Dr. Alex Liu: The Reveal on Peels

Before and after results after facial rejuvenation peels

Everyone talks abut peels these days, everything including cleansers now claim to be a peel of some sort. I recently sat down with cosmetic surgeon Dr. Alex Liu who I barraged with a list of questions. The most important being how it works. Once we reach the age of 20, our collagen stops growing on it’s own. Collagen is the layer of the skin below the dermis, so the top layer is the epidermis, then the dermis and below that is the collagen. The collagen keeps everything in shape, which is what we are after. After years of exposure to the elements as well as making expressions on your face, the skin begins to break down and even develop creases and cracks (like forehead and laugh lines) because of the lack of collagen. The only time collagen will grow is after trauma, in an effort to repair itself. That’s where the peel comes in to our lives. The acid in peels penetrates the epidermis and the dermis and reaches the collagen to traumatize it in a controlled manner so that it is “stimulated” to tighten. Remember, the skin has rejuvenation abilities but only after it is forced to by some sort of trauma. The peel also removes the upper layer of the skin to reveal the “new” skin.

The basic differences between all the different peels is the strength and are categorized into 3 levels: 7%, 15% and 35%. The 7% are acids like lactic and glycolic, it is the most superficial of all medical grade acids but are still only available through a doctor. It takes a lot more treatments to have an effect but the up side is that is the gentler on the skin so there is no downtime for the skin to recover. That means, so redness and no hiding from the sun.

The 35% is the highest level of peels that is still safe to use. This has an immediate effect but the skin will not look good right away. You will need to be out of the sun completely and will probably not be able to face anyone for a week. It is also strong enough to remove dark patches and scars. This is the type of peels celebrities will use 2 weeks before a Red Carpet event because it of its immediate effectiveness.

The 15% or a combination of acids is what is most often used and can be done in conjunction with microdermabration to enhance the peel effect. Dr. Liu prefers a multi prong approach of using microderm first then a combination of acids. This allows more penetration of the peel since now the dirt, grease and dead skin is removed so that a lower level of acid can be used to achieve the same results. Many doctors do the reverse but that approach does not allow a deeper penetration of the acids.

I asked why I couldn’t do this myself at home and why I couldn’t just buy the strongest acid to get the “best” results possible. The answer is really really scary. Anything higher than 35% will hurt your skin and cause irreversible damage. The face will melt off like candle wax and the chin will fall to the neck so they look stuck together. The skin will turn

bright while as all pigment is destroyed and what is left is actually scar tissue. A trained medical professional needs to determine the appropriate strength for you and neutralize it after it’s done to make sure only the intended effect is achieved. Which means, I would

not even do this if your facialist offers the service.

Most peels that you can buy and do yourself will not penetrate to the collagen to promote new growth and tightening, it will only have superficial results like removing the top layer of dead skin cells to reveal new skin cells and brighten the skin. Which is great and we can all benefit from that. But to actually remove wrinkles, you need to go deeper. Dr. Liu uses the analogy of getting body work on your car. Getting into an accident is like getting wrinkles, you need to fix the body of the car, the steel underneath, for the car to look new again. If you just get a paint job, it might improve the look a little bit but will not fix the dents to get the car looking new again. And that’s the same difference between a superficial peel and one that penetrates.

Interview with Dr. Liu to be continued… to come, Thermage (face lift without surgery), Smart Laser Lipo (super targeted lipo and reduced recovery time), and Photofacials (light treatment for hyper pigmentation).

Dr. Alex Liu has his own practice, Awaken Cosmetic Surgery in Los Angeles, CA. He is the only doctor I have ever met who is enthusiastic about speaking endlessly about what he does and will spend as much time as you need to answer every single question you have before you proceed with any procedures. He makes sure you get the exact results you are looking for because he understands that each person’s aesthetical ideal is unique. If you live in the area (or even if you don’t, he has a lot of clients who travel across the country to see him), it is worth a consultation, 310-791-2233.