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Outcomes Assessment of Combination Face Lift and Perioral Phenol–Croton Oil Peel

Ozturk, Cemile Nurdan M.D.; Huettner, Franziska M.D., Ph.D.; Ozturk, Can M.D.; Bartz-Kurycki, Marisa A. B.S.; Zins, James E. M.D.

Plastic and Reconstructive Surgery: November 2013 - Volume 132 - Issue 5 - p 743e–753e
doi: 10.1097/PRS.0b013e3182a4c40e
Cosmetic: Outcomes Article

Background: Face-lift surgery when combined with perioral phenol–croton oil peel is an underappreciated tool for face rejuvenation. The procedure results in significant central face skin tightening and wrinkle reduction.

Methods: A retrospective review of 47 consecutive patients who underwent simultaneous face lift and perioral peel was performed. The objective measures used to evaluate the change in appearance of the patients included (1) a validated patient satisfaction questionnaire, (2) an evaluation of apparent age, and (3) an evaluation of perioral wrinkles by independent reviewers using a validated model. The assessment of apparent age was performed as follows: preoperative and postoperative photographs were shown randomly to six reviewers, who were asked to estimate the patient’s age. The apparent age was compared with the patient’s actual age, and the reduction in apparent age was calculated. Improvement in perioral rhytides was evaluated by using the Glogau classification system (range, 1 to 4).

Results: Survey results documented overall patient satisfaction, which was rated as 6.5 on a scale of 1 to 7 (with higher scores indicating greater satisfaction). Patients’ postoperative apparent age estimate was 8.2 years younger than their real age (p = 0.0002). The Glogau classification system score demonstrated a mean reduction of 1.15 (3.3 preoperatively as compared with 2.15 postoperatively, p < 0.0001).

Conclusion: Outcomes measurements, including patient satisfaction, objective evaluation of wrinkle improvement, and significant reduction in apparent age, document the power of this technique.


Cleveland, Ohio; and Buffalo, N.Y.

From the Department of Plastic Surgery, Cleveland Clinic; and the School of Medicine and Biomedical Sciences, University of Buffalo.

Received for publication April 10, 2013; accepted May 7, 2013.

Poster presentation at the Aesthetic Meeting 2013: Joint Meeting of the American Society for Aesthetic Plastic Surgery and the Aesthetic Surgery Education and Research Foundation, in New York, New York, April 11 through 16, 2013; and podium presentation at the Annual Meeting of the American Association of Plastic Surgeons, in New Orleans, Louisiana, April 20 through 23, 2013.

Disclosure: The authors have no financial interest to declare in relation to the content of this article. No external funding was received.

James E. Zins, M.D., Department of Plastic Surgery, Cleveland Clinic, 9500 Euclid Avenue, Desk A60, Cleveland, Ohio 44195,

©2013American Society of Plastic Surgeons