By  on November 14, 2008

Milan-based dermatologist Bruno Mandalari's noninvasive techniques have won him a cult following among Italy's fashion and showbiz sets.

Late on a Milanese fall evening, dermatologist Bruno Mandalari is zipping about his sparse white clinic, prepping his tools for his last appointment of the day, TV presenter Simona Ventura—Italy’s equivalent to Kelly Ripa.

With a half hour to spare before she arrives, Mandalari throws on a rumpled lab coat over his casual uniform of jeans and T-shirt and settles behind his desk, which is illuminated by a Kartell lamp. Opposite is a view of the leafy street below, where dolled-up ragazze are striding toward the neighboring restaurant and bar complex Gold, Dolce & Gabbana’s eatery.

Mandalari’s stylish surroundings are no accident: He’s the go-to skin guru among Italy’s fashion designer and showbiz set, all of whom clamor for his noninvasive antiaging treatments. Unlike many celebrity derms, Mandalari shuns fillers and surgery. Instead, his arsenal of skin-saving procedures includes vitamin infusions and laser resurfacing. Add to that Mandalari’s tailor-made therapy approach and his methods ensure a month-long waiting list for an appointment.

“Here, no client just walks in, undergoes a procedure and walks out,” says Mandalari, of those lucky enough to score an appointment. “There’s a methodology to how I treat skin aging, and it’s not just about one magic tool that can fix everything.” He adds, “It’s not about miracles, but simple science.”

At 48, Mandalari is his own unofficial advertisement—his wholesome, glowing face is deep set with dark brown eyes. He’s slightly tanned from a recent sailing trip, but in Mandalari’s book, the sun is the devil and sunbeds are molto dangerous. He admits his opinions are harsh for some clients, who live in a country where regular sunbed sessions are part of a beauty regime and many of Italy’s biggest fashion designers sport year-round tans—where Valentino bronzes himself on top of his yacht cruising the Mediterranean coast and Donatella Versace has a tanning bed installed at home. But Mandalari makes a convincing anti-sun case, and other clients are quick to sign on to every element of his skin-saving doctrine.

For example, Dan and Dean Caten, identical twin brothers and designers behind the label Dsquared2, booked regular visits to Mandalari’s clinic after a summer spent on the beaches of Mykonos, followed by a stressful lead-up to their spring 2009 fashion show.

“We destroy ourselves through hard work and play,” confesses Dan, “and it takes it out of your skin. What Bruno does is so great because it’s nothing foreign or weird he’s putting into your skin. It’s like he’s giving you a deep facial, freshening it up and renourishing it. After I’ve done one of his treatments, everyone asks what I’ve done to my face.”

Though Mandalari won’t reveal the name of his celebrity clients, he’s happy to divulge in-depth details of his work. Through a customized blend of treatments, Mandalari’s aim is to regenerate collagen and the extracellular matrix, which he describes as the material part of skin tissue that provides structural support to the cells. Mandalari says that, if stimulated, extra collagen can fade scarring, discoloration and fine lines,  and plump up the skin with a fresh, softer, more radiant texture.

When a client visits Mandalari’s clinic for the first time, he begins with a multi-tiered study of her skin. The analysis includes UV photos to pinpoint sun damage, a DNA test—with the client’s permission—to indicate genetic-specific aging, and urine and blood tests to reveal what minerals and vitamins are lacking. His initial consultancy fee is about $270, while the DNA test is $400.

Afterward, Mandalari’s treatment options typically include his preferred tools: an ultrafast pulsating laser and a high-pressure pump that transmits vitamins and minerals into the skin. The dual approach treatment costs about $270, and Mandalari recommends three sittings in the space of a month.

“The machinery is the same as [that which] a lot of dermatologists use; it’s the way that I use them together to make the treatments more effective,” he says.

Mandalari refers to the high-speed Erbium laser as a “scrub” because the pulsating red light works by removing the top layer of the skin. “The laser’s heat puts the skin into shock, forcing it to create more collagen,” he says. Immediately after the laser, Mandalari follows up with a procedure he’s dubbed “biorevitalization,” which infuses active principles into the skin, either via a needle or a mechanical pump that blasts a concoction of vitamins, minerals and amino acids at high velocity. “Because the pump has extraordinarily high pressure, it is stretching the skin, allowing the minerals to penetrate deep into the layers of the epidermis, and stimulating it to rehydrate and improve volume and elasticity,” he says.

According to Mandalari, the treatments take no more than 30 minutes, aren’t painful and have minimal side effects. In addition to the face, he also focuses on the hands, neck and décolleté.

“There’s little redness because I use the laser for such short periods. In the days following the treatments, patients notice their skin becomes clearer and more luminous, but you see the best results after 25 to 28 days, the usual time it takes for the skin to renew itself,” he says.

For particularly damaged and aging skins, Mandalari rounds out the treatments with injections of hyaluronic acid (at about $500 a vial).

In Milan, Mandalari divides his time between two clinics. In September, he inaugurated a medical spa inside a new five-star resort hotel in the picturesque Tuscan countryside. The Petriolo Spa and Resort is tucked away in the verdant hills of Tuscany’s coastal region of Maremma, between the cities of Siena and Grosseto.

At the hotel’s spa, Mandalari has duplicated the treatments his Milan clinics offer, adapting the procedures into short weekend and longer weeklong therapies. Guests book a dermatological treatment program with a specifi ed diet and exercise plan, devised by a dietician and personal trainer in collaboration with Mandalari. The spa also boasts another jewel: centuries-old thermal waters integrated into its pools. Between appointments, guests can soak their respiratory, muscular and skin ails away in the sulfur-rich 90-degree Fahrenheit waters.

Mandalari also is working on an eponymous skin care line. The products will contain high concentrations of the minerals and acids Mandalari administers in treatments, but will be available only for clients, he says, whom he insists are the sole focus of his work.

“My clients don’t distinguish me because of my capabilities, but the type of serene beauty I strive for, a beauty that’s more real,” he says. “It’s not easy to erase a small wrinkle or make the skin more luminous, elastic and have a splendor to it. It’s very difficult, but I think what I am doing is part of the future of dermatology, because the skin I work with remains natural. It’s not full of silicone or Botox—it breathes.”

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