Fredric Brandt, cosmetic dermatologist, 1949-2015

Dermatologist to the stars, Fredric Brandt had a client list that included Madonna, not to mention a string of others whose identities were kept private. While an ever more image conscious age ensured that the Miami physician became something of a celebrity himself, as a researcher he changed the way his profession administers cosmetic treatments such as facial fillers.

For Botox, the botulinum toxin that was initially used in smoothing out wrinkles around patients' eyes and mouth, Brandt developed a method that injected the paralysing substance into opposing muscles. At its best, for those who flocked to Florida for his treatments, the procedure brought much the same effect as a facelift.

"The knife and scalpel were not his thing," says Roy Geronemus, a partner in the New York practice Brandt also opened. "He used techniques that really hadn't been done before, which eliminated or delayed the need for surgery."

Demand grew apace. "He liked to characterise himself as the world's biggest user of Botox, and that was probably true," says David Pyott, the recently departed chief executive of Allergan, which makes the drug and has just been taken over by the Dublin-based Actavis.

The man once dubbed the "Baron of Botox" by W Magazine, the Conde Nast glamour monthly, expended much effort on cultivating his own appearance too. Along with an exercise regime that included daily sessions of yoga, Brandt underwent regular injections himself of the products he purveyed.

Self-medication is not unusual for top cosmetic physicians, according to Mr Pyott, who says many elite practitioners inject themselves or ask their closest colleagues to do it for them. "They need to know how it feels and exactly what the product does to you."

What the doctor was less able to cope with were the bouts of depression to which he fell prone. Brandt hanged himself at home on Easter Sunday, aged 65.

Fredric Sheldon Brandt, who is survived by his brother Paul, was born on June 26 1949 in Newark, New Jersey, where their parents owned a candy store. He graduated from Rutgers University and gained a medical degree at Drexel University, before completing residencies in nephrology and oncology.

After settling on dermatology as a specialism, Brandt moved to Florida, launching a private practice in 1982. He became known as a leading authority on cosmetic injectables, opening his New York practice in 1998 where he treated many of his celebrity clients.

Fittingly for an aesthete, he developed a passion for art, adorning his New York apartment, his Miami townhouse and his two practices with pieces by Damien Hirst, Richard Prince and Anish Kapoor. Even while launching a range of skincare products, authoring two books and hosting a radio show, he devoted most time of all to treating clients. The Miami practice became one of the largest of its kind, allowing him to participate in clinical research trials of the latest cosmetic injectables. "There were 15 exam rooms, all with great artwork," says Mr Pyott.

Colleagues describe a workaholic who often put in 12-hour days but who also found the time to indulge in retail therapy. Joan Kron, a veteran beauty journalist, joined him on several shopping trips followed by lunch in Barneys, the upscale Manhattan store. Brandt would eat only fish and vegetables, a diet apparently influenced by earlier indulgences in his parents' sweet shop.

Yet his unusually primped and puffed appearance threatened to overshadow his achievements in the clinic. Brandt was repeatedly mocked in the media, says Ms Kron. "Every time there was a profile done of him, he would ask if I thought they were making fun of him. In many cases they were."

A few weeks before he died, Net­flix streamed what was seen as a parody of him in a comedy series called Unbreakable Kimmy Schmidt. Friends say that though the show hurt his feelings, Brandt was already coming to find his despairing inner gloom hard to endure.

Yet for all his success in a field oft disparaged by other physicians, his friends describe a man who never stopped seeing himself as a real doctor - and with justification. When her mother, then 103, broke out in shingles, Ms Kron phoned Brandt for advice. Cancelling his afternoon appointments, he rushed to her with medication.

His depression was kept from most who knew him - especially his clients, who during procedures were instead treated to boisterous renditions of show tunes. It was "a way of disarming their anxiety", says Dr Geronemus. Or as Ms Kron observes: "Clowns are always the ones who are the saddest people."

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