is a classic finding in the aging face.