The #1 chemical peel for aging eyes [Colleen Phillips, PA-C - Portland, Oregon]

Eva Sheie (00:00):
You're listening to Where Before Meets After. What is the Luxe Peel and who is it for?

Colleen Phillips (00:06):
The Luxe Peel is a phenol and croton oil based aggressive skin peel for the face. You can do the whole face for sun damage, fine lines, etched lines, precancerous lesions, if you have actinic keratosis have had basal cell before, this is a treatment for precancerous skin conditions, along with the cosmetic results. But it is a deep exfoliation into the reticular dermis where you are recruiting stem cells from the hair follicles to regenerate the skin. One of the best things about this peel is the no see, no touch treatment for the first week. You think of CO2 laser resurfacing where you are shedding the skin and you're doing vinegar soaks five times a day and watching this skin come off your face and worrying about these little open areas and things. The Luxe Peel, after the peel, we are applying a bismuth mask that protects your skin for a whole week, and all you have to do is keep this dry and your skin is healing under it.

(01:23):
So by the time that comes off at one week, you are through all the difficult part for the patient of watching this all happen. So that is just incredible about this peel. So when we're doing just the eyelids, just peel the eyelids and put the yellow bismuth on then and you come back in a week, we take that off and you see the skin is all regenerated already, so you don't have to go through all that slough period. But it is an aggressive peel that gets down to the reticular dermis and truly regenerates your skin. And we are seeing etched lines go away in a way that nothing else has been able to touch these lines. You'd have to do a fully ablative CO2 laser resurfacing, which is eight months of red face. We used to do it. Nobody can tolerate the downtime anymore, but this peel, I mean with the full face, it is a good three weeks of downtime, but the results are incredible. It is for fine lines and wrinkles, sun damage, discoloration, acne scars, precancerous lesions, so many indications for it, the outcomes of the smoother, brighter skin, the texture as the results are incredible.

Eva Sheie (02:42):
Why did you decide to do it and what results were you expecting from it?

Colleen Phillips (02:47):
I decided to do it because I felt my eyes were aging me and I honestly feel like the eyes are what ages most people first. And when we talk to people, we look at the eyes first, the crepey aging skin around the eyes from sun damage and just environmental things, this peel will just correct. And peeled skin doesn't really know how to age anymore, so the results are incredibly long lasting. I hate that term one and done, but if there's anything that we do that's one and done, this thing is incredible. It's a non-operative operated look of the eyes where you can really improve the redundancy of the upper skin and just the texture, the smoothness. It's not Barbie doll smooth where you're looking saying what in the world, the eyes are not in harmony to the rest of the face. You will get some texture back and things, but the improvement in the aging part of the skin is phenomenal.

Eva Sheie (03:52):
What's the difference between having your whole face done and just having your eyes done?

Colleen Phillips (03:57):
Well, that is an important thing to look at you in the face, it is all about harmony. We all know that person who put everything into their top part of their face and nothing to the bottom. The disharmony is not a goal. So if you have very sun damaged skin on your whole face, very much the same as your eyes, you are probably not going to do yourself any favor by doing just your eyes. And that's something that between me and Dr. O'Brien and Dr. Hayes, we would hopefully steer you in the right direction. But it is all about harmony. So typically if you're doing just the eyelid peel, you are feeling like your eyes are aging a little more than the rest of your face, which it is thinner, thinner skin. So the fine lines become more apparent there than on your cheeks and forehead and such.

Eva Sheie (04:56):
What is the treatment actually like?

Colleen Phillips (04:58):
Day of the peel, if you don't have an already clean face, we will wash your face, take a full round of pictures, go into the procedure room, get the pronox, the nitrous oxide all set up. First you start with a little acetone to the eyelids and then the phenol application. The phenol makes the nerve endings all numb. It numbs the nerve endings, so as you apply it, you can almost count 11 seconds and the stinging will be gone. It's a very mild burning, but you feel it. 11 seconds, it's gone. We go to the lower eyelid, 11 seconds, upper, lower, and then we go to the croton oil, apply the croton oil very gently. It's very, we use different strengths for in different areas. Very well tolerated, occasionally needing to breathe on with the nitrous for a minute. When we finish, we put the bismuth on. It feels very good. It feels nice and cooling when you put it on. Nitrous oxide is out of your system in about six minutes and we chat for a minute and you're off to your next.

Eva Sheie (06:09):
And what color is your face at this point?

Colleen Phillips (06:11):
Your eyelids are then very yellow. The bismuth is a yellow color. It goes on creamy. It gets kind of firm before you leave. We have you stay here till it's, not crusty, but it's firm. It's like a mask. You can blink and everything. It's very comfortable. You forget you have it on. Over the course of the week. It just sort of slowly kind flakes off a little bit. At one week we apply what's called hydra balm. It re constitutes the bismuth, so it gets back to that creamy soft feel. You jump in the shower using just the fat pads of your finger, kind of clean it all off. Anything that's staying, if something feels like it wants to stay, you leave it. We never pick any kind of crust off. That is the risk of this peel. The bismuth, things are healing behind it and it is spitting off that mask as you heal behind, so you want to be sure that you're not picking any of that off. It's like any a scab or anything anywhere else.

Eva Sheie (07:15):
I was just going to say it's like a scab.

Colleen Phillips (07:16):
That will cause scarring and that is the biggest risk with this peel is scarring. Anytime that it has happened, it has been a situation where it has been picked at and tried to get off too soon. Again, the full face croton oil peels are done under general anesthesia.

Eva Sheie (07:38):
They are.

Colleen Phillips (07:38):
Yes. Part of that is because of the phenol and you have to apply it slow. It can in history has caused some heart arrhythmias, so patients really need to be on a monitor when you're doing that.

Eva Sheie (07:54):
Why did you decide to bring this into the practice?

Colleen Phillips (07:57):
I known plastic surgeon, Dr. Richard Bensimon is known worldwide for chemical peeling. He is up there with Dr. Hetter, who is the one that kind of played around with the Baker Gordon phenol peel, and introduced more croton oil and has gotten this to a safer and a less hypopigmentation than some of the phenol peels of, I'll say the olden days. The modern day peel does not have as much of a risk of that. We can do this peel in all Fitz skin types. It all kind of went away when lasers came out and everyone was doing lasers and it's all lasers. Well lasers, when you get this aggressive, you really get into problems with pigmentation and scarring and seeing those templates. We've all seen patients that have the stamped on appearance of the lasers. The chemical peel, you don't have those issues and it's so much more customizable. Those percentages of these solutions come in all different strengths and you can really customize it to a face. It's very artsy. I think that's one of the main reasons why we decided to do this. It's a very, it's safer, more customizable, controlled than expensive devices that come with a little more, you're handcuffed to a little more skin types and depth that you can go safely.

Eva Sheie (09:26):
Will you give us an idea of what to expect for the cost range of this peel?

Colleen Phillips (09:32):
Well, our most current prices are always on the website, so you could look there. I will tell you the price of this for the results that you get is incredible. It's very results driven.

Eva Sheie (09:47):
It seems like it's an alternative to surgery, really.

Colleen Phillips (09:51):
It is. The best candidate for this eyelid peel, I could tell you the one thing that makes you a candidate for a blepharoplasty, an eyelid, which is cosmetic eyelid surgery versus the peel, is whether you have fat in the orbit that's pushing on the muscles of the lower eyelid that causes puffiness and typically you see that either in the medial part of the upper lid or all along the lower lid. If there's fat in there, and that's one of your complaints is the puffiness. The peel isn't going to be the best option for you.

Eva Sheie (10:25):
It won't be.

Colleen Phillips (10:26):
But if it's crepey skin texture, redundancy of the upper eyelid skin, crow's feet, even etched crow's feet, these are perfect candidates for this eyelid peel, which I'm able to do with just a little bit of nitrous oxide, pronox, which you just take, it's a little breathing tube. You breathe in and out on it and it helps you decrease any anxiety and things with the procedure, but just an hour and it's an incredible peel. I'll also say I have done a couple patients that had blepharoplasties done years before, but still wanted this peel because it deals with the texture and the true skin. With surgery, you're just getting rid of extra skin and taking out some fat, which improves the shadowing and things. But if you don't have any fat and not a lot of extra skin, just the crepey texture that you feel is aging you, then this is a great option.

Eva Sheie (11:29):
Thank you, Colleen.

Colleen Phillips (11:30):
Oh, thank you.

Eva Sheie (11:31):
I'm so appreciative of all your expertise today.

Colleen Phillips (11:34):
Thank you.

Eva Sheie (11:35):
Thanks for listening. I'm your host, Eva Sheie. Follow the show and submit questions for our experts at wherebeforemeetsafter.com. Where Before Meets After is a production of The Axis.