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About-Face

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{Figs. 26 and 27} The Jolie Nose   

Dr. Fredric Brandt is routinely described in the press as Madonna’s dermatologist, though neither Liz Rosenberg nor Brandt would confirm it. One Friday morning I meet him at his offices on 34th Street. Hanging on the wall just outside his door is a giant framed photograph by the fashion photographer Steven Klein. In the foreground a toned, tanned, naked man lies out by the pool while, unbeknownst to him, Dr. Brandt, holding aloft a giant needle, lurks in the background, ready to sneak up and inject the unsuspecting hot guy (and perhaps … paralyze him! Bwah-ha-ha-ha-haaa!).

Brandt, who clearly enjoys evincing a clownishly “sinister” Dr. Evil–meets–Pee-wee Herman persona, is dressed like Simon Le Bon circa “Hungry Like the Wolf”: black parachute jacket, white shirt with big silver zipper, pointy black shoes, pegged black high-waters. His face is a smooth, frozen mask that juts outward and is a very extreme example of the New New Face—not a single line, wrinkle, or variation in tone. But it is the shape of his face that I recognize. It has the same inverted triangle shape as Madonna’s face and Naomi Campbell’s face. When he tells me that the superstar hairdresser Garren is a client and that he knows fashion photographer Steven Meisel, I begin to realize that he’s hooked into a certain crowd of people who are all connected by one degree. It is not hard to imagine that some patient zero told two friends about Brandt and then they told two friends and now many of them have a variation on the same face.

“What we notice when people age,” he says, “is that our fat pads start falling, the cheeks start dripping down, and we start losing volume in the upper face and it causes sagging in the lower face. You lose what we call the ‘youthful convexities’ of the face. And the convexities are the fullness and the roundness. And they get broken up into uneven planes. Instead of being one smooth convex plane, it becomes hills and valleys.” He pauses for a moment. “God, I wish I had my slideshow.” Then he points to his 29-year-old publicist, who is sitting silently in a chair off to the side. She is very pretty. “She has the fullness, and she has these beautiful, even, uninterrupted cheeks. And if you take a look at me—because I freely admit that I do all these things to myself and have injected myself completely—I have restored the volume to this portion of my face.” He is now touching his cheeks and under his eyes. “You can see, even though I’m not her age (he is nearly 60), I have the same type of convexities throughout here and in my cheeks. A face-lift is good for tightening, but it doesn’t do anything for volume loss, and a lot of people still don’t understand this concept.”

When I ask how much of the new aesthetic is dictated by his ideas of beauty, as opposed to advances in technology, he says it’s a combination. “I always believe more,” he says, laughing. (Bwah-ha-ha-ha-haaa!) “A lot of people start off very gradually, and then they end up seeing the light.”

It is not easy to get an appointment to see the Great Pat Wexler, Wizard of Injectables, Queen of Volume, Mother of the New New Face. I had been told by a socialite friend (in her late thirties and “loving Restylane”) that Wexler’s waiting room is “like one big cocktail party” where “the Calvin Kleins and the Carolina Herreras and the Vera Wangs” all bump into each other all the time. Wexler, who opened her practice 22 years ago, gets credit as a New New Face pioneer because she intuited that volumizing was the future: injecting and filling the face with either fat from the patient’s own body, collagen, or synthetic fillers, instead of stretching the skin tight over all that sagging infrastructure.

“That’s what I call the Beetlejuice phenomenon,” she says when we meet. “You keep pulling and pulling, and your head gets smaller, and your body gets bigger as you age, and so you wind up with this little head on this big body. But we now know that you need volume to keep a face looking young. Volume means a face that goes out. And it’s all about the cheeks and the jawline.”

When I tell her that making the face bigger or “fatter” seems counterintuitive, she says, “I know, that’s why no one was doing it twenty years ago.”

“How did you figure it out?” I ask.

“Because I was doing lipo and I don’t like to throw anything away.”

Wexler herself is a vision of creamy-white linelessness. With her super-skinny jeans, stilettos, and poker-straight fire-red hair, the 56-year-old doesn’t look a day over Miley Cyrus. She comes across as a thoughtful empath, a disposition that makes you feel like she will be careful when she liposuctions fat out of your butt cheek and injects it into your face. Her gaze is so steady that she puts me into a trance—though I snap out of it just before she can talk me into “some fillers around the cheeks for some volume that will lift your whole face and a little Botox to lift your jawline.”


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