THE PHOTO FACE LIFT
BY
ROBERT P.K. KELLER, M.D.
KELLER SKIN & BODY INSTITUTE
MEDICAL CORPORATION
KELLER SKIN & BODY INSTITUTE
MEDICAL CORPORATION
174 CARMELITO AVE
MONTEREY, CA 93940
TEL 831-373-1100
FAX 831-373-1627
WWW.KELLERSKIN-BODYINSTITUTE.COM
THE SKIN INSTITUTE AT PEBBLE BEACH
POST OFFICE BOX 1128
1516 CYPRESS DRIVE
PEBBLE BEACH, CA 93950
TEL 831- 622-6480
FAX 831- 622-6483
WWW.PBSKININSTITUTE.COM
HOW SKIN AGES… THE BASICS
The most obvious sign of aging is the appearance of our skin. But to fully understand how skin ages, we need to
review the basics of skin and the aging process.
Figure 1 shows a microscopic view of skin. One of the most important layers in the skin is the basal cell region.
We have a saying in cosmetic medicine that “ye who controls the basal cells layer, controls the aging of skin”. Basal cells
migrate upward to form new skin and they also influence the production of collagen and elastin, among other things.
Life is good for basal cells, until they become damaged. Once this happens, they do one of two things: either they
go wild and form cancer cells, or they become dysfunctional and fail to make healthy skin. In the latter case, basal cells
become dormant. I call this the “Sleeping Beauty Syndrome”. These beautiful cells are in suspended animation waiting for
“Prince Charming” to kiss them awake.
How, then, do they become damaged? And who is Prince Charming? First, let’s talk about the theory of cellular
damage, and then we’ll introduce you to the Prince.
Imagine going inside one basal cell, deep into its interior to a structure called mitochondria. This powerhouse
produces energy pellets, which allow the cell to make proteins, etc. All this production is dependent on oxygen, a key
player in cellular function. When an oxygen molecule becomes damaged, our problems begin.
To see how oxygen gets hurt, we can use ultra violet light (sunlight) as a general model to understand cellular
dysfunction. For example, UV light travels in the 350-nanometer wavelength range. Picture a marble (a photon) traveling
at this speed. When this marble collides with an oxygen molecule inside the mitochondria, the photon punches an oxygen
electron out of its orbit. Now we have oxygen without one of its electrons… a state oxygen hates. This is what we call a
‘Free Radical’. It will do anything to get an electron and indeed, pulls rank to take one. After all, it IS oxygen and we
must have it to live (i.e.-produce energy). So, what does kingpin oxygen do? It steals an electron from DNA. Taking an
electron from DNA is like pulling a leg from a table. The DNA ‘collapses’ and becomes damaged. When DNA is
damaged it cannot make products, like skin, collagen, elastin, etc.
REV 3
02/11/2004
THE PHOTO FACE LIFT BY ROBERT P.K. KELLER, M.D.
PAGE 2 OF 5
As a result, this cell becomes impaired. It
slows way down in producing anything useful; in fact,
it becomes dormant. One less cell is able to make good
skin. Now the aging process begins in earnest.
Multiple this scenario times a billion and you can
appreciate what is happening to your skin. Remember,
sunlight is just one of many things which cause
‘oxidation’ of our skin cells. Smoking, for example,
produces ten thousand free radicals per puff of smoke!
Incidentally, ‘anti-oxidants’ like vitamin C,
supply a rich source of electrons to free radicals.
Oxygen takes its missing electron from the antioxidant, leaves DNA alone and the cell remains
undamaged. Aging, therefore, is free radicalization of
oxygen with subsequent damaging of DNA.
In the oxidation of skin cells, an interesting thing
happens. These damaged basal cells go to sleep. The
stage is set for Prince Charming to make his
appearance. Recall that 350-nanometers is ‘bad’ UV
light, causing free radicals. As it turns out, there is a
‘good’ light. Like so many things in nature, ‘that
which hurts, also heals’. We have discovered light at
590-nanometers is Prince Charming. A photon traveling at this
wavelength actually ‘energizes’ the damaged cell. This Prince
Charming frequency re-awakens Sleeping Beauty, causing the dormant
basal cell to manufacture new skin. In addition, other dysfunctional
cells (such as fibroblasts) are rejuvenated to produce collagen.
HOW THE PHOTO FACE LIFT WORKS
Finally, we can turn our attention to the LunchTime facelift. Using an Intense Pulsed Light laser, 590-nanometers and
other beneficial frequencies are generated and used to restore
damaged skin.
The procedure is simple, affordable and has no
downtime. Shining this light on aging skin causes immediate
and long-term restorative changes (figure 2).
Observe figure 3. These are biopsies of skin before and after
IPL treatment. Notice how the ‘before’ microscopic slide shows an
epidermis as thin, wavy wrinkles are present and how disorganized the
collagen layer appears. In the ‘after’ slide, the surface is smooth, the
epidermis is thick and the collagen layer is organized and healthy. This
is young, rejuvenated skin!
Things get even better, though, for IPL treatments attack aging
skin on several fronts. First, consider brown spots or pigment on the
face. This is a subtle sign of aging. If we revisit a damaged basal cell, one of the few defense mechanisms it has is to
throw up an ‘umbrella’ to protect itself from the sun. Every freckle, liver spot or age spot has underneath it a damaged
REV 3
02/11/2004
THE PHOTO FACE LIFT BY ROBERT P.K. KELLER, M.D.
PAGE 3 OF 5
cell. Our eyes compare people with brown spots against the uniform color of young skin. Over time, we can guess a
person’s age by the amount of uneven color on the face.
IPL treatments erase brown spots. Figure 4 shows how
effective this laser is in removing age spots. To illustrate how
uneven color (Dyschromia) makes us appear old, consider one
of my patients. She is a famous model, known for her youthful,
athletic beauty. During a recent magazine shoot, she noticed
the camera crew using light filters on her. She also was told to
put on more make-up. As her trademark is ‘natural beauty’,
she was understandably upset. She came to me to find out why
her ‘look’ was changing. As it turned out, she was developing
very subtle pigmentation. After a recent pregnancy, years in
the sun and the stress of being a super model, her skin was
changing. She was not aware of how this dyschromia affected
her beauty. We decided to treat with IPL and the results were
amazing. She sent me a photograph of a recent ad and her skin
glowed. She was back up top!
This patient illustrates the principle of beauty and refractive defects. Consider this: When you walk into a room,
your image is the sum of the light, which bounces off your face, into the retina of the observer’s eyes. Young people have
a high refractive index and so almost all the light, which strikes their face, reflects off and enters your retina. Hence, that
image is complete and seen as ‘young’. When dyschromia is present, the room light is absorbed by the brown spots or
diffused by wrinkles. Fewer light rays are bounced back to your eyes and the image is incomplete. Our mind fills in the
small holes, but we perceive this person as ‘old’. By melting away the liver spots with the IPL, our refractive index goes
up, more light is reflected off the skin and we appear younger. We now beam! In fact, one of the most frequent comments
my patients get is this: “You glow! Did you take a vacation, get some rest, win the lotto, etc., etc.” In fact, there is a
very good basis for these comments. Your refractive index got higher. You are reflecting more light off your
face. You are in fact, radiant!
Another wonderful benefit of
our magic 590 IPL is its affect on red,
blushing skin (Figure 5). Fourteen
million Americans suffer from
Rosacea. Whether it is flushing
cheeks, a WC Fields nose, facial veins
or adult acne, Rosacea is often
mistaken for alcohol abuse. When a
fifty-year-old sales executive came to
see me, he complained of losing
clients. His customers inferred he was
drinking too much, when in fact he
was a devote Mormon, shunning all alcoholic beverages. He wanted the red out. IPL was successfully used and he later
told me people commented on how young he looked. No more references were made to suspected alcohol. Plus, he looked
vigorous and at the top of his game.
The third benefit of IPL is on collagen production. Another tale-tale sign of aging is sagging, lack luster skin.
Much of this is due to decreased collagen production. IPL stimulates the production of collagen with a resultant tightening
of the skin and decrease in fine wrinkles. Figure 6 shows how beauty is enhanced when collagen production increases.
Still another advantage of IPL is the reversal of sun damage. Known as solar elastosis, sun aging makes us look
weathered. As Indiana Jones stated, “It’s not the years but the mileage!”
REV 3
02/11/2004
THE PHOTO FACE LIFT BY ROBERT P.K. KELLER, M.D.
PAGE 4 OF 5
Finally, a consistent comment my patients make 10 minutes after treatment is how tight their skin feels. Again,
there is a very good explanation for this tightening. As we age, our collagen gets ‘loose’. Our skin sags partly because the
collagen molecules are lacked. When IPL is passed over the skin, water is evaporated from the collagen molecule. This
shrinks the collagen and tightens the skin. Hence, you feel immediate tightening after IPL treatment.
Frequently Asked Questions…
What differences in my skin should I expect to see after an IPL? Immediately after IPL, the skin is slightly red.
Red is good. It indicates where the prior damaged skin was hiding. Red also shows us the laser has treated that damaged
area. This redness will usually disappear by the end of the day. Within ten minutes after treatment you will feel and see
your face tighter (the water in the existing collagen has been vaporized and the collagen has tightened). The first one to
three treatments will target the dyschromia and reduce the age spots and pigmentation. These brown spots will form
‘peppering’ and slough off over the next few days. Underneath these melted brown spots beautiful, new skin will appear.
Remember that a skin cycle is 4-6 weeks; therefore, every month your skin will appear more improved as the old skin
sheds and the new cells migrate to the surface. In the intervening weeks, small blood vessels will be eradicated and
Rosacea will diminish. At this time, new collagen is being produced and the skin takes on a youthful appearance. After the
brown spots are gone, no barriers to the IPL laser remain. Hence, the fourth treatment allows delivery of the light wave to
reach the basal layer in full strength. This is what we have been waiting for…complete absorption by the basal cells. By
now, people will comment on your fabulous appearance. “Did you lose weight, go on vacation, win the lotto?” are
common remarks my patients receive. Your friends and family cannot figure out what is different except that you look
radiant. And we know why! Finally, an amazing thing happens about 6-8 months from the start of treatment. In a process
called ‘recruitment’, a critical mass of cells come together to produce new skin in a coordinated effort. I call this the “fifth
wow” of IPL.
How long do the results last? We have given you a fresh start. But remember: free radicals will continue to be
produced. The balance for youthful aging is a pull between oxidation and production of new skin. Minimizing the
oxidation process is paramount to maintaining healthy skin. Use of anti-oxidants, avoiding sunlight, smoking, etc. help
shift the scales to more production of new skin and less destruction. A good homecare skin system, such as SIA
Formulations, is extremely important. Overall, we find most patients come in for one touch up treatment every 6 or 12
months to keep the rejuvenation process strong.
How many treatments are necessary? We recommend 4 treatments. These can be spaced every 3-4 weeks; however,
many of my patients come from all over the United States and Europe. In these cases, we can treat as infrequently as
every 6 months.
Is there any down time? No! In at noon, diner at seven! As you are probably aware, many of my patients are in the
public eye. They cannot afford to lose time away from the camera or boardroom. IPL is safe, fast, affordable and has
minimal discomfort.
We hope this short explanation has made you curious about the Photo face-lift. The Skin Institute believes that
well-informed patients get the best results. We want to exceed your expectations…every time.
Please contact us at (831) 622-6480 and join us in the journey of youthful aging.
REV 3
02/11/2004
THE PHOTO FACE LIFT BY ROBERT P.K. KELLER, M.D.
PAGE 5 OF 5