I have been using standard electrocautery for removing or flattening all kinds of growths for more than thirty-two years with gratifying aesthetic results. I have found this modality particularly useful for getting rid of overgrown oil glands that protrude above the skin surface (sebaceous hyperplasia); yellowish, fatty deposits around the eyelids (xanthelasmas); milia (essentially larger clogged pores related to sebaceous cysts); and even skin tags. After numbing the area with a little local anesthesia, the cautery--when set to the precise setting needed and triggered for the precise miniseconds needed--can heat the treated tissue to a temperature in which it literally "pops." Performed in this fashion, quite a few lesions or even a large fatty deposit may be treated in just a couple of minutes. Healing is generally uneventful, like a healing scratch with a crust, and when treating small lesions, like milia, skin tags, and sebaceous gland overgrowths, leaves imperceptible aftermarks. The results of cautery treatments in my experience rival or exceed the more hyped laser alternative, and are typically much less expensive.
If a TCA peel (or any other peel, for that matter) is contemplated, I would strongly suggest that the peel be performed first and then the electrocautery treatment. If the order is reversed, the wound created by the cautery treatment might permit deeper-than-desired penetration of the peeling agent that might result in a burn and subsequent scarring.
Naturally, these procedures should only be performed by board certified aesthetic physicians with extensive experience with these treatment approaches.