Really wrinkled lady with DRAMATIC results on mouth smile lines (parentheses) - would a TCA peel work for me? (photos)

Ok, I am 41, and have never had *anything* done to my face, no botox or filler, nothing at all. The only thing that bothers me about my face are the parentheses around the mouth. I saw a woman (she looked MUCH older than me in the before) who had a 35% TCA peel, and those lines were just GONE. Would that be something I could try. I am including some really unflattering, slack faced photos of me in direct sunlight

Doctor Answers 2

TCA Peel

Thank you for posting your question. Deep chemical peels such as the TCA peel penetrate from the epidermis through the dermis, causing a second-degree burn of the skin. These may be used to improve deeper wrinkles, treat pre-cancerous growths and blotchy skin color. Phenol is the chemical used for these treatments. The deeper penetration of these peels carries the risk of hypopigmentation where the skin pigment does not regenerate leaving lighter colored areas. I recommend meeting with an experienced physician in-person to determine whether you are a candidate for the peel. Best of luck.


Bellevue Facial Plastic Surgeon
5.0 out of 5 stars 15 reviews

Fillers Work Well For Fine Lines & Crinkles

The kinds of parenthesis lines you demonstrate in the photo are a very common problem that I have found responds extremely well to the use of fillers.In fact, I have the dramatic before and after photos of a particular patient of mine about the same age and extent of problem in my own photo collection treated with a filler. My choice for this in my Upper East Side Manhattan office is Belotero Balance, since it possesses little to no tendency to give rise to the unwanted, bluish Tyndall Effect when injected superficially within the skin, as needs to be done to elevate these kinds of finer wrinkles. (Teosyal Redensity II would be my choice for this in my Israel satellite facility where a far greater number of regulatory agency approved fillers are available.) The results are typically immediate and very gratifying, and there would be no need for applying TCA, which may offer some improvement (but in my experience not to the same extent as a direct injection of filler), and possesses other potential risks for giving rise to post treatment redness, blotchy pigmentation, or even loss of pigment. Make sure to consult with a board certified aesthetic physician and ask to see his/her before and after photos before agreeing to proceed. 

Nelson Lee Novick, MD
New York Dermatologic Surgeon
4.8 out of 5 stars 24 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.