Madonna-Approved Dermatologist Dr. Paul Jarrod Frank on Why Twenty-Somethings Should Consider Botox

Dr. Frank breaks down the most common antiaging asks, including when is the right time to start, and more.


Dr. Paul Jarrod Frank already has an Upper East Side office filled with patients (a third of them men), but with a collaboration with Madonna (a rumored patient) underway the wait is about to get much longer. While MDNA—a skincare line created by the Queen of Pop with Japanese beauty and wellness brand MTG—won’t be available in the US until later this year, you can experience the line’s facial at Frank’s office now. It’s, however, not the only offering the top dermatologist has for his anti-aging-obsessed clientele. Here, Dr. Frank breaks down the most common anti-aging asks, including when is the right time to start, and more.

So you’re doing some work concentrating on the jawline. Well there are short term fixes, and there are long term fixes. The short term fixes are using injectables. As we get older, we don’t just lose collagen; we lose bone mass in our jawline. [Short term] we can use fillers to build up the jawline again, just to where it was. The most popular filler is Radiesse, which is calcium-based. It’s great for treating the area above the bone. We also try to target the platysma, which is the muscle net that hugs underneath the neck and the jawline and goes over the cheek. As we get older, we develop these platysmal bands that work as tightropes on the jawline, which draw it down.

In that case, what do you do? We can use Botox to get rid of those bands, which will cause a reflexive tightening and lifting of the jaw. We call it the Nefertiti lift. So for most of my patients who want a trackable in a matter of days, a combination of jawline fillers and Botox makes a huge difference. But for someone who has a heavy neck, the injectables aren’t going to work well.

What’s a heavy neck? Meaning they have jowls, fat in the neck. Long term, what can be done for younger patients are skin tightening devices. Exilis Ultra, Thermage, Ultherapy. Again, they’re for patients with mild to moderate laxity who are in their 40s or good 50s. Patients who are older and have skin that’s hanging, they really need to go for more surgical things. It’s about starting relatively early.

And how early is that? For people who are used to having a jawline when they’re young, they start at 40.

What about someone in their 20s or 30s? I’m a laser liposuction person; meaning I can remove a pocket of fat and patients can go to work the next day.

What if someone isn’t into liposuction? Can Botox help? No, there are people in their 30s that I use Botox on in the jawline and the neck. There are people in their 20s and 30s that have problems with the grinding of the teeth. It makes the tissue bulbous [around the jaw] and we can weaken that. People don’t grind their teeth in their 60s, they grind them in their 20s. It’s a stress thing.

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Do men come in with the same requests? The jawline is the most common concern for men. In fact, that’s why I developed it. I call it the cannulift treatment. I don’t inject it with a needle, I make a tiny needle hole at the top of the jaw and then I use a cannula so that I can build up the jawline without bruising or swelling. I mean neck, everyone wants neck. But for men, the jawline and their eyes are the number one.

Do you ever talk to patients about health and lifestyle instead in addition to treatments? I always talk to them about that. I can only help them achieve the best versions of themselves if they help me. You can’t Botox a smile, you can’t Botox weight loss, you can’t Botox people taking care of themselves. My ideal patient is someone that lives the same ethos that I believe in: sleep, exercise, nutritional control. What I do is icing on the cake.

Do you have a nutritionist that you like to work with? I do, Dana James. She’s amazing and works in L.A. and New York. I don’t do liposuction on fat people. Unfortunately, no matter how well you take care of yourself, sometimes you still get bags under your eyes, you still get a little love handle, and that’s where I come in. I try and reinforce the ethos of sleep, exercise, and nutrition. I think that’s the most important thing.

In terms of preventive measures and working with younger patients, are there things that you turn them away from? Sugar. I look at my own children. We have to stop treating young people differently than we treat ourselves when we’re middle aged. If someone comes to me and says, “What are the best ways to do it?” I’m going to tell them what they don’t want to hear. Get your sleep, cut down on sugar, exercise, wear sunscreen. And then if that doesn’t work, I have plenty of tricks.

When did you start? I was doing Botox on myself when I was 27 years old. People want to know when it’s time to start using Botox. When do you clean up your room? You clean up your room before it gets dirty so you never have to do spring cleaning. So some people get wrinkles at 25, some don’t until they’re 40.

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And what treatments do you use on yourself? Everything.

Everything?! Not everything. I do Botox and fillers. I’ve used skin tightening treatments. I’ve used lasers for sun damage. The only realm of treatments that I haven’t done on myself that are my area of expertise is fat removal. But I don’t do anything in my practice that I wouldn’t do on myself, my wife, or my mother.

Skincare-wise, what do you recommend? I’m very basic. [You know], for most of my patients that do things like laser resurfacing—it’s kind of a waste of time to use a lot of anti-aging stuff. And I think most people use too much. I’m all about simplifying. There are a lot of great all-in-one products out there, as long as they have [the] sunscreen.

And what do you recommend to your patients? I go after what bothers people. Patients who come in with problems with pigment, I recommend one or two products. I don’t like huge regimens. In Asia, they love huge regimens. But they like it because they like the regimental aspect of it. Most people in New York, they want quick and easy. So I have to get a sense of a patient’s psychology before I make recommendations.

Would you ever come out with your own line? I really don’t have a desire to, I worked with Estée Lauder for seven years. I like product development, I like the marketing aspect of it. There are a lot of doctor’s lines out there. I don’t want to do what other people have done. I want innovation, and the closest thing I can find to innovation is what’s going on in Asia. I’m excited about the partnership [with MDNA]. I’ll never say never, but I like being in my office every day.

The Beauty Secrets of Supermodels:

The Beauty Secrets of Supermodels