Dr. Alex Liu: The Reveal on Peels

awaken_before.jpg       awaken_after.jpg

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.

12 thoughts on “Dr. Alex Liu: The Reveal on Peels

  1. Is this the same person? The eyes are a different color, the lips are not the same, eyebrows are gone on the person to the right…………….

  2. Danielle on said:

    Great article. One of the best on the site for a long long time. IS that the same person? There are some similarities, but there are enough differences where it could be a whole different person..

  3. Michelle Kirst on said:

    I agree with the above two comments, in that this is in no way the same person. They have completely different features.

  4. It’s the same lady; however, I think she has some makeup on in the second pic. I disagree with the statement that you shouldn’t use anything over 35%. When using acids, you face build a tolerance, so it’s perfectly safe to gradually move up in percentages, as long as you are gauging your skins tolerance. I’ve been using glycolic peels and in the past 2 years, I’ve moved from 30% up to 70%, at the advice of my dermatologist cousin. I have naturally oily skin and used to be acne-prone with some very fine smile lines around my mouth and eye brows. Doing glycolic peels have taken away all lines I had and I don’t break out anymore. I currently use 70% once a week but I don’t leave it on long just a little over a minute. My skin has never looked better. At 28, I look like I have much younger skin and I’ve had absolutely no case of sagging skin. But it might be different with each person.

  5. Danielle on said:

    Your skin does not “get used” to products and build up tolerance over time.

    http://www.thebeautybrains.com/vanilla/comments.php?DiscussionID=718&page=1#Item_0

  6. Lulu what product are you using?

  7. I use Glycolic acid peels and Danielle that is one person’s view; however, many dermatologists increase amounts of chemicals that are used because of how the skin changes. Maybe my use of the word “tolerate” might not be 100% correct but what works for skin one day may not another.

  8. Lulu-can the acid peel you use be purchased over the counter or do you need a prescription?

  9. Anonymous on said:

    I don’t understand this article. You use the word peel several times, but you only name specific types of peels once (glycolic and lactic acids). The percentages you listed for those peels to be used safely is surprisingly low as both are available in strengths up to 70%. Salicylic acid peels are not mentioned at all? Are you talking about the TCA peel only?

    On another note, I can plainly see that that is the same woman in both pictures. It looks as if she’s had a lot more than peels done.

  10. It’s medical grade glycolic acid that is slightly diluted with purified water. I’ve gotten mine from free from my cousin. His practice gets it from the manufacturers in bulk…so there’s not purchasable brand that can be bought. I think that they only use it in office. If you ask your dematologist about the percentages of glycolic peels he uses, he could broubably recommend a good number that he could start you at. I think in-office peel are like $30-40. I have seen “medical grade” glycolic peels sold on ebay by so call aesticians (wrong spelling i know) but i’m not sure the quality because I haven’t tried them. Best bet is to ask your derm :)

  11. indee blue on said:

    she also had a facelift.

  12. tried AHA peeling, my combination skin became dry and sensitive skin! easy to get wrinkle.

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