Mary P. Lupo, MD, remembers exactly where she was and what she was doing when the first filler received approval from the US Food and Drug Administration (FDA). The year was 1983, and the filler was Zyderm collagen. She knew it was the beginning of something big, and asked her then supervisor to incorporate injections into the core curriculum via a resident cosmetic clinic.
Lupo, a board-certified dermatologist and clinical professor of dermatology at Tulane University School of Medicine in New Orleans, was right and remains on the front lines of minimally invasive cosmetic surgery to this day. Now, some three decades later, Zyderm and other collagen-based fillers have been usurped by a host of neurotoxins and hyaluronic-acid injectables that constantly top the list of most requested non-surgical procedures. Lupo recently participated in the clinical trial that led to a new crow’s feet indication for Botox Cosmetic (onabotulinumtoxinA).
And she remains the director of Tulane’s Resident Cosmetic Clinic, where she has been teaching students about fillers, Botox, sclerotherapy, chemical peels, and laser therapies since 1984.
Lupo talked to Beauty in the Bag about her illustrious career and why she still loves what she does.
Here’s what she had to say:
How do you define beauty?
Physical beauty is about the balance and symmetry unique to each face. Inner beauty is about centered confidence, integrity, and knowing where you fit in the universe.
What is your signature procedure?
Non-surgical rejuvenation. My main artistry is with fillers and neuromodulators, i.e. injectables. They allow me to enhance the face by balancing the shape and allowing me to enhance the contours and convexities, while diminishing the shadows and concavities. I use lasers to complement my injections.
How did you get started in the beauty business?
As a resident, in 1983, Zyderm collagen injections received U.S. Food and Drug Administration approval. I went to my Tulane University program chair and said “I think this concept will be big.” I asked to start a clinic where, as residents, we could practice on patients. It was the FIRST residency program to have injections as part of the core curriculum. I continue to staff that clinic to this day.
What sets you apart from others in your space?
My aesthetic eye and good hand-eye coordination. I see what is missing and replace it, but subtly. My patients look better, not “done.”
Who are your beauty inspirations?
Audrey Hepburn, Greta Garbo, Grace Kelly, Lena Horne.
What is your beauty mantra?
It is a process, not a procedure. It requires constant vigilance and I prefer early, little steps over waiting too long and having to be aggressive.
What is the procedure you find most challenging?
Sculptra, but doing it right separates the men from the boys, so to speak.
What charities do you support?
Second Harvest Food Bank; NO City Park and WWII museum, the Dermasurgery Fund of the American Society for Dermatologic Surgery, and the Legacy Fund of the Women’s Dermatologic Society. And of course, my Alma Mater, Tulane.
Why do you love what you do?
It is science and art combined. Every face is different, so I can do something new every day.
Tampa, Fl-based facial plastic surgeon Edward H. Farrior, MD, FACS, recently took over as the president of the American Academy of Facial Plastic and Reconstructive Surgery (AAFPRS), the world’s largest specialty association for facial plastic surgery. This is always a big job, but this year marks the Academy’s 50th anniversary, which means even more fanfare and planning than usual.
Farrior is up for the challenge. He spoke to Beauty in the Bag about his goals for his term in office, his facial plastic surgery practice and the state of facial plastic surgery today.
What do you hope to accomplish during your one-year term as president?
I want to conclude our quest for recognition of our fellowship training by the Accreditation Council for Graduate Medical Education, an organization that certifies training programs. The Academy has many excellent fellowships for facial plastic surgeons, but this would provide a different path for interested parties.
I also want to create more state plastic surgery societies. Most of the big states have such societies, but a lot of the smaller states do not. For these smaller states, multi-state societies may be an option. State societies help promote patient education and political advocacy. For example, many have been very influential in helping to assure that only qualified individuals perform cosmetic surgery in their states.
I plan to energize the FACE TO FACE: The Domestic Violence Project from the AAFPRS by contacting more shelters. In 1994, the AAFPRS teamed up with the National Coalition Against Domestic Violence to develop the program that has helped 2,500 domestic abuse survivors. Through this program, facial plastic surgeons provide pro bono reconstructive facial surgeries to women who have been badly injured. Another academy program, Faces of Honor, helps veterans, returning from deployment, gain access to facial reconstruction surgery. Most veterans have access to superb Veterans Affair’s health care. Most of the VA Hospitals have facial plastic surgeons on staff, but there are some veterans who return to smaller towns or communities who can’t commute or don’t want to commute to bigger facilities. I also plan to strengthen this program.
What is your signature surgery?
Rhinoplasty, primarily revision rhinoplasty.
That’s pretty complicated stuff, correct?
Yes, once someone has his or her nose operated on the anatomy can become extremely distorted making the procedure much more complex. You have to think on your feet and be creative in the moment. The more experience the surgeon has the better you are at revision rhinoplasty.
How did you get started in this field?
My father Richard Farrior, MD, now 88, was a premier rhinoplasty surgeon in the 1960s, 70s and 80s. He was my role model and inspired me to follow in his footsteps.
Do you ever run tough cases by him?
Yes, every now and then I will.
Do you have children, and will they follow in your path?
I hope so. I have a son and two daughters. My son is a law student, my oldest daughter has a master’s in teaching and is teaching middle school math, and one of my daughters is a pre-med student. She was going to go to veterinary school, but switched to pre-med. I have my fingers crossed.
Why do you love what you do?
I love the technical aspect. It is is almost like composing or sculpting, and to be creative with living tissue takes a great deal of focus. It’s also one of the few specialties in medicine where doctors and patients can develop relationships. This communication is really paramount. With elective procedures, it is imperative for us to educate and empower patients to make the right decisions and to get to know their lifestyles, their family, and their goals. We don’t have the pressure of having to see five or more patients every hour so we can really build a personal relationship.
What, in your opinion, will be the next big thing in facial plastics?
A reversible permanent filler that you can undo if there is a problem. Facial implants are great, but it takes a surgical intervention. They also come in a variety of sizes but not enough of a selection to fit every facial and skeletal contour. Injectables are nice in that you can customize them and there is no downtime.
What is your tried-and-true anti aging advice?
If you keep skin hydrated and protected from the sun you will need fewer interventions.
The AAFPRS just put out a survey showing that 50 is the new 30. Do women today really feel and look younger than their chronological age?
Absolutely. Today, women in their 40s and 50s are more confident and beautiful than ever before. They have the life experience and knowledge to look as great as they feel. And with the growing number of minimally invasive and nonsurgical options, they are able to maintain their youthful appearance for longer.
Board-certified dermatologist, Internet entrepreneur, and skincare brand pioneer, Craig Kraffert, MD, is committed to creating healthy and beautiful skin on many levels. First, as owner of Redding Derm, he operates the largest dermatology practice in northernmost California. Second, he founded DermStore.com, the hugely successful online resource for hard-to-find skincare products, which he sold in 2007. And most recently, as president of Amarte, a luxury skincare line, he has combined the heritage of traditional Korean skincare with cutting-edge technology.
Dr. Kraffert’s commitment and passion for dermatology is evident in all aspects of his life. Here, he shares a few of his insights with Beauty in the Bag.
Gosh, I don’t know where to start. Tell us a bit about how your commitment to dermatology began.
Like many people, my interest in the social and medical aspects of skin began at an early age. I was first drawn to dermatology during my medical training at UCLA—not out of career convenience or status but out of an innate interest and passion for skin health and beauty. Over the course of my career, I’ve tried to channel my passion for this subject into meaningful endeavors for my patients and society at large.
At your private practice, do you treat medical and cosmetic patients?
Yes, at each of my four offices we treat both medical and cosmetic dermatology patients, and in some cases, these two concerns mingle together including treatment for acne, rosacea, and sun damage. My practice is committed to bringing the latest cosmetic advances to patients and offering cutting edge treatments before they’re widely available (for example, we adopted Botox in 1998, many years before its FDA approval).
Please describe the Korean technology that inspired you to create Amarte?
Korea is experiencing a perfect storm right now in creating skincare products—the Korean heritage for creating therapeutic skincare products that dates back to antiquity combined with the mastery of high tech scientific advances in cosmetic chemistry has put Korea at the center of the “beauty map.” This synergist approach to skincare has resulted in the development of several breakthrough skin innovations, including odorless nano-sulfur, which is featured exclusively in Amarte products. Sulfur has been used as an active skin therapeutic agent for a very long time and has been an active ingredient in prescription products for decades, but Korean innovation has made this ingredient more effective, elegant and odorless. Another major Korean innovation is nano-encapsulated retinol. This breakthrough ingredient preparation method enhances the stability, efficacy and tolerability of retinol—an ingredient well established as one of the most important functional cosmeceuticals. Koreans are also responsible for perfecting many natural and botanical extracts for skincare as has been documented in Korean writings for over 500 years. Botanical extract preparation is a key component of this unique Korean expertise and precise proprietary fermentation techniques developed over many years help formulators express the best qualities of botanical extract preparations. Compounds such as the natural mushroom based emollient ingredient found in Amarte’s Wonder Cream all relate to this legacy.
Since skincare products are not considered drugs, how can we be sure they are really effective and safe?
This is an excellent question and a source of a great on-going debate between the cosmetic industry and the US Food and Drug Administration. Consumer safety is of paramount importance. Presently, the FDA is charged with regulating skincare and cosmetic products and desires to increase regulation within the US in the name of safety as there continue to be safety issues with products sold in the US. Amarte products, however, are manufactured in Korea and are held to a much higher standard than required in the US. Each Amarte product is periodically evaluated by the Korean FDA (KFDA) in their national laboratories to ensure safety. The KFDA is notoriously strict and cosmetic safety problems are extremely rare in Korea and all Amarte products have been KFDA tested and approved with safety certificates.
Efficacy is hard to measure in cosmetic products, as the most rigorous scientific test methods capable of accurately assessing product effectiveness are prohibitively expensive. A certain body of scientific evidence does exist for many individual ingredients found in skincare and cosmetics. Nevertheless, objective, unbiased, scientifically rigorous data on individual product effectiveness is uniformly absent for skincare and cosmetics. This is why real world results in terms of socially relevant skin improvement are the true gold standard of skincare product effectiveness.
How did you come to launch DermStore?
In the early days of the Internet I decided to make a store for patients and consumers around the world to find the skincare products they were looking for and couldn’t readily obtain elsewhere. DermStore was a way of bringing my skincare expertise and passion to a much larger audience than could be seen in a brick and mortar dermatology clinic. I wanted the store to also be a place where people could go to get questions answered and receive unbiased skincare, dermatology and beauty information. Many late nights were spent answering countless questions from Internet surfers and shoppers in the early DermStore days. It was important for me to create an online store environment where people could come to find products they were looking for and be exposed to new and interesting products that they weren’t even aware they needed. This mission of customer engagement and DermStore overall have been huge successes.
You are really a beauty renaissance man. How do you find time to fit in everything in a day?
Thank you for these kind words. The key to achieving big things rests in surrounding oneself with people who are even more focused, productive, passionate, and intelligent than you are. I’ve always reached out to partner with the best and brightest associates available and have welcomed the chance to see us achieve things together that we could never accomplish individually. Prioritization and delegation of tasks is also essential for efficiency and overall productivity. I try to ask myself not how good my work is but how good my work is per hour. Finally and most importantly, a loving and supportive family is the key foundation upon which all my projects in the health and beauty world rest.