{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,17]],"date-time":"2026-03-17T18:52:53Z","timestamp":1773773573036,"version":"3.50.1"},"reference-count":24,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>The aim of the current study was to determine the effect of perioral phenol\u2013croton oil peeling on philtrum length in patients undergoing primary facelift.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective cohort study was performed on Caucasian females undergoing primary facelift with perioral heavy formula phenol\u2013croton 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>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\u2005kg\/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 &amp;lt; .001). Control patients had no difference in philtrum length postoperatively (P &amp;gt; .05).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Phenol\u2013croton 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence: 3 (Therapeutic)<\/jats:title>\n                    <jats:p\/>\n                  <\/jats:sec>","DOI":"10.1093\/asj\/sjaf262","type":"journal-article","created":{"date-parts":[[2025,12,21]],"date-time":"2025-12-21T12:43:03Z","timestamp":1766320983000},"page":"433-440","source":"Crossref","is-referenced-by-count":0,"title":["Adjunct Perioral Phenol\u2013Croton Oil Peel Shortens Philtrum Length in Patients Undergoing Primary Facelift"],"prefix":"10.1093","volume":"46","author":[{"given":"Pierce L","family":"Janssen","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5051-0581","authenticated-orcid":false,"given":"Osama","family":"Darras","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elad","family":"Fraiman","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-5476-1566","authenticated-orcid":false,"given":"Marjorie C","family":"Kragel","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6682-2371","authenticated-orcid":false,"given":"Max","family":"Mandelbaum","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicholas","family":"Sinclair","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James E","family":"Zins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"key":"2026031712020888800_sjaf262-B1","doi-asserted-by":"publisher","first-page":"440","DOI":"10.1097\/PRS.0000000000005190","article-title":"Aging of the upper lip: part I: a retrospective analysis of metric changes in soft tissue on magnetic resonance imaging","volume":"143","author":"Ramaut","year":"2019","journal-title":"Plast Reconstr Surg"},{"key":"2026031712020888800_sjaf262-B2","doi-asserted-by":"publisher","first-page":"1364","DOI":"10.1007\/s00266-023-03302-5","article-title":"Different techniques and quantitative measurements in upper lip lift: a systematic review","volume":"47","author":"Zhao","year":"2023","journal-title":"Aesthetic Plast Surg"},{"key":"2026031712020888800_sjaf262-B3","doi-asserted-by":"publisher","first-page":"173","DOI":"10.1007\/s00266-020-01871-3","article-title":"Aesthetic surgical enhancement of the upper lip: a comprehensive literature review","volume":"45","author":"Yamin","year":"2021","journal-title":"Aesthetic Plast Surg"},{"key":"2026031712020888800_sjaf262-B4","doi-asserted-by":"publisher","first-page":"816","DOI":"10.1093\/asj\/sjaa174","article-title":"The impact of the philtrum on facial attractiveness, perioral proportions, and perceptions of facial aging","volume":"41","author":"Nunes","year":"2021","journal-title":"Aesthet Surg J"},{"key":"2026031712020888800_sjaf262-B5","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1093\/asj\/sjae120","article-title":"Micro-coring: a novel approach to perioral rejuvenation","volume":"44","author":"Carruthers","year":"2024","journal-title":"Aesthet Surg J"},{"key":"2026031712020888800_sjaf262-B6","doi-asserted-by":"publisher","first-page":"990","DOI":"10.1097\/00006534-198606000-00024","article-title":"The lip lift","volume":"77","author":"Austin","year":"1986","journal-title":"Plast Reconstr Surg"},{"key":"2026031712020888800_sjaf262-B7","doi-asserted-by":"publisher","first-page":"199","DOI":"10.1097\/00006534-196202000-00007","article-title":"Chemical face peeling and rhytidectomy. a combined approach for facial rejuvenation","volume":"29","author":"Baker","year":"1962","journal-title":"Pllast Reconstr Surg Transplant Bull"},{"key":"2026031712020888800_sjaf262-B8","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1097\/00006534-200001000-00039","article-title":"An examination of the phenol-croton oil peel: part I. 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