If you’ve ever wondered what a celebrity dermatologist has to offer, meeting Beverly Hills-based Dr. Stuart Kaplan makes you understand. In this intimate interview, Dr. Kaplan tells Make Me Heal about some of the treatments, beauty secrets, and skin care tips that have made him the go-to cosmetic dermatologist for film, music, and television stars.
Make Me Heal: With all the available choices for dermal fillers, which ones do you think work best for the various areas of the face.
Dr. Kaplan: It is important to understand the difference between Botox, a muscle relaxer, and Juvederm, Restylane, Collagen, etc. which are fillers.
The easiest way to visualize the difference is to think of a crease as a valley between two mountains. Botox prevents the mountains from being pushed together, and fillers fill in the valley.
If someone has a crease that is apparent only when frowning or squinting, Botox should be all that is necessary. Botox is most often used on the forehead, crow’s feet, and frown lines. It can also be used to treat neck bands. (Its most recent FDA approval is for armpit sweating and sweaty hands. For these conditions, results can last 6 months or longer.) Botox works on creases in two ways. First, it weakens the muscles that cause the creases. Second, and even more important, as the muscles get weaker, the patient gets out of the habit of creasing and using those muscles. In this way, Botox actually prevents the progression and deepening of creases.
Now, as we get older, our creases also age. They become deeper and deeper, even when we are not frowning, squinting, or using facial muscles. If creases are only apparent when we squint, only Botox is needed. If creases are visible at rest, and not made worse by squinting, then fillers are necessary. If creases are present at rest, and get worse with facial expressions, then Botox AND fillers will be necessary.
Here is my summary on Injectable Wrinkle Fillers:
The differences between fillers has to do with thickness and longevity. In general, the thicker the filler, the better it will fill creases, but the greater the chance of possible bumps. Bumps are more likely in thinner skin such as the lower eyelids, and crow’s feet. Zyderm (a type of Collagen), and Restylane Fine Line are the least thick and can be used around the eyes, but they are also the shortest lasting. Juvederm Ultra Plus is one of the longer lasting hyaluronic acid fillers. It can be used for deeper creases. Juvederm Ultra Plus can last between 3 and 6 months.
Fillers can also be used to improve or enhance facial structures such as:
• Filling in acne scars
• Enhancing cheek bones to make them fuller and more defined
• Enlarging lips for a fuller, softer pout
• Correcting lip deformities or asymmetry
• Non-surgical nose-job to fill in dips and valleys in the nose bridge
• Filling in hollows under the eyes that contribute to dark circles
Other new trends and uses of fillers include:
* Rejuvenation of the tops of hands (as we age, our skin thins, and the tops of our hands look “veiny” and boney. Adding a filler material creates a layer of filler that plumps the skin on the tops of our hands, and makes our hands look younger.
* Nipple enhancement
* Injecting into the soles of the feet to make wearing high heeled shoes more comfortable
Four other fillers deserve mention:
Radiesse is considered the longest lasting filler, It is made from a similar material that bone is made from. Although it is not permanent, it can last up to one year in many cases. It is ideal for the nasolabial folds that get deeper as we get older. It is also my treatment of choice for hand rejuvenation. When combined with laser, the laser improves the discoloration on the surface of the hands, while the Radiesse plumps and thickens the skin, making our hands look more youthful and vibrant.
Sculptra is a volumizer, and fills larger areas of the face, such as sunken cheeks. It is FDA approved for treating fat atrophy in HIV patients, but is also useful for cosmetic improvements in all patients. It requires several treatments, each about one month apart. While still classified as an injectable filler, its effect is more like a tissue expander, increasing volume and filling in larger areas. Imagine a balloon gently being blown up under the skin. It is not a balloon of course. It is made from the same material that dissolvable sutures are made, and is not permanent. After several treatments, results can last 1 – 2 years.
Silikon 2000 (Silicone) and Artefill (polymethyl methacrylate aka PMMA) are permanent synthetic products that the body cannot metabolize or remove. While they have unique benefits, they also have unique risks in that once injected, they are permanent, and cannot be removed.
Make Me Heal: There are many lasers to choose from today like Fraxel, Active Fx, Palomar’s Starluxe, CoolTouch, and many others. Which laser do you like to use for facial rejuvenation and wrinkle reduction?
Dr. Kaplan: I use the state-of-the-art Sciton Laser, which has various wavelengths for Skin Tightening, Pore Refinement, Redness and Pigmentation. Because many lasers can be used to combine and overlap treatments, I believe the Sciton produces superior, unparalleled results.
Make Me Heal: What do you think are the best temporary fillers for augmenting lips?
Dr. Kaplan: There are many different injectable fillers on the market today, and most of them can be used to shape and augment the lips. It is important to understand that every product is different, and has it own unique advantages and disadvantages.
For the best results, the right product needs to be matched for each individual patient. Successful outcomes also depend on you choosing an experienced doctor with excellent injection techniques. Based on my personal experience, the perfect lip is the one that “wows” the patient and makes them happy with the procedure. Everyone is unique, and a reputable, capable doctor will approach each face individually to give the best possible cosmetic result.
Here is a brief overview of the most popular fillers:
Radiesse – a calcium based injectable filler, which is considered the longest lasting (may last a year or more). While not used for the lips, Radiesse works especially well in the nasolabial folds, the lines that run diagonally from the outer corners of the mouth to the nose.
>>>Cost: $1,000 per 1.3 cc syringe. Most times, only one syringe needed, but for deeper creases, and depending on the outcome you desire, you may need more than 1 syringe.
Hyaluronic Acids – brand names include Restylane, Perlane, Juvederm Ultra, and Juvederm Ultra Plus. While acting as a filler, these agents also bind to water to keep skin molecules plump. The filler itself is soft and pliable, giving you a smoother, more natural result. No pretreatment or allergy testing is necessary. Restylane works best for medium wrinkles and lasts about six months. Juvederm Ultra can be used for fine lines, while Juvederm Ultra Plus works better for medium-to-deep wrinkles and folds, and can last up to nine months.
>>>Cost: $500 – $600 for each syringe.
Collagen – brand names include Zyderm and Zyplast. Because collagen is obtained from the skin of cows, and a small percentage of the population is allergic to bovine collagen, you must have an allergy test done first. Zyderm is best for superficial wrinkles. Zyplast is better for deeper wrinkles, furrows, deep scars and lips. It lasts three to six months.
>>>Cost: Collagen injections cost about $250 to $300 per 1 cc, and depends on which material is being injected. The allergy test costs an additional $75.
Additional considerations before going in for your cosmetic injections
1) Inquire about the doctor’s skill and experience with the particular filler. Also, does the doctor do the injections or does a nurse or assistant? In my practice, I do all the injections, as I feel that an assistant can never substitute for 20 years of experience.
2) Different fillers have different benefits and risks, and depend largely on a person’s facial features as well as personal preference. Your doctor should evaluate your needs and recommend the best filler for you.
3) Remember, what looks great on your friend, may not always be the best fit for you.
4) Different fillers come in different sizes. For example, Radiesse comes in a 1.3 cc syringe, while Juvederm comes in a 0.8 cc syringe. Your cost will be based on how many syringes you need to achieve your desired result. Keep in mind you may need more than 1 syringe.
Make Me Heal: Do you use any permanent facial fillers? If so, when do you recommend using them?
Dr. Kaplan: No, I do not. The skin on our face continues to age and thin, as we get older. Creating a certain skin plumpness today may ultimately become elevated years from now when our skin gets thinner.
Make Me Heal: We know that you have celebrity clients and that you treat some of them in preparation for the Oscars. What are the most requested procedures from clients walking down the red carpet?
Dr. Kaplan: Cosmetic procedures with little down time are popular during award season. Particularly
1. Botox injections to the underarms and palms, to prevent underarm sweating and sweaty handshakes. This is beneficial since anti-perspirants can leave a white residue, discolor clothing, or irriate the skin, especially when used after shaving the underarms.
2. Injectable fillers for deep creases or to give lips a more youthful pout. There is an art to injecting just the right amount of material to give a very natural result. The worse outcome is an obvious “something-was-done” look.
3. Other popular procedures include a laser skin peels, which gives skin an even skin tone and freshness, and skin tightening laser, to tone and tighten skin around the thighs, upper arms, neck and stomach.
4. Laser treatments for facial blood vessels, which are difficult to cover with make up.
5. Sclerotherapy for leg veins, especially when wearing short dresses that show a woman’s legs.
Make Me Heal: What celebrities have you treated and for what?
Dr. Kaplan: It is against medical ethics to disclose patient information. However, I can say I have treated dozens of Oscar, Grammy, Emmy, and Tony Award winners.
Make Me Heal: What are the best non-surgical preventive steps to keep the skin from aging?
Dr. Kaplan: Stay out of the sun, wear sunscreen even on overcast days (since 85% of UV rays still filter thru the clouds), and stick to a dermatologist recommended skincare regimen. Do not use overly drying cleansers or toners, always use a moisturizer with an SPF during the day, and use a nighttime skin repair product at night. I also recommend using a mask 2-3 times a week, and using a non-abrasive exfoliant on days you do not apply the mask. And of course, please remember to use an SPF on the lips. A lot of these lip glosses and lipsticks contain castor oil or petroleum jelly as the main ingredient. This acts like cooking oil on the lips when you step outside. One of the first noticeably signs of skin aging is wrinkles around the eyes and lips.
Make Me Heal: What are the new innovations in treating acne?
Dr. Kaplan: The use of Photo-Dynamic Therapy, using Levulan and multiple laser wavelengths. I have seen incredible results using this treatment. It is an excellent alternative to Accutane, requires fewer visits, and is less expensive.
Make Me Heal: What do you think of acne clearing home devices such as Zeno, Tanda, and the Marvel Mini?
Dr. Kaplan: I do see patients that have tried these products. However, if I am seeing these patients, they are coming to me because these products have not worked. When a product works, the patient does not need to come to me.
Make Me Heal: How can you rejuvenate the appearance of aging hands?
Dr. Kaplan: Radiesse can be used to plump the hollows between the bones in the hands. It is a quick, easy outpatient procedure, that takes less than 15 minutes. Also, Laser can be used to remove age spots and freckles on the hand, as well as smooth uneven skin texture.
Make Me Heal: What are the best way to get rid of spider and varicose veins? Please discuss the lasers you use, how the procedure is done, pain involved, and whether the changes are permanent.
Dr. Kaplan: It depends on the thickness of the vein. Spider veins can be removed very easily with the Sciton Laser. The pain can be likened to a rubber band snapped against the skin. For larger varicose veins, a solution is injected directly into the vein to push out the blood trapped in the vein and allows the vein to collapse onto itself. Results are long lasting. However, the longevity of the result is determined by the patient’s activities, such as standing for long periods, crossing their legs for long periods, etc.
Make Me Heal: What are you using today to remove brown and age spots? Please discuss the procedures you use, how the procedure is done, pain involved, and whether the changes are permanent.
Dr. Kaplan: I use a laser to remove brown and age spots, as well as freckles. Popular areas to treat include the face, forearms and décolleté. The pain can be likened to a rubber band snapped against the skin, repeatedly. The procedure is relatively quick, with very little downtime. Patients do experience some redness, but that disappears in a few days. As far as the results, they are long lasting, but again, they depend on the patient’s activities. Wearing sunscreen, even on overcast days, and staying out of the sun altogether, will keep the results more or less permanent.
Make Me Heal: Do you surgically treat people with skin cancer? What are the current best treatments now for the disease?
Dr. Kaplan: I perform Mohs Skin Cancer Surgery to remove Squamous Cell Carcinoma and Basal Cell Carcinomas. Mohs surgery involves using a microscope to check the edges of the tissue after it has been removed. If any skin cancer remains, that area can be re-excised at the time of the visit. Mohs Surgery gives the highest rates of cure available for removing skin cancers. The procedure is done in my office using local anesthesia.
Make Me Heal: You have your own skincare line called KaplanMD. What is the philosophy and technology behind the line?
Dr. Kaplan: The concept of the kaplanMD line is “10-3-1” : 10 active ingredients per product, to prevent and treat all 3 types of skin aging, in 1 concise line.
Most skincare products today focus only on 2 types of skin aging: Chronologic Aging and Sun Damage. Yet, many skin symptoms are in fact result of a third type of skin aging, which has never been addressed by a skincare line: Skin Aging due to hormonal imbalances.
It is important to understand that Hormones are what maintain and regulate the production of Collagen, Hyaluronic Acid, and Elastic Tissue. Collagen is what gives skin its strength, structure and plumpness. Hyaluronic Acid keeps our skin moist, plump and hydrated. And Elastic Tissue is what gives our skin its elasticity, or youthful ‘bounce-back’ quality. All 3 components are vital for healthy, youthful looking skin.
Only kaplanMD Skincare was created to help prevent and treat all 3 types of skin aging in one convenient line. Each product contains no less than 10 active ingredients, including an exclusive Phytogenic Triactive Complex of Soy, to firm and plump skin, Grapeseed Extract, to combat free-radicals, and exotic Black Cohosh, to help balance and relieve skin symptoms.
These ingredients are then delivered deep within the skin using a patented Time-Release Microsphere Delivery System, previously found only in prescription medications.
The result is healthy, radiant and glowing skin—for life.
Make Me Heal: What do you think differentiates KaplanMD apart from the myriad of skin care brands on the market?
Dr. Kaplan: I created kaplanMD as a complete balanced diet for the skin. Most skincare lines on the market today only address anti-aging or sun damage. But there is a third type of skin aging, caused by hormonal imbalances in both men and women, which starts in our late 20s and early 30s. This is a revolutionary new concept in skincare, and kaplanMD is the only skincare line specifically formulated to meet all these needs.
But to put it simply, kaplanMD Skincare has 5 points of difference from anything else on the market today.
1) Formulated using a unique “10-3-1” Concept : Ten active ingredients per product, working synergistically to prevent and treat all 3 types of skin aging, in one concise line.
2) Exclusive Phytogenic Triactive Complex of Soy, Grapeseed, and Black Cohosh in every kaplanMD product.
3) Patented, Time-Release Microsphere Delivery System for maximum efficacy.
4) Concept of the Vehicle: kaplanMD gives the benefit of a dozen ingredients in one convenient, effective application.
5) Concept of multi-patented ingredients to treat one symptom ~ Maximizes benefits with minimal irritation.
Make Me Heal: If someone were to buy your products, how do you suggest they use them in a daily regimen for normal, oily, or dry skin.
Dr. Kaplan: The kaplanMD product line was created to prevent and treat the 3 types of skin aging, which is independent of the oily vs. normal vs. dry skin hype created by the industry for marketing purposes. I believe that skin, regardless of ethnicity and skin type, experience the same skin symptoms as we all age. By using a potent combination of botanicals and peptides, we can prevent some of these skin symptoms from occurring, and help slow the skin aging process.
Make Me Heal: What are your top skincare tips for the summer?
Dr Kaplan: Most people know that using sunscreen protection is essential for healthy summer skin, but there are other important steps that you should take to make sure that you look your best this summer. Below are my top 10 tips:
1. I usually see an increase in cosmetic procedures pre-summer for things like injectable fillers (Restylane, Juvederm, Radiesse, Sculptra) and Botox. This only makes sense because Spring/Summer beauty trends lean toward natural looks and beautiful skin. Injectable fillers are a great way to enhance certain features on your face, and even help correct dimples caused by liposuction or irregular distribution of cellulite. If done correctly by an experienced dermatologist, your results should look very natural.
2. Protect Your Lips! Always apply sunscreen or a lip balm with a minimum SPF 15 to your lips BEFORE applying your lip-gloss/lipstick. Many lip products contain castor oils and petroleum jelly. These oils coat the lip and actually increase the amount of sunlight that penetrates the skin on your lips. It is like putting baby oil on your lips. This will increase the lip wrinkles and the risk of skin cancer on your lips. Try the kaplanMD LIP 20, which moisturizes, repairs, plumps and protects with SPF 20.
3. Laser Hair Removal. A popular pre-spring/pre-summer procedure I perform in my office is laser hair removal in the underarm and bikini areas of women, and backs and necks for men. Remember, it takes anywhere from 2 to 5 treatments for the best results, so begin your treatments early.
For men, I am now lasering away facial hair on the neck. Even if a man has a beard, he does not have to spend time shaping it. By removing hair on the neck and adam’s apple area, a man has less to shave, and gets fewer ingrown hairs.
4. Reduce Ingrown Hairs in Women. To get rid of unsightly shaving bumps or ingrown hairs in the bikini area or underarm, your dermatologist can inject the area with a dilute anti-inflammatory. The inflammation of the pimple will flatten within a 1 to 2 days.
5. Botox Can Reduce Sweating. For women who love wearing tank tops but are concerned about underarm sweating, or the residue of anti-perspirants, know that Botox® has been FDA approved to treat excess underarm sweating, also called hyperhydrosis. It is very effective, and lasts approximately 6-8 months.
6. Remove Spider Veins. Again, with spring/summer beauty trends leaning toward au natural make-up and more time in the sun, consider getting laser vein removal for those pesky red spider veins around the corners of your nose. There is virtually no down time and the results are immediate.
7. Remove Varicose Veins. New lasers, as well as the standard sclerotherapy, can treat unsightly spider and varicose veins on your legs. Results are immediate and long lasting.
8. Scrub Away. How to get the beautiful after winter, summer skin glow? Exfoliate with a mild scrub 2 to 3 times a week. I recommend scrubs that contain date seed power or pineapple and papaya enzymes. These are all natural, botanical ingredients that are mild yet effective.
9. Use A Clay Mask. Increased humidity and high temperatures in the summer lead us to sweat more, and cause more oil and buildup on our face. To refine skin, remove dead skin cells, and tighten pores, I recommend using a clay mask 1 or 2 times a week. I do not recommend exfoliating and using a scrub on the same day, as this may dry out your skin.
10. Know your SPF. Some things most people don’t know about Sunscreen:
1. It should be applied 30 minutes before you go out in the sun to give the product time to penetrate your skin. If you apply sunscreen while you are outside in the sun, you are basically exposing your skin to UV radiation for the first 30 minutes.
2. For the absolute highest sun protection, use a sunscreen that contains physical sunscreens such as titanium dioxide and/or zinc oxide. These particles lay on top of your skin and actually deflect light away from your skin. The higher concentrations work better at blocking the sun, but also can leave a slight residue discoloration on the skin. This is particularly an issue for people who want to wear sunscreen on their face, but don’t like the white residue or skin discoloration. Try the kaplanMD Day Cream SPF 15, which contains a highly micronized titanium dioxide, along with 9 other active ingredients. An anti-wrinkle cream, moisturizer, and SPF 15 all in one, the kaplanMD Day Cream SPF 15 leaves no messy white residue while providing long-lasting sun protection.
3. Most people don’t apply enough sunscreen. To get the full benefit of a sunscreen, it must be applied liberally.
4. Use at least an SPF 15. Higher concentrations give only marginal improvement in sun protection, but can also irritate your skin, and leave a white residue. This residue following the use of ultra-high SPF products is particularly bothersome in Asians, African Americans, Hispanics, and anyone with a darker complexion.
5. Re-apply your sunscreen every 3 hours. There is no such thing as a water-proof sunscreen. Some are water-resistant, but you should still re-apply your sunscreen often.
6. Don’t forget to wear a hat to protect your scalp (even for women) and sunglasses to protect your eyes. And use lip products that are “all-in-one” that plump, repair, moisturize, and contain SPF.
Make Me Heal: Have you gotten any cosmetic procedures done?
Dr. Kaplan: I give myself Botox injections to my forehead, frown lines, and crow’s feet. I actually do the injections on myself, using a mirror. I also use my own kaplanMD skincare products.
About Dr. Stuart Kaplan
Dr. Stuart Kaplan graduated with honors from New York University, earning his Bachelor’s Degree in Biology with honors in two and a half years. He applied for medical school in his sophomore year of college, and graduated from the Albert Einstein College of Medicine. He completed his Dermatology residency at UCLA Medical Center, where he was chosen as the Chief Resident of the program in his final year. A nationally renowned Cosmetic Dermatologist, Dr. Kaplan’s office is in Beverly Hills, where he has been in private practice over 22 years. He has also been an Assistant Clinical Professor at UCLA Medical Center and the Wadsworth VA Medical Center for 20 years. In 2008, Dr. Kaplan was listed by the Consumer’s Research Council of America as one of America’s “Top Dermatologists.” He has received numerous awards from the American Cancer Society, the American Medical Association and the United States Congress. He has been honored for his volunteer work by the youth and foster children of Los Angeles County, Children of the Night, and Youth Organization United. He lectures and teaches other dermatologists about the newest cosmetic advances, and is a frequent medical consultant for the media including CNN, MSNBC and Entertainment Tonight, as well as the Los Angeles Times, In Style, and Glamour Magazine, to name a few. Dr. Kaplan’s philosophy is simple: help patients look as good on the outside, as they feel inside.