Would you buy a new face from this man? Dermatologist Dr Frederic Brandt. Photograph: Phillip Toledano
Dr Frederic Brandt has several claims to fame. He is, for instance, the largest user of injectable collagen and Botox - in the world. 'I just love fillers!' he tells me. And how. When we meet at his New York clinic he wastes no time in revealing that he regularly injects himself.
'The last session I did was six-and-a-half vials!' His face is a smooth, jowl-free mask. Imagine a tub of frozen yoghurt, not a single line or wrinkle. He is cosmetic medicine's Peter Pan.
In fact, in the 25 years since he began practising (Brandt set up shop in 1982 after completing both an oncology and dermatology residency at medical school in Philadelphia) he has personally tested every procedure and product he uses in his clinics - on himself.
All of which has made the 59-year-old Brandt surreally young-looking, and very rich. He is the Baron of Botox, the King of Collagen. His clients pay up to $7,000 for a full face of injections and come to him from all over the world, some as often as six times a year.
Now he's becoming increasingly well known as the doctor behind the 'New New Face'. He specialises in what's called the Y Lift, where filler is injected into the area just below the cheekbones. Ten years ago women wanted their cheeks and foreheads to be pulled, stretched and tightened, like vacuum-packed pieces of steak. These days they arrive in his consulting rooms demanding something more youthful and plush. Think of a plumped-up cushion. Out with pinched, in with peachy. There's a new face around - and it's a baby's.
Jonathan Van Meter, a writer at New York magazine and US Vogue, blames fashion and celebrity glossies filled with images of teenagers for the New New aesthetic. 'Their faces are plump and dewy and flushed with youth. As thin as their bodies are, they still haven't entirely shed the baby fat on their faces. This is what women in their forties and fifties are now after: baby fat.'
The idea that New York women want to make their faces fatter seems counter-intuitive when they're in a desperate battle to get the rest of their bodies, from the neck downwards, down to a Hot-Box-yoga-honed, 800-calories-a-day size zero, but the current theory is that what they need to keep their faces looking young is volume.
Someone like Cher, according to Van Meter, is the essence of the old way of doing things: tight skin, trout pout, skinny nose. On the other hand, Demi Moore epitomises the New New Face - youthful skin, defined cheekbones and chin, heart-shaped face. Industry insiders report that in MST (Movie Star Time) clients want to look the way they did four films ago - or about eight years in RPT (Regular People Time). As Van Meter quips: 'The New New Face is really your old face.'
They may say their dewy glow is all down to healthy eating and exercise, but increasingly it's more likely due to a new regime of fillers and injectables. In the US, there has been a 754 per cent increase in the number of non-surgical procedures since 1997 compared to a 114 per cent rise in surgery. Dermatologists are the new glamour doctors and Dr Brandt is one of the biggest players, with two clinics - one on East 34th Street in Manhattan, the other in Miami; two best-selling books including Ten Minutes/Ten Years: Your Definitive Guide to a Beautiful and Youthful Appearance, and a successful anti-ageing skincare range that is sold in 40 countries.
We meet at the beginning of a typical working day - 27 clients, 10 hours, seven consulting rooms. Brandt, who gets up at 6.30am, has already done an hour and a half of Ashtanga yoga. Hanging on the wall just outside his office is a giant framed photograph by the fashion photographer Steven Klein. (Brandt is a fan of contemporary art. His collection includes Richard Prince, Damien Hirst, Gilbert & George.) In the foreground, a toned, tanned, naked man lies by a pool while lurking in the background is Dr Brandt himself, wielding aloft a giant needle.
'What can we do for you today?' Dr Brandt asks a New York society hostess, who has homes in Manhattan and the Hamptons. She is, I estimate, about 50, dressed in a navy ensemble of Chanel cardigan, capri pants and ballet flats, and a diamond ring the size of a golf ball.
'I'm a mess,' she mumbles out of the side of her mouth, which she can barely move due to the anaesthetic cream smeared all over her face.
'I've been under such stress.' Her skin - or what I can see of it beneath all the gloop - looks great to me, much better than mine, but she is adamant that she looks awful: 'Make me look younger! Lift me up! I have to be in a photo shoot on Wednesday.'
Brandt starts on her cheeks with Perlane, a favourite filler of his because it gives volume to the mid-face and jaw (it is a hyaluronic acid, made from the by-products of the fermentation of strep bacteria). 'It's all about having those convex surfaces to reflect light,' he trills.
Each time the Perlane is squirted into the apple of the cheek the tissue puffs up a little and a bright spot of blood oozes out. This is dashed away with a wad of surgical tissue. Squirt. Puff. Squirt. Puff. Chanel lady's cheeks inflate like a bicycle tyre.
'Oooh, that looks fabulous,' Brandt says, admiring his handiwork. 'Am I right?' Yes, yes, I say. She does look fabulous, in a slightly disconcerting way - the image of a Hitchcock blonde with bruised cheeks.
Brandt's assistant, dressed in the staff uniform of black scrubs, passes another hypodermic needle, and Brandt injects amounts into the fine lines under the eye. Zap - a line disappears. Zap. There goes another. Now the Cosmoderm comes out, a collagen used to combat the very fine feather lines that form in the naso-labial area of the face. On and on it goes.
'How about the lips?' he inquires.
'I'm so afraid of looking puffy,' she says.
'OK, just a little then.' Brandt squirts Juvederm around the lips just above the vermilion border.
'I don't tell anyone, not even my daughter,' the grande dame reveals, shooting me a look as she clasps a Latex glove containing frozen peas to her bruised cheeks. 'My fiancé, who is 16 years younger than me, said, "You wouldn't put that stuff in your face, would you?"' She denied it. 'I don't mind getting older....' She tells me. 'As long as I don't look it.'
Now it is time for the big guns: Botulinum toxin, better known as Botox, one of the most powerful nerve poisons known to man. Brandt uses so much of it he calls it Bo for short.
'Frown, relax, frown, relax,' he instructs, injecting between her eyebrows and then along the imperceptible furrows of her forehead. There's a pause as he reloads with more ammunition.
'What happened to Jocelyn?' asks the grande dame in a regretful tone of voice, referring to the ex-wife of the art dealer Alec Wildenstein whose face was made so unrecognisable by surgery that she is now known as 'the Bride of Wildenstein'. 'She's so intelligent. Why did she do that to herself? She was so beautiful.'
'People don't see themselves,' Brandt sighs, without irony, jabbing more Botox into the taut muscles of her neck and grimacing as he pulls out the needle. 'It's the same as anorexics. They don't see themselves.'
Chanel lady concurs. 'They become obsessed.' Later, I discover she is, incredibly, 70.
In a break between clients Brandt snacks on spinach and beans. His father owned a sweet shop in Newark, New Jersey, and died early from juvenile diabetes at the age of 47. His son, too, used to have 'the worst sweet tooth' until as an adult he decided to wean himself off sugar by embarking on a programme which has been so successful he has never come off it. It is a diet completely devoid of sugar, wheat in any form, any grains with gluten, yeast, juice, dairy, root vegetables, and most fruit, and he recommends you try it.
He's wearing a grey and black Prince of Wales check jacket, nipped in at the waist; white Dolce & Gabbana shirt covered in zips; olive green designer camouflage pants; blinding metallic Gucci sneakers; and purple Alain Mikli glasses that offset his blond hair. It's an outré get-up that chimes with his uncannily youthful complexion.
When, I ask, did he first start using Botox on his clients? 'In the early Nineties.'
How often should clients see you? 'Injectables are recommended every four to five months.'
How young is the youngest person he has seen? 'Probably early twenties,' he says. 'I think in the mid-thirties most people start showing their age.'
How about reports of the dangers of Botox? 'Perfectly safe.'
At what point does he think having cosmetic procedures can go too far? 'When it's your only focus. When it becomes not a part of your life but your entire life. Instead of enhancing your life, it takes over your life. Ready to go?'
Brandt is off again, skipping like a mountain goat.
The next client is a chic, fine-boned wife and grandmother who divides her time between a house in Palm Beach and an apartment in New York. She has been a Brandt client for two years.
'I'm seeing the ex-husband on Saturday, so we don't want bruising,' she teases Brandt, smiling through the anaesthetic. (This can be a teeth-grittingly painful procedure. Bruising can last anywhere between two days and two weeks.) Dressed in black skinny jeans, Chanel cardigan, white sneakers, her YSL bag on a nearby chair, she looks the picture of a youthful fiftysomething. She tells me she is 65. I nearly fall over.
Brandt begins by injecting Perlane into her cheeks. 'This is what we're using to add volume and it pulls the whole face up. You can see that, right? It gives volume to the jaw.'
I ask her how often she sees Dr Brandt. 'I come more often than most because I'm a little more vain,' she says. 'I've had plastic surgery. With surgery the ageing process still continues. I think this keeps you looking like you did when you first had plastic surgery, kind of fresh. It's a perfect way to maintain your appearance. It's so natural-looking.'
'Your lips are holding up great,' Brandt says as he reaches for the Cosmoderm.
Do the needles hurt? I wonder. 'My husband always asks that,' she replies. 'I tell him, "However much it hurts - it's worth it".' Why did she start? 'You think you look fine, and then one day your hair is white, and you have a cold and you're wearing no make-up, and you walk into the bakery and they ask you if you have ARP [the US equivalent of qualifying as an OAP].'
According to Brandt, what we notice when people age is the fact that their cheeks start dripping down, and they begin to lose volume in the upper face which causes sagging in the lower face. We lose, he says, our 'youthful convexities'. What he means is that instead of having beautiful even uninterrupted cheeks, our faces end up as a series of hills and valleys. 'A facelift is good for tightening but it doesn't do anything for volume loss.' Which is where the New New face comes in.
Next door a pretty thirtysomething New York career girl is waiting for Brandt in a state of panic because her skin has been frozen by Botox, the result of visiting another dermatologist.
'I can't feel my eyebrows,' she wails. Her forehead is completely unlined, like a block of ice. 'I can't inject anything to take it away,' Brandt says sadly. 'But eventually the movement will come back.' He lifts her brows slightly with a couple of judiciously placed Botox injections and tells her to be patient.
Next we see a 50-year-old New Yorker, who has had a full face and neck of injections from Brandt and looks completely overdone, her lips verging on the trout pout. 'I always tell him, "Do it more!" she says. 'But that's just my personality.'
And after her we see a 26-year-old brunette from Miami who in my opinion shouldn't have been let within 10 miles of a cosmetic dermatologist's office. Tanned and eager, she holds a hand mirror two inches from her nose throughout the 10-minute session.
'Ooh, I've never had that before!' she exclaims as Brandt uses filler on her jawline. 'Awesome. I'll get hooked. Ooh, you're so good.'
Wasn't she too young? I asked Brandt afterwards. 'She had some fine lines around her lips,' he shrugs.
Later we enter the room of a woman who is one of Brandt's most devoted clients. A very attractive 49-year-old wife and mother, she flies from Switzerland to New York six times a year to see him.
'Two-and-a-half years I'm coming,' she says, eyes shining. 'She's got a lot of air miles,' Dr Brandt says, smiling. He's using an Aluma laser on her décolletage, a non-burning laser that sucks up the skin and makes it contract, which stimulates the production of more collagen.
'Ooh, look at that!' he says, hoovering her skin. 'I'm going to throw you off that chair and put myself on.'
I ask her why she first decided to have cosmetic procedures. 'It's just a thing in your life,' she says, with some drama. 'You reach a certain age. It's not that we're just stupid chickens with too much money who want to look 20 or 30 years old again. It's not that your husband or your boyfriend or whatever is losing interest. There's just a point, it comes for every woman, when you reach a certain age, and the skin looks wrinkly and suddenly you're miserable. For beautiful women, this is hard.'
She pauses for a minute. 'My mother, somehow she looked like she gave up on her life. She just did needlework and made tea. Suddenly she was closed and stopped socialising. I think surgery is a big risk, so I had to decide [whether or not to get fillers]. I would never change my doctor now.'
She beams at Brandt. 'He listens to you. This makes you feel so good. You know, I have two children. My son and his friend were over and his friend said, "You have a very young mother". I felt wonderful!'
How Dr Brandt's clients love him. As he races, sneakers flashing, between his brightly lit examining rooms you can almost feel the place throbbing with desire. You begin to see why people call this the female yuppie heroin. Every woman I see leaves his office with a beatific smile on her face, as if she was in the throes of a grand passion. It may be calamitous on the bank balance, but is it so morally reprehensible? I begin to wonder if just a little judiciously placed Botox might not be a good idea, after all.
Between clients, I ask Dr Brandt for an assessment of my own 40-year-old skin. How would I get the New New face? 'I think you need to take care of your skin,' he says, 'make it more radiant. I think you need some volume in your cheeks,' he continues. 'And under your eyes and around your eyes.' He thinks for a minute. 'And then we could do some Botox around your eyes and your forehead... And fill in your cheeks where they're getting hollow. Those can be filled in with collagen.' He thinks again. 'And then we could do some laser treatment.'
To say I was despondent is an understatement.
It's 6.30pm. Among Brandt's last patients of the day are a husband and wife who sit swathed in white blankets with white anaesthetic on their faces, a slightly nervous air about them. A handsome couple, they are both successful - she is a colourist at a leading New York salon; he owns a furniture shop in SoHo.
'How long have you two been married?' Brandt asks, skipping about the room.
'Nineteen years,' the husband says.
'Where do you get your energy from?' he asks Brandt, who is now singing 'Younger than Springtime'.
'Not really from my mom or dad. But I was always a little different in my family. Everyone was quiet and reserved and there I was, putting on those Broadway plays in the living room!'
More syringes come out for the wife, who is now wincing a little from the pain. I mention that I had witnessed one client that day, a yoga fanatic, whose pain threshold was so high she didn't have any anaesthetic cream.
'Wow, no anaesthetic?' they both say, horrified.
'When I inject myself I never numb,' Brandt chimes in. The last session I was six-and-a-half vials! I think I'd better stop!' Brandt is hitting his stride now. 'I always say, it's lucky I work here or I'd need to go on a payment plan!'
The husband climbs up on the chair. 'You look like a schoolboy now!' says Brandt, syringes flying. 'You know,' he adds, 'I always say, this is the only doctor's office where if you can't move, you're happy.'
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