"Behind the Scenes with a Dermatologist"

Story Published in Allure

dermatologist


BEHIND THE SCENES WITH A DERMATOLOGIST
by Patricia Lynden

A gawky teenage girl with acne on her chin walks out of dermatologist Mary Ellen Brademas's examining room. A moment later, the blond, dazzlingly pretty, green-eyed, and white-coated Brademas, the chignon at her nape starting to unravel after a busy morning, dashes out after her. "Don't forget that I will personally come and kill you if you do anything wrong," she admonishes the girl.

Brademas is a top member of a group of high-profile dermatologists who are expert at rejuvenating aged or damaged skin in ways that were unheard-of a generation ago. Chief of dermatology at Manhattan's St. Vincent's Hospital, an attending physician at Bellevue Hospital, and an assistant clinical professor of dermatology at New York University Medical Center, Brademas also has a private practice. Half of these private patients have medical problems, and half are "vanity patients" -- mostly women "who just want beautiful skin," she says. Brademas has a national reputation for being very good at helping them.

She also has a reputation for being quite a character. The traditional physician's persona of seriousness and probity is not for her. She wears designer clothes and has the breezy manner of the bridge-playing Junior Leaguer she was during her first marriage. Then there's that I'll-come-and-kill-you style of her nostrums and admonitions. She loves to shock and sometimes goes out of her way to do so.

Where other dermatologists might simply warn their patients that the sun's rays are dangerous, Brademas dramatically refers to them as "death rays" and swears she never even walks on the sunny side of the street. Her personal nightly facial routine includes, she says, an acid treatment with "anything from lemon juice to lactic acid to salicylic acid to Retin-A to trichloroacetic acid to sour milk." Sour milk? She lets milk spoil and then smears it all over her face? (We'll come back to this.) As for the body below her face, she scrubs all over ("and I mean really scrub") every time she showers with a lethal-looking pumice stone that she says is what keeps her skin looking young.
Patients who go to Brademas for vanity reasons get what all up-to-date cosmetic dermatologists are taught to prescribe. Besides avoiding the sun and "having good genes," she says, women can routinely exfoliate, usually with prescriptive acids. If the epidermis is made to slough off dead surface cells at an accelerated rate, the skin looks youthfully pink and glowing, and the pores don't fill up and become enlarged or infected. Sloughing, says Brademas, "makes skin thicker, which wards off aging. Young people have a thicker epidermis. Thickening the skin is the whole point of all abrasives. That's the whole point of my pumice. That's the whole point of Retin-A. A brush does the same thing. A file does the same thing. A rock does the same thing. Acids do the same thing. Have you noticed that if you walk on sand how nice your feet look on the bottom after a while? That's because you've been sanding them."

It would be hard to exaggerate how terrible-looking is that pumice stone with which Brademas has scoured herself "every morning for years and years." Try to imagine yourself being dragged naked along a rough sidewalk for five whole minutes and you'll have a good idea. "You have to work up to it," Brademas explains. "You probably shouldn't mention it, because some fool will read this and go out and try it and get excoriated. But you start with a loofah, then a brush, before you go to a pumice."

Body pumicing is not universally accepted among Brademas's colleagues. Marianne N. O'Donoghue, associate professor of dermatology at Rush-Presbyterian-St. Luke's Medical Center in Chicago, is also a "vanity" dermatologist, but she does not endorse self-abrasion. "While we do find that you can have better skin by stimulating it to turn over," says O'Donoghue, "most of us feel the gentle way, using glycolic acids, is good. I would not subscribe to the pumice stone or to using mechanical abrasives because it can cause injury from the trauma."

Above the chin, Brademas's "face thing," as she calls it, varies. "Depending on what samples I have, I try this, I try that, so I'll know what patients have to suffer. At night I use some kind of an oil on my face -- a sample I'm checking out, or Pond's, or Albolene, or mineral oil -- to clean with. I pat it off with a tissue. Then I go over my face with a damp washcloth. Then I put on an acid. I use different acids on my face depending on what kind of peel I want. I try to do that every night." And, no, she admits when pressed, she doesn't really smear sour milk all over her face. "It would be sort of inelegant and smelly, and lactic acid is a very nice product that you can buy in a drugstore that does the same thing."...

People ask Brademas all the time if she's had a facelift. Her answer is no, except for her eyes, which were done in 1984. "I'm kind of glad I look the way I do," she says. "I don't want to look like I'm 22. I'm a grandmother of four, and that's all right. I don't think I look too bad for being as old as I am." ...She stretches the skin on each cheek back toward her hair, saying, "I hate this look. Even with a good plastic surgeon it can happen. So, no, I don't think I would want to do that. I mean, my face, in a way, is my fortune."

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Copyright © Patricia Lynden 2010-2013. Site designed by Bruce R. Jaffe.