Has the bo­tox back­lash started?

He changed the way a gen­er­a­tion of rich women looked. Hannah Betts and Tim Tee­man on Dr Fredric Brandt, an un­likely beauty guru who said Bo­tox is here to stay

Friday - - Contents -

It was a ruth­lessly ef­fi­cient sys­tem: a nar­row cor­ri­dor of treat­ment rooms in­side which were women (and men) who had made ap­point­ments months ear­lier to have brows or fore­heads smoothed, cheeks and lips plumped or necks tight­ened by the ex­pert hands of Dr Fredric Brandt. When he fin­ished one treat­ment, he would head into the next room. It was a dizzy­ing blur of ex­its, en­trances, jabs and flutey hel­los.

Dr Brandt – nick­named the Baron of Bo­tox, and an ex­ot­i­cally plumaged bird in his own right – was the largest cos­metic user of Bo­tox in the world and was his own strik­ing ad­vert for the 5,000 vials his prac­tice used in a typ­i­cal year.

Be­fore his death in April – which shocked the plas­tic world of beau­ti­ful peo­ple – Dr Brandt pub­licly crack­led with spriteish en­ergy. He was found at his Florida home hav­ing hanged him­self af­ter suf­fer­ing what is be­lieved to be de­pres­sion.

But dur­ing his busy ca­reer, 65-year-old Dr Brandt, who had his own ra­dio show, was at the van­guard of min­i­mally in­va­sive cos­metic surgery, of which there were 13.4 mil­lion pro­ce­dures in 2013 in the US – in­clud­ing 6.3 mil­lion Bo­tox in­jec­tions and 2.2 mil­lion fillers. The global mar­ket is fore­cast to reach $2.9 bil­lion (Dh10.6 bil­lion) by 2018.

Last Novem­ber, the com­pany that patented Bo­tox was bought for $66 bil­lion. If there is a beauty aes­thetic for this gen­er­a­tion, it would be the one in­vented by Dr Brandt. A hand­ful of celebri­ties may claim that there is a Bo­tox back­lash, but the 21st-cen­tury face, as smooth and plumped up as whisked egg whites, is every­where, from the TV screen to board­rooms to the fac­tory floor.

Yet Dr Brandt’s Man­hat­tan clinic was not the glam­our palace you might imag­ine: it was on the un­fash­ion­able mid­town-east flank of the city. The first marker of his sta­tus and his love of ex­pen­sive art

was the Damien Hirst paint­ing in the re­cep­tion. Dr Brandt was a keen col­lec­tor and when we met him last year, he had just re­turned from Mi­ami’s Art Basel. More strik­ing than his chem­i­cally en­hanced fea­tures was his honk­ing laugh, which was gut­tural and stran­gu­lated.

He was known in the industry as the most cre­ative prac­ti­tioner – he knew just where to in­ject to get the best vis­ual re­sult, while the pa­tient could still smile and move their fea­tures. Those pa­tients in­cluded so­ci­ety women, wealthy pro­fes­sion­als and celebri­ties (he de­clined to name the best­known, but Madonna has spo­ken glow­ingly of him and Demi Moore is a ru­moured former pa­tient), as well as lawyers, rich house­wives, de­sign­ers and au­thors. Pa­tients flew from western Europe, Rus­sia and the Mid­dle East to see him.

He cooed brisk greet­ings to ev­ery pa­tient and then swiftly ex­e­cuted their treat­ments. The ones we met looked to be in their 50s, 60s and 70s. We were asked not to talk to them. Hav­ing dabbed the lit­tle bub­bles of blood away from botulin or filler-in­jected skin, Dr Brandt smiled at his hand­i­work. Then he trilled, ‘By­eeee, see you soon. Make an ap­point­ment be­fore you leave’, and he was off into the next room.

If you couldn’t af­ford his treat­ments, his fame meant that he be­came a brand, and you can buy his prod­ucts for tight­en­ing, lift­ing and smooth­ing your skin.

The lat­est is called Nee­dles No More, an anti-wrin­kle cream he claimed tar­gets crow’s feet and frown lines. It’s as ef­fec­tive as Bo­tox, but Dr Brandt didn’t rec­om­mend you lather it on. His sec­ond of­fice, in Florida, served as a lab where he tested new prod­ucts with place­bos used on hu­man guinea pigs for com­par­i­son, re­fin­ing the pep­tide con­cen­tra­tions that in­ter­fere with the con­trac­tion im­pulses of mus­cles. He was ex­per­i­ment­ing with a botulin toxin mol­e­cule to treat crow’s feet that, he said, would be ef­fec­tive for up to 120 days. Nee­dles No More is the off-the-shelf ver­sion con­tain­ing mag­ne­sium as a mus­cle-con­trac­tion in­hibitor.

What treat­ments had he done, we ask. ‘Me? I’ve never done a thing,’ he replied. There’s that dis­tinc­tive honk-honk laugh. ‘I’ve not had a facelift. Ev­ery­one thinks I have. Look be­hind my ears.’ No scars. ‘I haven’t had surgery, but I al­ways want to ex­per­i­ment on my­self be­cause if some­thing hap­pens, let it hap­pen to me.

‘I’ve done Bo­tox on my­self since the mid-Nineties. I’ve in­jected fillers to re­store the cheek area and around the eyes to fill in the hol­lows, and my jaw­line to res­culpt that.’

Was he dis­sat­is­fied with how he looked? ‘I wanted to see what the treat­ments do for pa­tients, but of course I wanted to main­tain my­self.’ He said he did Bo­tox twice a year, but ‘fillers I haven’t done in months’.

The younger of two broth­ers, Dr Brandt was brought up in a mid­dle-class home in Ne­wark, New Jer­sey; his fa­ther, who died when Dr Brandt was 15 (his mother died seven years later), owned a sweet shop. That wasn’t as much a won­der­land for a child as you may imag­ine, he says.

His par­ents wouldn’t al­low him sweets be­cause they were bad for him, and they were so com­mit­ted to the shop, they didn’t spend a lot of time with their chil­dren. The young Dr Brandt was a dreamer, ‘al­ways want­ing to know how things worked’. He took apart ra­dios and put them back to­gether. He liked maths and sci­ence.

‘I don’t think you think about your ap­pear­ance at that age,’ he re­flected. ‘You’re just a kid. I didn’t have the health­i­est diet as a child, but I wasn’t heavy, al­though I was noth­ing like as lean as I am now.’ He worked out through­out his adult life – run­ning, swim­ming, bik­ing, cross-train­ing – and later did yoga six times a week, first thing in the morn­ing.

Dr Brandt stud­ied at New York Univer­sity and was due to go into on­col­ogy, but as a ‘very vis­ual per­son’, ob­served the skin man­i­fes­ta­tions of dis­ease and went into der­ma­tol­ogy in­stead.

When Bo­tox first ap­peared in the early Nineties, it was rev­o­lu­tion­ary. Af­ter the peels and col­la­gen in­jec­tions of the Eight­ies, it meant you could ‘do things with­out surgery you couldn’t do be­fore’.

In the Eight­ies, Dr Brandt used retinol and al­pha-hy­droxy creams on him­self. He was well-lo­tioned, us­ing one of his creams to build col­la­gen at night, along with a resur­fac­ing serum, an an­tiox­i­dant cream, and other spe­cial serums for the day.

Did he ever think, let na­ture take its course? ‘Never,’ he said firmly. A good sun­screen is the most im­por­tant thing to use, he ad­vised.

Was he vain? ‘I think ev­ery­one is to a cer­tain de­gree. I don’t think I’m overly vain. My motto is, ‘You want to be the best you can be for your­self’. You can’t com­pare your­self to a movie star; you try to look as good as you can for who you are. That’s what I tell pa­tients.’

Did he think he looked good? ‘Peo­ple are sur­prised by my age, so I guess I’m in good shape.’

But he was at the top of an industry that trades on dis­sat­is­fac­tion with how we look. ‘I don’t re­ally agree with that,’ he said, smile cur­dling. ‘Many peo­ple who have it are happy with how they look; they just want to look bet­ter or more youth­ful.

‘My pa­tients will say, ‘I’m 60 or 70, but I feel the same way as I did when I was 25’. Then they look in the mir­ror and don’t see that per­son. It makes them feel a lit­tle bet­ter to have more bal­ance be­tween their per­ceived no­tion of how they feel and how they ac­tu­ally look.’ A lot of his pa­tients want to re­main ‘com­pet­i­tive in the work­place, es­pe­cially the tech industry, and want to look youth­ful be­cause of be­ing in a youthob­sessed so­ci­ety’.

Dr Brandt in­sisted he doesn’t in­ject peo­ple on com­mand, but judges each pa­tient’s needs. ‘You have to be peo­ple’s mir­rors – their voice of rea­son,’ he said.

He COOED brisk greet­ings to ev­ery pa­tient then swiftly EX­E­CUTED their treat­ments. Hav­ing DABBED the bub­bles of BLOOD away from BOTULIN or filler-in­jected skin, Dr Brandt SMILED at his hand­i­work

Van­ity, he said, isn’t some­thing new. ‘We just have more tools now, and peo­ple are liv­ing longer. I tell peo­ple, ‘This is not a mat­ter of need. This is about choice’.

‘Peo­ple want to look more nat­u­ral now: cheek vol­ume, which I was do­ing 12 years ago, is very pop­u­lar. Peo­ple are very con­cerned about their necks, and fat­ness in them. When peo­ple get older, the fat cells in their cheeks de­plete, so we fill those out.’

Men like to have Bo­tox in the neck to im­prove their jaw­lines. Dr Brandt used an ul­tra­sound tech­nique to tighten skin with­out cut­ting or scars, and the clinic was await­ing ap­proval on a new prod­uct that would be in­jected into the fat pock­ets of the neck, melt­ing the fat and tight­en­ing skin. Lasers were be­ing used more in short pulses to re­ju­ve­nate skin. Dr Brandt imag­ined stem cells would be used in fu­ture treat­ments.

At the clinic, Dr Brandt’s av­er­age treat­ment costs $800-$1,000, and pa­tients come twice a year. ‘It’s not cheap, but con­sider what women spend colour­ing their hair,’ he said. ‘It all adds up.’

Dr Brandt, who was sin­gle, got recog­nised on the streets of New York. ‘I don’t feel as much of a celebrity as ev­ery­one else feels I am,’ he said of his own stardom. ‘I’m a lit­tle bit of a showman. I could be in a clas­sic movie.’

The day we met him, his first pa­tient was in her early 50s and had acne scars. ‘He has the magic touch,’ she said. He in­jected, ask­ing her to purse her lips, frown and re­lax, to mon­i­tor the an­i­ma­tion in her face.

In the next room was a vis­i­bly richer woman in her late 40s. She had been see­ing Dr Brandt for four years, com­ing for treat­ments ev­ery three months. ‘Did you go to Art Basel?’ she asked him.

‘Yes, I bought two paint­ings, in­clud­ing a Ge­org Baselitz,’ he told her.

She was slathered in numb­ing cream to re­duce sen­si­tiv­ity to nee­dles. ‘What’s great about Dr Brandt is that he does less,’ she said. ‘When I came to you, I had had too much.’

‘I evened it out,’ said Dr Brandt, peering through his wrap-around mag­ni­fy­ing glasses. ‘Your lips held up good.’ He be­gan in­ject­ing Bo­tox into her tem­ple and also pulled up her brows. ‘I’m in­ject­ing un­der the mus­cle to lift the whole cheek area,’ he said, ‘re­plac­ing the fat loss there and also pick­ing up the mus­cle to give it a beau­ti­ful con­tour’.

The next pa­tient was ready, a skin can­cer sur­vivor. ‘I’m a jew­ellery de­signer, I’ve been do­ing it 57 years, and I still love it,’ she said. ‘Jane Fonda is my age. How come she looks so per­fect? Is it hered­i­tary?’ She looked in her 70s, and was dry and funny.

‘Of course I’m fright­ened,’ she told Dr Brandt about her im­mi­nent, first Bo­tox treat­ment. ‘I want to be able to smile. You’re the artist. You come highly rec­om­mended. All my friends swear by you, so here I am.’

He started in­ject­ing her around the lips. Filler will be put into sunken cheek pads.

As with all the women that morn­ing, part of us wanted to tell her she looked fine. Our ap­pear­ance-crazy, ageing-fear­ful world is mad and the clinic was the man­i­fes­ta­tion of that. But Dr Brandt’s work was deft and its re­sults – if that was what you are af­ter – were im­me­di­ately vis­i­ble.

‘I think this is go­ing to ex­ceed your ex­pec­ta­tion,’ said Dr Brandt to the woman. ‘Oh, it’s phe­nom­e­nal,’ she

said. She looked at us. ‘You can use my name. I’m proud to be here.’

Carol Dau­plaise was 76. ‘I am go­ing to tell ev­ery­body I did it,’ she said of this de­but treat­ment.

Will we ever fall out of love with Bo­tox? ‘I think peo­ple want to look nat­u­ral,’ said Dr Brandt. ‘Our catch­phrase is, ‘Fab­u­lous, not frozen’.’

The next pa­tient was 57, with great, smooth skin and no vis­i­ble sign of any­thing either need­ing to be done, or hav­ing been done.

She was hav­ing Bo­tox for the first time. ‘I orig­i­nally came for smile lines, which I haven’t seen since,’ she said. ‘He al­ways leaves me look­ing nat­u­ral.’ Do her loved ones no­tice? ‘Not at all. My part­ner of 11 years doesn’t know I do this.’

Dr Brandt started jab­bing filler into the woman’s cheek pads. Then came the Bo­tox into the fore­head and brows. Jab, jab, dab, dab and she was done. And off he went into the next room down the long, nar­row cor­ri­dor. ‘How are you? What are we do­ing to­day?’

He may not have been the first to use Bo­tox cos­met­i­cally (rather than med­i­cally, where it had been de­ployed to treat palsies and the like), but Dr Brandt was the first to use it aes­thet­i­cally. His pi­o­neer­ing work back in the early Nineties spawned an industry that Amer­i­cans clutched to their ar­ti­fi­cially in­flated bo­soms.

Celebri­ties who have ad­mit­ted try­ing Bo­tox but have now stopped in­clude Gwyneth Pal­trow and Ni­cole Kid­man. ‘I did try Bo­tox, but I got out of it and now I can move my face again,’ Ni­cole Kid­man told a reporter in 2013.

But even to­day, the Bo­tox busi­ness re­mains a gold mine. Ac­cord­ing to the Amer­i­can So­ci­ety of Plas­tic Sur­geons, Bo­tox was the No. 1 min­i­mally in­va­sive cos­metic surgery tech­nique used in the US last year with 6.7 mil­lion pro­ce­dures per­formed, up 6 per cent from 2013.

Next in line were fillers at 2.3 mil­lion pro­ce­dures, up 3 per cent from 2013. Dr Brandt was the colos­sus who be­strode this lu­cra­tive industry.

Yet while his work was cel­e­brated for its nu­ance, the cow­boys who came af­ter him were not so discerning.

By the time Bo­tox reached the UK in the late Nineties, it was viewed as the pre­serve of so­cialites with hair big­ger than their brains, ladies who lunched de­spite dif­fi­culty open­ing their mouths and celebri­ties who were happy to look rather odd. ‘Early, clumsy prac­ti­tion­ers just wanted to kill the line,’ re­calls the Lon­don Bo­tox guru Dr Michael Prager.

When Bo­tox first be­came a phe­nom­e­non around 2000, peo­ple who had early, crude Bo­tox looked star­tled and an­gry, ac­tu­ally older. Pun­ters were promised lunchtime facelifts in the wake of which their fea­tures would stiffen into as­ton­ished im­pas­siv­ity, with per­ma­nently raised eye­brows the alarm­ing give­aways. Fa­cial­ists did it, den­tists did it and women had it done while re­lax­ing at par­ties.

Film di­rec­tors com­plained that a gen­er­a­tion of ac­tress had sprung up who were sud­denly un­able to emote, their fore­heads flatly, shinily and ul­ti­mately very spook­ily de­void of ex­pres­sion. Yet, among nee­dle acolytes, a dys­mor­phia set in: no face was con­sid­ered too bizarre so long as there was no hint of a wrin­kle.

‘Look around Lon­don res­tau­rants to­day and the rich­est women still of­ten look the weird­est,’ sighs Dr Prager.

Once they’d ren­dered their fore­heads ric­tus, the rich then sought to re­store a youth­ful vol­ume to the face, lead­ing to sus­pi­ciously puffed-out filler faces. Fillers, skin-plump­ing bursts of hyaluronic acid, ac­tu­ally pre­ceded Bo­tox, but did not be­come ob­vi­ous – very ob­vi­ous – in their us­age un­til Bo­tox was mak­ing head­lines.

First came the trout pout, where the up­per lips were grotesquely over-plumped. Then came pil­low faces, where the jux­ta­po­si­tion be­tween anorexic bod­ies and painfully in­flated chip­munk cheeks made cer­tain celebri­ties look as if they were stor­ing nuts and berries for win­ter.

‘The prob­lem,’ says Dr Prager, ‘was a filler pop­u­lar be­cause of its long-last­ing ef­fects. Pa­tients al­ways want to know how long it will last. Well, it lasted a long time, but it also gave you cheeks like golf balls.’ He, as Dr Brandt did, favours a thin­ner prod­uct that he ap­plies in tiny mea­sures and which re­quires more fre­quent top­ping up. The ef­fects make grown women go pos­i­tively dreamy.

Op­po­nents may protest that there has been a Bo­tox back­lash – ac­tresses in par­tic­u­lar feel­ing the need to in­sist that they would never do it – but who are they try­ing to kid? Bo­tox is more pop­u­lar than ever.

A re­cent UK gov­ern­ment re­port on the Bri­tish cos­metic surgery mar­ket stated: ‘The value of the UK cos­metic pro­ce­dures mar­ket is grow­ing. It was worth £2.3 bil­lion [around Dh13 bil­lion] in 2010 and it is es­ti­mated that it will grow to £3.6 bil­lion by end of 2015. Non-sur­gi­cal pro­ce­dures ac­count for 75 per cent

of this to­tal.’ It’s just in­jected so deftly, in the man­ner of Dr Brandt’s work, that users can deny hav­ing had it.

For the great ma­jor­ity of fa­mous names that cov­eted the nat­u­rally rested look in­cludes a de­gree of nat­u­ral-look­ing work.

Newby Hands, the con­tent di­rec­tor of feelunique.com, is in her late 40s and re­fresh­ingly hon­est about her ap­proach: ‘I still do Bo­tox, but I do it in a re­ally dif­fer­ent way to how I used to. I have baby Bo­tox, which is ba­si­cally a di­luted form, be­cause I like to be able to move my face.

‘The der­ma­tol­o­gist Dr Nick Lowe once said that pa­tients are happy when he can stop their sub­con­scious move­ment but still have con­scious move­ment and I agree. So I can raise my eye­brows, but I don’t sub­con­sciously frown while talk­ing to you. Women want their chil­dren to be able to see when they’re happy or an­gry. This is a pop­u­lar ap­proach in Bri­tain.

‘Plus I don’t do it too of­ten be­cause – like ev­ery­one – I got scared by those big, shiny, frozen fore­heads. I saw a former in­tern of mine the other day and thought it couldn’t be her be­cause she looked so old. She’s 30 but she’s so frozen she looks like some­one of 40.

‘As a pa­tient you have to get in­volved, talk about how the last lot went. It’s not an ex­act sci­ence, mean­ing it’s not the same ex­pe­ri­ence ev­ery time. You can’t be pas­sive.’ Hands sees Dr Anne Men­de­lovici at Dr Se­bagh’s Clinic in Lon­don and also rates Dr Jules Na­bet of Kens­ing­ton.

In Dr Prager’s wait­ing room one sees ac­tresses, busi­ness lead­ers and cul­tural fig­ures, but also a good many ‘civil­ians’, male and fe­male. For them, see­ing a good Bo­tox prac­ti­tioner is as un­con­tro­ver­sial as see­ing a good den­tist – some­thing you do to smarten your­self up with­out be­ing ob­ses­sive about it.

This is where such treat­ments are now. In a sense, Dr Brandt’s pro­fes­sional legacy had fi­nally come of age. Dr Prager, who is al­ready be­sieged by clients from as far away as Aus­tralia, is viewed by many as the Amer­i­can’s nat­u­ral heir. The good doc­tor is far too dis­creet to con­firm this but I would be sur­prised if the phone to his Wim­pole Street surgery were not en­gaged con­stantly as news of Dr Brandt’s demise broke. Af­ter all, the cult of youth isn’t go­ing away. As Dr Brandt said last year, ‘Bo­tox is here to stay.’

Strangely Dr Brandt con­sid­ered his ageing and mor­tal­ity keenly since he was a child. ‘I ac­cept it as an in­evitable part of the life cy­cle. Ageing doesn’t scare me: I’ve passed the scare point.

‘We’re all go­ing to die. I just wouldn’t want to be in a nurs­ing home. I want a quick death, to die in my sleep. It would be ter­ri­ble not to be able to do what you like to do. It’s just not liv­ing.’

He said he’d like his own beauty TV chat show. He seemed so cheer­ful. ‘Peo­ple say I’m al­ways happy, but I say no­body is al­ways happy.’ But he knows how to put on a nec­es­sary act. ‘Laugh and the world laughs with you. Cry, and you’ll cry alone.’

For ‘civil­ians’, SEE­ING a good Bo­tox prac­ti­tioner is as NAT­U­RAL as see­ing a good den­tist – some­thing you do to SMARTEN up

Dr Fredric Brandt did Bo­tox twice a year

A lot of Dr Brandt’s pa­tients wanted to look youth­ful in a youth-ob­sessed so­ci­ety

Madonna has spo­ken glow­ingly of Dr Brandt’s abil­ity to turn back time for ageing women Ac­tresses such as Gwyneth Pal­trow and Ni­cole Kid­man are former Bo­tox users

Many users pre­fer a deft, more di­luted touch, so they can deny hav­ing had any work done at all

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