LAM FACIAL PLASTICS

Hi Dr. Lam,

First of all, this is a fantastic resource, and I have benefited greatly from your expertise and willingness to educate the masses. Here is my question: Is a TCA peel (with either Jessner's solution or Glycolic acid applied immediately beforehand for more even penetration) safe for under-eye skin? And will this peel effect a noticeable reduction of under-eye fine lines?

I have considerable sun damage that has manifested in the form of lax skin and cross-hatch fine lines under my eyes, so I am looking for resurfacing results. I have heard too many horror stories of laser to feel comfortable with that modality. I recognize TCA comes in many strengths and should be tailored to each case, but I wonder it is particularly risky for the lower eyelids, as I have read of some people complaining that it actually exacerbated their under-eye wrinkles.

My second question is, do you know of any dermatologists/plastic surgeons in the LA or SoCal area who can perform this peel with skill? I know there are many risks including scarring, so I want to make sure I find a doc who is astute with peeling. Many docs now eschew peels in favor of lasers, but I am just not willing to take that bet. I thank you so much for your time and generosity.

hi,
yes, TCA peel under the eyes is safe in the right hands. i can't recommend someone for you but i used to do it myself (now i use plasma) but TCA is safe in someone experienced. i used to use Jessner's prep plus 35% TCA. if you go lower than that it probably won't do much and if you go higher, you risk scarring. finally, you still need Botox and good skin care products along with avoiding the sun and good diet to minimize those fine lines.
s.