Gregory S. Keller, MD, FACS, an internationally known facial plastic surgeon, was recently presented with a Lifetime Service Award for founding the Division of Facial Plastic Surgery at UCLA School of Medicine. In a celebration dinner at the Beverly Hilton Hotel, in Beverly Hills, California, Dr. Keller was joined by many of the doctors that passed through that division as residents in training, some who now have their own divisions at leading teaching institutions. In addition to his UCLA affiliation, Dr. Keller has maintained private practices in facial plastic surgery, rhinoplasty, and hair transplantation in Santa Barbara, Beverly Hills, and Los Angeles, CA for more than 25 years. In this exclusive interview with Aesthetic Insider™, Dr. Keller discusses his tenure as a leading innovator in the field of aesthetics, what led to his founding of the UCLA Division of Facial Plastic Surgery, many of the unique approaches to facial aging that he has developed and what he sees for the future of aesthetic medicine. To learn more about Dr. Gregory Keller, visit www.gregorykeller.com.
Congratulations on receiving the UCLA Lifetime Service Award. How did the UCLA Division of Facial Plastic Surgery come into being, and how did it feel to receive such a prestigious award?
The UCLA Lifetime Service Award was wonderful to receive. UCLA is a phenomenal institution and it has really been my pleasure to serve it over the years. Together, with many of the others in the department including Keith Blackwell, MD and Jeff Rawnsley, MD, we’ve really worked hard to advance teaching, techniques, technologies and everything in the field of facial plastic surgery. The UCLA Head and Neck Surgery Division primarily managed cancer. One of the fellows, for instance, did the first full face transplant. It’s a very serious place and the department really needed something to fill out its residency program and I was elected. It was purely happenstance at the time. Dr. Keith Blackwell was there and I decided to do a fellowship based on both reconstructive and aesthetic surgery. It really was just being in the right place at the right time in a period when advancements and knowledge were happening all around us.
How many Fellows have gone through the program, and where are they now?
We have had 24 fellows go through the program and countless residents. I am really proud to say that they are all incredibly capable human beings who have gone on into both academia and private practice in a variety of regions and many have divisions of their own in facial plastic surgery, and are publishing and doing great work teaching others.
Were you surprised to be given this award?
Yes. I was very surprised. We were having a residency graduation dinner at the Beverly Hilton Hotel and after the graduation speeches I was called up to receive this prestigious award which was completely unexpected. I was very humbled by the entire experience.
What was your first aesthetic patent?
My early work with the use of endoscopes in facial plastic surgery, particularly endoscopic forehead and brow lifting, led me to develop my first patent. It was so exciting to go from doing surgical techniques to having the ability to enhance our work and increase results through the use of scopes and lasers and it led to my giving over 91 presentations around the world in just one year! I’m not sure how I was able to practice, but it was a lot of fun and very gratifying.
Where did your practice and career take you from there?
I began consulting to a company called Laser Scope (and then many other similar companies came into the industry) and we began to do research into skin resurfacing. I worked for a long time with lasers for skin tightening, scalpel free surgery, etc. I was involved with much of the early work with the CO2 Laser, Erbium Laser, and all the way up to the PhotoFacial. Now, I am working with radio frequency devices and other fractional devices to actually tighten the skin without ever having to lay a knife or chemical to the tissue. It is pretty amazing because we had not been able to achieve that before and working with all the different energy devices has been very satisfying. In the mid-90s we even raised money to start a non-profit which serviced all of the hospitals in the Santa Barbara area with laser work for years. One of the areas that I found particularly enjoyable was working with children with port-wine stains. At that time there were no treatments for port-wine stains, and for some reason there were numerous children affected by them. It took many treatments to remove the stain, but that was probably one of the most gratifying things that I did then and it still is, although we now use some of the newer machines which give even better results.
What areas are you currently researching?
My current passion is working with biologicals. Our own body makes things that I think are our future. We’ve worked in stem cells now for over 22 years and I think that these advances are finally taking shape, literally. In addition to advancements in surgical technique, we are now able to enhance aesthetic results with combinations of biologicals and devices. For instance, in a facelift we might use PRP for healing, a modality such as FaceTite by InMode or one of the other devices to tighten the skin. This type of combination actually gives better results to a facelift procedure. But there’s no question that stem cells are coming. Right now they are primarily used in wound healing and burns and other areas, but I think that we’ll see more advances in that area in addition to PRP. I have more recently been involved with a company called Medicell Technologies, LLC that makes a cosmeceutical skin care line called DefenAge™ which contains Defensins® which trigger our lgr6 stem cells. Defensins naturally occur in the body to defend it against infection or trauma. For instance, if we cut ourselves the defensins are secreted and cause the lgr6 stem cells to make new basal cells which then propagate to make new skin. Turning that into a cosmeceutical has been a major advancement and one that I feel very fortunate to be part of.
Do you see stem cells as the new frontier in aesthetic medicine?
Yes. I think the biologicals are interesting and that they are the new frontier. Of course the new technologies for face lifting, face tightening, body enhancement and other things that are coming out and creating instant lifts are all good and helping patients see immediate improvement with little if any downtime. However, I’m a believer that if we can get the human body to perform better using its own natural biology, well that is groundbreaking. Most of what we do in developing these things isn’t an all of a sudden inspiration, but a natural extension of our (my) work this far in my career. How do we tighten skin more? How do we improve the appearance of the skin? You have to ask the questions to get the answers.
You recently were part of a multi-center placebo controlled study on Defensins, can you explain further?
I was a clinical investigator, along with very well respected dermatalogists Dr. Vivian Bucay and Dr. Amy Taub. We each studied 15 patients over a 90 day period. Half the group used products containing Defensins, half did not. The results speak for themselves. There was significant improvement in fine lines and wrinkle reduction, pore size, skin texture and smoothness. The most significant improvement we saw, and which was validated by QuanitifiCare which is a company that uses sophisticated microscopic evaluation and 3-D measuring techniques, was that Defenins were able to obtain skin tightening results similar to what we see with retinols, but without any of the inflammation associated with a retinol. That was very encouraging. It was really exciting to see that a cosmeceutical could actually stimulate the same stem cells that defend the body naturally, rather than using growth factors. The QuantifiCare technology was a big help as it is a device that can actually measure a wrinkle, as well as measure the oiliness of the skin, the pore size and the water loss in the skin, all of which saw significant improvement from using the products containing Defensins.
How do you balance your private practice, with your research and development projects?
I’m a busy man, and always have been. I wouldn’t have it any other way. My main practice has been located in Santa Barbara, CA for several decades, but I also have the UCLA Los Angeles practice and a Beverly Hills location too. I’m primarily known for surgery of the aging face, hair transplantation and rhinoplasty. I am good at taking advice, however, and over the years I have met and had the good fortune to work with a number of good practice marketing and management specialists that have helped me develop a great team. My team and my wife of course help keep me balanced by doing a great job at marketing and managing the practice(s) not just for me, but with me.
Have you seen a change over the years in the number of surgeries vs. lesser invasive treatments?
Absolutely. According to various journals non-invasive treatments have gone up over 5000% in the last decade or so, while the number of surgeries has stayed pretty much the same. So while I do a lot of surgeries. It’s exciting to be a part of the rise of the non-invasive, minimally invasive procedures available today. In fact, in the 1980s, my Santa Barbara practice was one of the first medi-spa type practices in aesthetics. This was considered a very foreign idea at the time and was not very profitable but nowadays non-invasive work is almost surpassing the invasive work even for those of us who are very busy surgically.
Are patients undergoing aesthetic procedures at a younger age?
Yes. The younger patients we call pre-juvenation, and there are certainly a number of those patients that are trying to prevent aging from happening. The aesthetic engineers are also becoming more progressive and are making better, longer lasting fillers, as well as improved tightening devices. Treatments usually go by age group, although not entirely as some people age very well. A patient in their 20’s- 30’s might start to use cosmeceuticals, Botox or Dysport and possibly fillers. As they get into their 40’s, where we used to perform mini-facelifts, or lower-facelifts at 42 – 45, there are now some very good non-invasive options available to them.  The 50’s and 60’s is the pre-post-menopausal period of time, and those patients are opting to combine surgery with non-invasive technology such as RF treatments for the face and jawline, Kybella, etc. Overall, patients are starting younger and studies show that.
What do you see on the horizon for aesthetic medicine in general?
Well, I think the technologies are always going to improve, and as I said earlier I think the future is in biologicals, things our own body makes such as stem cells. Undoubtedly there are some genetic sequencing things that are going on, but I think we are also going to see some pharmaceuticals and other age resistant developments made available in the not too distant future. There are literally billions of dollars being invested by billionaires to try and find a cure for aging at every level and of course that’s where everything is going – just trying to find the cure for aging. I hope that happens in my lifetime.
Gregory S. Keller, MD, FACS is an internationally known facial plastic surgeon, who specializes in naturally restoring a youthful facial appearance. A board certified facial plastic surgeon, Dr. Keller limits his practice to facial plastic surgery, rhinoplasty and hair transplantation. He has invented and published natural facial rejuvenation techniques that are used internationally by a majority of facial plastic, oculoplastic, general plastic and cosmetic surgeons, who perform facial aesthetic surgery. In addition to his UCLA affiliation, Dr. Keller has maintained private practices in facial plastic surgery, rhinoplasty, and hair transplantation in Santa Barbara, Beverly Hills, and Los Angeles California over the last 25 years. To learn more about Dr. Keller, visit www.gregorykeller.com.
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