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.