EDGELOSANGELES| April 4, 2009

There comes a time, somewhere after forty, that the inevitable pulling and tugging-of eyes, neck, cheeks-begins. In Los Angeles, this happens first in car mirrors (in combination with the glaring sun, a most unforgiving reflective apparatus). But wherever you first start lifting and tugging, the effect is the same: How did I get to look like THIS?

We talked at length with Stuart H. Kaplan, M.D., a dermatologist in private practice in Beverly Hills. Dr. Kaplan, who has treated a long list of celebrities-including members of the Red Hot Chili Peppers and Guns ’n’ Roses, as well as Oscar winning actors and actresses-is warm, empathetic, and patiently provided a kaleidoscopic view of the in-office treatments available today.

Above all, Dr. Kaplan offered a very convincing rationale for seeing a dermatologist for these procedures. "Many plastic surgeons offer similar ranges of services as part of their practices. However, even when they themselves administer the procedures-and you must keep in mind that sometimes it is nurses who do so, not the doctors themselves-their field of specialization involves cutting of the skin, rather than treating the skin itself. Treating skin is the exclusive province of dermatologists, who spend four years in medical school, then four additional years in residency."

Further, Dr. Kaplan advises, "Anti-aging treatment of the skin cannot be separated from overall medical treatment of the skin." He himself has seen cases of patients who go to so-called medi-spas (where a doctor’s name may be associated with the business, but his/her presence is not constant) in which nurses or aestheticians misdiagnose serious skin problems such as shingles-and can actually cause further skin degeneration. Certainly, nurses and aestheticians are "not trained in the musculature and anatomy of the skin and face," another argument against seeing lesser trained practitioners. Likewise, "only a dermatologist is trained to recognize and treat skin cancers, melanomas, and other conditions; thus, it would be very ill advised to have any aspect of your skin health-preventive, anti-aging, or otherwise-treated by someone outside the specialty."

Kaplanmd.com