The Baron of Botox Is Gone, But His Face Lives On
Dr. Fredric Brandt redefined cosmetic dermatology forever by bringing a smooth, plump, and ageless face to the masses
When socialite and former model Aviva Drescher learned in the fall of 2011 that she had been cast on season five of The Real Housewives of New York City, she was eager to put her best face forward. “I knew I was going to be on a reality television show, and I had just heard about the fantastic and extraordinary Fred Brandt. If I was going to be on TV, I really had to go to the best of the best,” she said. Like anyone who sought an appointment with the dermatologist known as the “Baron of Botox,” Drescher called in a favor. When she arrived at Dr. Brandt’s pristine offices on the far side of East 34th Street, an intentionally unchic part of Manhattan where patients were less likely to run into acquaintances, she did what everyone who went to see Dr. Brandt did: She waited, sometimes for hours.
An appointment with the man who had personally perfected the faces of celebrities like Madonna, Gwyneth Paltrow, and Kelly Ripa was well worth it — as was the cost, which could easily exceed $7,000 in a single visit. Drescher soon became a devotee, regularly allowing Brandt to determine where, and how, her face could benefit from a vial of Botox — or, as the doctor lovingly called it, “a bissel of Bo.”
Americans spent more than $16.5 billion on cosmetic procedures in 2018, but when Fredric Brandt first opened up shop in the early 1980s, there were few alternatives to going under the knife. Botox, a nerve-freezing substance originally used to alleviate twitchy eyelids, became Brandt’s paintbrush, a way to gently redesign a face by manipulating the muscles under the skin. What he was able to achieve over the course of his 35-year career wasn’t just a new way to use Botox and fillers—it was a new way to talk to women about what they saw when they looked in the mirror. Fred Brandt took the once-dirty desire to look beautiful and rebranded it as an appropriate and acceptable form of self-care.
“Nobody wants to look older than their age, and no one wants to grow old gracelessly,” said Linda Wells, the founding editor of Allure and a longtime Brandt client. “We all knew what we were getting into by going and getting these things done, but Fred managed to make everybody feel like this was normal.”
The Baron of Botox: Easter Sunday | Chapter 1 on Apple Podcasts
On April 5, 2015, cosmetic dermatologist to the stars Dr. Fredric Brandt is found hanging from an electrical cord at…
A visit with the Baron of Botox was a cross between therapy and theater. He listened when a patient had a personal problem and was always empathetic. To distract from the discomfort of needle sticks, he sang show tunes and made jokes, often smothering the punchline with his warm, honking laugh. He would examine each face before he began his work, perhaps injecting the vertical lines between the eyebrows with Botox before switching to a filler like Restylane or Voluma, which he would place just so below the brow to lift and open the face. Unlike the “rootless exoticism” of today’s Instagram Face—a flattened, poreless look inspired by celebrities like Bella Hadid and Kendall Jenner—Brandt favored refined features that enhanced an individual’s face without any overt suggestion of intervention. Aviva Drescher, who has platinum-blonde hair and round, high cheeks, already resembled Grace Kelly. After a few well-placed injections from Brandt, even her husband thought she looked like a prettier version of herself. “Fred really looked at me as though I was a work of art,” she said. “And he was going to improve me.”
Brandt was also obsessed with the physiology of beauty. He would frequently experiment on his own face, injecting Botox into his neck or placing dots of filler under his cheekbones, staring in the mirror until he was satisfied. Then he’d fill the wastebasket with empty syringes and bloody gauze and go to bed. “He didn’t do to his patients whatever he was doing to himself,” Drescher said. “He wanted perfection,” said his friend and celebrity hairstylist Garren Defazio. “Everything he did was to be perfected.”
Fredric Sheldon Brandt was born on June 26, 1949, in Newark, New Jersey, the second son of Esther, a bookkeeper, and Irving Brandt, a veteran who had served as a private first-class during World War II. Together, the Brandts ran a candy store in the predominantly Jewish neighborhood of Irvington, a few miles outside of Newark. The candy store, and young Fred’s affinity for sweets, would later serve as anecdotal fodder for his famously disciplined lifestyle. He wrote in his 2007 beauty guide, 10 Minutes/10 Years, “My father was a diabetic who didn’t take care of himself or modify his diet as well as he could have, and he died way too young from renal failure.” Irving Brandt passed away in 1965 when Brandt was only 15 years old; his mother died just six years later, leaving 22-year-old Fred to fend for himself.
In high school, Fred — or “Freddy,” as he was known then — was in the debate club and on the political science team. “He was very bright,” recalled his former classmate Alvin Felzenberg, who played Brutus to Brandt’s Julius Caesar in sixth grade. “I’m sure he had straight As. I’d be shocked if he had an A-minus or a B-plus in anything.” Freddy was also private, avoiding his classmates’ questions about his family. “There was a general sense among those close to Fred that the household he grew up in was not a very nurturing one,” Lili Anolik wrote in a 2015 Vanity Fair profile of Brandt after his death. “He didn’t want anyone talking about his family — ever,” Felzenberg said.
If young Brandt was at odds with himself, his senior portrait from 1967 doesn’t betray it. In the photograph, 17-year-old Freddy wears a white button-down and black bowtie; his brown hair is neatly parted. His lips, closed in a small smile, are naturally and attractively plump. The accompanying text notes his “infectious grin and good sense of humor” and predicts a “medical career ahead.” Decades later, as Fred tested the boundaries of his natural bone structure, his features morphed into something more angular and modern. In 2014, he told the New York Times that people often asked whether he was from Sweden. “Actually,” he’d say, “I’m a Jewish kid from Newark.”
After graduating from Rutgers and then Hahnemann Medical College in Philadelphia, Brandt moved to New York City, where he completed his residency in internal medicine at NYU in 1978. It was during this time that he met an oncology nurse named Karen McDonald, who remembered him as prematurely bald, “schleppy,” and uncomfortable in group settings. “He was like a little mouse,” she said. “It didn’t even occur to me that he might be gay.” In 1978, Brandt moved to Florida to complete a residency in dermatology at the University of Miami. “I remember thinking, ‘That’s perfect for him,” McDonald said. “He can study his lesions and have a quiet life.”
“We all knew what we were getting into by going and getting these things done, but Fred managed to make everybody feel like this was normal.”
In the early 1980s, cosmetic dermatologists were mostly skin cancer specialists, mole removers, and pimple interventionists. During a time when people still smoked on airplanes and considered bronzed skin a sign of good health, Fred Brandt was hiding from the Miami sunshine and admonishing friends for tanning with baby oil. He began living with a young male dancer, but the romance was short-lived. By many accounts, Brandt never found himself in a serious relationship again. Instead, he surrounded himself with people who were the best in their fields — aesthetes, like himself, who valued their career and lifestyle over family. Brandt also began collecting art; early acquisitions from Marilyn Minter, Richard Prince, and Christopher Wool were “a way of keeping score, of being a trendsetter,” said Paul Frank McCabe, his personal art dealer. “To him, the aesthetic interaction, the living with it and being excited by it, was more important than the cash.” Brandt’s sexuality, though not a secret, was rarely discussed. “He definitely had some romantic interludes or involvements, a couple of which ended in a hard way for him,” said Jonah Shacknai, former CEO of pharmaceutical company Medicis, which distributed the filler Restylane. “Had he been born 20 years later, he would have lived a very different life.”
Brandt was undeniably beholden to the ideals — and the limitations — of his postwar generation. He grew up during the golden age of Hollywood, when studios had a stronghold over their stars and plastic surgery made its bombshells appear more blue-blooded. Brandt’s most famous faces shared the unmistakable contours of beauties like Bette Davis, Judy Garland, and Rita Hayworth, who reportedly had her hairline raised to obscure her Latina roots.
At the beginning of his career, in the 1980s and early ’90s, plastic surgery was the domain of the famous and conspicuously wealthy. Robbie Myers, the former editor in chief of Elle, remembers a dermatologist telling her how to recognize the handiwork of a certain plastic surgeon. “They wanted people to know they’d been to this Upper East Side doctor. They didn’t mind that it was obvious they’d had work done. His ‘look’ was a sign of status — like having an Hermès bag.” Brandt preferred not to leave a trademark. “My goal isn’t to make you look like you’ve had obvious work done. My goal is to make you look younger,” he wrote in 10 Minutes/10 Years. “What ages you the most… is a loss of volume. Fillers replace that lost volume. A face-lift takes it away.”
In 1980, the year Brandt became a board-certified physician in Miami, Dr. Alan B. Scott published a study on the effectiveness of injecting botulinum toxin to alleviate crossed eyes and eyelid spasms in humans. In 1989, the FDA approved Botox for ophthalmological use; two years later, Vancouver doctors Jean and Alastair Carruthers noticed that their patients enjoyed the wrinkle-erasing effects of eyelid injections. They presented their findings to the American Society for Dermatologic Surgery in Orlando in 1991. Jean later told Reader’s Digest Canada that medical friends considered it “a crazy idea going nowhere.” Brandt, who had been lecturing all over the world on the effectiveness of injecting collagen to erase wrinkles and fill lips, began to focus his efforts on the cosmetic application of Botox. (Though the FDA doesn’t endorse off-label usage of approved substances, it isn’t responsible for how doctors administer them.)
During a time when people still smoked on airplanes and considered bronzed skin a sign of good health, Fred Brandt was hiding from the Miami sunshine and admonishing friends for tanning with baby oil.
If you didn’t want to go under the knife back then, the only available cosmetic treatments were dermabrasion — a treatment that left a patient raw and wrapped in bandages — chemical peels, or microdrops of silicone, which were notorious for hardening under the skin. There was no such thing as volume-recapturing “filler.” Sculptra, the first product approved by the FDA to combat HIV-induced facial wasting, wouldn’t come to market for another 20 years. A dermatologist colleague who met Brandt back when they were both starting out described their early clientele as either “very wealthy” or “crazy.” In women who wanted to improve their appearance without having to cop to it, Brandt had stumbled upon an underserved and lucrative demographic.
Linda Wells didn’t hear about Botox until the mid-1990s — several years after its cosmetic benefits were discovered. “There was a lot of negative stories, a lot of bad news, a lot of skepticism and danger attached to the whole idea of injecting your wrinkles, and it sounded very sci-fi and really wrong,” she said. “It was hard to imagine that this would be a real thing. It was very buzzy and bizarre.” (An early headline in the New York Times: “Botulinum Toxin’s Promise as Drug May Rival Its Potential as Weapon.”)
Linda Wells goes to Dr. Brandt for a touch-up
Stream Linda Wells goes to Dr. Brandt for a touch-up by Medium from desktop or your mobile device
Wells, who founded Allure in 1991, recalls first meeting Brandt at an event hosted by the magazine. “It was like, ‘My God, Fred Brandt is here. You have to go see him,’” she said. “It was a little bit unkind, because it was to get a look at this person who had experimented on himself. His face was distorted and unusual-looking. But also that he had this reputation as being a magician and an alchemist with these injectables.” Wells soon became a Brandt disciple, and like his other patients, she gladly submitted to his unorthodox techniques: “There were all these things he did that I didn’t know weren’t entirely kosher, but Fred was always one step ahead of the science.”
With an ever-increasing demand for his services in New York, Brandt’s publicist connected him with a cosmetic dentist named Jonathan Levine, an early proponent of porcelain veneers who sublet treatment rooms to Brandt in his Central Park East offices during the mid-1990s. “The notion of a dermatologist working in an aesthetic dentistry office was fairly unique,” Levine said. At the time, interdisciplinary practices were uncommon; specialists didn’t necessarily see the benefits of a holistic approach to aesthetics. It didn’t take Levine long to realize he was in the presence of something — and someone — special. “I was fascinated by what he did and the response of his patients, who couldn’t wait for him to be back in New York to treat them,” he said. “This was something big that was only going to get bigger.”
By 1998, Brandt had opened his own practice in New York. His forward-thinking treatments, coupled with his reputation as Madonna’s on-call skin guru, netted him profiles in magazines like Harper’s Bazaar, Vogue, and Allure. Suddenly, his name and his unforgettable face were everywhere. But the press, which was typically skeptical of injections and the women who got them, also took jabs at his appearance. A story in W titled “C’est Chic le Freak” cited Brandt as an example of a beauty professional who couldn’t accurately see his own reflection. “There was a pull quote in the middle of the page that said something like, ‘When I see Dr. Brandt’s face, it makes me glad I have wrinkles,’” his friend Kyle White told the New York Times.
Brandt was hurt by the coverage, but it did little to deter his desire for press — even if that meant having to play the part of the mad scientist wielding an oversize syringe. He loved to be photographed and act like the models who came to his office for treatments. “He created this image, and I think he was enjoying it until there was a certain point,” his friend Garren Defazio said. A 2006 photoshoot by fashion photographer Steven Klein for L’Uomo Vogue depicts Brandt as a high-fashion executioner with a needle in hand. In front of him, a muscular, nude male model draped across a lounge chair writhes in fear. Brandt hung the photograph in his New York offices.
On April 15, 2002, a decade after Brandt started using it on patients and years after the New York Times story, Botox was finally approved by the FDA for wrinkle prevention. The taboo and shame that had accompanied its usage finally began to fade. That December, the New York Times published a piece about the rise of the at-home Botox party. “We’ve gone public with our vanities,” it read, “converting narcissism from an embarrassment into an achievement.” All of a sudden, doctors from all over the world, not just dermatologists, clamored to see Brandt lecture on the subject.
Never outpaced, Brandt set his sights on a new and unproven substance. In 2003, after serving as part of a years-long trial, he helped bring Restylane to market, a hyaluronic acid-based filler and facial plumper. “He saw that there was a need for less radical ways of rejuvenation,” said author and critic Daphne Merkin, who first met Brandt while writing an article titled “Keeping the Forces of Decrepitude at Bay” for the New York Times in 2004. “He figured out ways to use all these injectables. He was the initiator of a lot of what would become the cosmetic dermatologist’s ‘black bag of tricks.’” Brandt also continued to diversify his business, launching a bestselling product line in 2001, a radio show for SiriusXM in 2011, and appearing as a regular guest on daytime talk shows like The View. “He wanted to win all the time,” said Joan Kron, his friend and former editor at large for Allure. “He wanted to be ‘the one.’” And when he wasn’t, he was crushed. Merkin recalled attending the annual Allure Best of Beauty awards one year when Brandt didn’t take home a trophy. “He actually cried sitting next to me. He cried,” she said. “I felt so sad — he was at the pinnacle of his profession.”
There were other, more clandestine setbacks to Brandt’s career. In 2015, a famous patient was reportedly irate when she developed a hard nodule in her face after Brandt injected her with the filler Voluma. When Brandt tried to get the product taken off the market, he was confronted by an employee for the manufacturer, Allergan, according to two people familiar with an incident that allegedly took place at the American Academy of Dermatology meeting in March of 2015. “I remember a particular conversation that I witnessed where someone from the company, a relatively junior person, was just berating him, asking him about his hygiene technique in the office — things that would be fantastically insulting to any physician.” (Allergan did not respond to multiple requests for comment; a study published four months after Brandt died discovered that nodules developed in less than 1% of Voluma patients.) Brandt’s SiriusXM series was canceled in early 2015; shortly after, he met with the production duo behind Million Dollar Listing and RuPaul’s Drag Race to discuss, among other things, a reality makeover show. “He was really trying to stay out there,” said former W beauty director Dana Wood. “It makes me sad to think that he was still chasing relevance when he was Fred Brandt.”
But the Botox bubble had burst. With its FDA approval had come a gold rush, and everyone wanted in. Batches of black-market Botox were being shipped in from China and India. Walk-in bars where customers could get injected without having to make an appointment popped up next to Verizon stores and nail salons. Clients started turning up on East 34th Street with a drooping eyelid or a frozen forehead, souvenirs from last night’s wine-soaked Botox party. Fixing botched jobs and consoling distraught patients began to wear on Brandt, who often performed his services free of charge.
The bright light that once defined Fred Brandt had begun to dim. According to some, so did his restraint, as patients asked for more and more injections in a single visit. “He acceded to the request, whether or not it was beneficial to have so much filler,” Merkin said. The demand for poutier mouths, sharper jawlines, more everything was taking hold. Plastic surgeons, who had once worked outside the realm of cosmetic dermatologists, began offering red-carpet laser facials and Botox services alongside nose jobs. Dr. Brandt’s patients, like The View co-host Joy Behar, bragged publicly about avoiding the knife. “Now it’s just like a stamped pattern. Everybody has the same lip,” Defazio said. “That wasn’t Fred’s aesthetic.”
In the winter of 2015, Brandt became more withdrawn. “He would carry this Louis Vuitton bag that was, like, one of four that were made, and it was filled with vitamin bottles,” said his former colleague Dr. Rhoda Narins. For the first time in his career, Brandt canceled appointments and referred patients to his protégé, Dr. Robert Anolik. (His wife, writer Lili Anolik, would later cover Brandt’s last days for Vanity Fair.) Brandt escaped to his Miami home, where he watched TV in bed with his rescue dogs, Surya, Tyler, and Benji. He did yoga at 9:30 a.m., three hours later than his usual 6:30 a.m. workout. Friends hoped he was finally slowing down.
And then the unimaginable happened. In March 2015, Tina Fey’s Netflix-produced comedy Unbreakable Kimmy Schmidt featured a grotesque character played by Martin Short called “Dr. Grant.” The apparent resemblance to Fred Brandt was uncanny and unkind. There is a swipe at Grant’s gender; the character’s lips are so overstuffed with fillers that he pronounces his own last name as “Franff.” (The show’s creators, Tina Fey and Robert Carlock, have never publicly acknowledged whether they based the Dr. Grant character on Fred Brandt. In response to a request for comment, a representative for Fey called the conjecture “unfounded.”) A month later, Brandt was found hanging from a yellow-and-black rope in his garage in Miami. At the time of his death, he had been under the supervision of a psychiatrist and on suicide watch for 10 days. There was an alarming mix of antidepressants, benzodiazepines, and sleep aids in his system. He was 65 years old.
Fred Brandt didn’t leave a note, but in many ways, his fate was writ large. A recent study by Allergan — the company that bought Botox in 1990 for $8 million — predicted that the aesthetics market will be worth $26.53 billion by 2024. According to sources familiar with the matter, Brandt had accumulated significant debt and displayed a concerning lack of business acumen. Stéphane Colleu, the current CEO of Dr. Brandt Skincare and co-executor of Brandt’s estate, says he sold the doctor’s collection of modern art to keep the company afloat. “Nothing was planned,” Colleu said. “The banks stopped the credit line because everything depended on one unique man.” A new era of beauty, one that values manufactured sameness over customized results, had dawned. And this era worshipped many gods.
Fred Brandt took the once-dirty desire to look beautiful and rebranded it as an appropriate and acceptable form of self-care.
Brandt’s bespoke faces and a business model that relied on a single pair of hands had an inherent issue of scale. “He was generous in sharing his insights with other people, and I think it shaped the current aesthetic,” said Jonah Shacknai, the former CEO of Medicis, which distributed Restalyne. “I think he fundamentally didn’t see that as threatening, because he didn’t imagine anyone could do it as well as he could.” Fred Brandt miscalculated the value of his art. The techniques that were once proprietary to his work have become mainstream. And the overripe look for which he was ridiculed is now accessible, acceptable, and popular. For all his foresight, maybe Brandt didn’t see the homogeneity of Instagram Face coming. Or maybe he did and wanted nothing to do with it.
Five years after his death, Dr. Brandt’s beauty empire soldiers on without its namesake. In New York, his disciple Dr. Robert Anolik continues to treat each face as its own canvas. Anolik wears a white lab coat and comfortable work shoes to his office each day; his own face is lightly lined and a little tan. He might refuse to erase a “forever line” in someone’s forehead if it will create too much tightness around the eyes. Though the Steven Klein photo is no longer on display, Anolik still performs the Y-lifts and rejuvenating neck treatments he learned directly from his mentor. Occasionally, he’ll play the Baron of Botox by making a corny joke or instructing a patient to “frown” and then “relax” before making an artful injection to lift the tip of the nose. After a long day, Anolik might even take the back stairwell favored by stars hoping to avoid the prying eyes of the public. But he’ll leave the needles at the office.
For even more exclusive interviews and insight into the extraordinary life and work of Dr. Fredric Brandt, subscribe to “The Baron of Botox” on Apple, Spotify, or wherever you like to listen.