Dr Robert Freund

New Podcast on “The Entrepreneurial MD”

From entrepreneurialmd.com:

Robert (Rob) M. Freund MD has big dreams.

As a practicing plastic surgeon with a restless, curious mind, he has joined the elite crew of physician inventors with patents and products that actually sell.

Not only does he tinker and invent, but he has also found time to write two books (the second is soon to be published), while ensuring he doesn’t miss his son’s baseball games. I was relieved to hear that he doesn’t sleep much – otherwise I’d have to believe he is super-human.

Listen to this lively 20 minute podcast in which Rob offers a glimpse into his full and creative professional life. Then tell us what you think …

Fat Transfer

Fat Transfer is a great technique that has taken a lot of criticism in the past.
What is it? What are its’ limitations?
Fat is taken from one area of the body and injected as a filler into another area of the body.
Why?
Fat can be used to fill a contour defect from liposuction. It can be used to correct a contour defect from other surgeries, like breast biopsies or mastectomies.
Fat transfer can be used to improve cosmetic deficits.
It can be placed in wrinkles, deep facial folds or the hollows under your eyes. It can also be placed in hollow temples, along the jawline, around the eyes or in the lips.
It can also be used to reduce the aged look of older hands. Remember that the hands can give away the age of even the youngest looking older person.
The benefits of fat over other synthetic fillers is that it is natural, safe (no allergic reaction to your own tissue) and most people have enough to fill large deficits (unlike synthetic fillers which come in expensive 1 milliliter vials).
The complaints in the past have been about lack of durability and too much injection at one time. These complaints go hand in hand. The doctor knows that only the live tissue will survive; he/she also knows that only a small number of the cells that are injected are alive, therefore they inject a large amount of fat to compensate. This large amount is lumpy and distorted and then goes away in an irregular fashion.
The Viafill system – Just out! is designed to provide a larger number of live cells thus eliminating the necessity of overfilling.
Fat Transfer has moved back into the conversation as the most important cosmetic and reconstructive filler. Stay tuned for more information.

New York Skincare in a Recession

Forget for a moment that I am a plastic surgeon. Think of me as your guide to overall anti-aging treatments. Too often, people think that my understanding of the aging process and its’ treatments consist of surgery alone. Well, in order for my patients to look as good as possible, whether it is before or after my surgical procedures, I must be keenly aware of all the important preventative skin care treatments and there actual worth.

The actual worth of a skin care product implies both the worth of the actual product in achieving the desired goals as well as the worth in relation to the cost versus the actual benefits. Most often I comment on the actual worth of the product in achieving the desired goal – dispelling the myths and unravelling the hype. But for today I would like to talk about good preventative skin care that justifies the cost for the desired effect. Read the rest of this entry…

The History of Laser Skin Resurfacing

In the beginning there was spoiled lambs milk! That’s right, In ancient Egypt, it is told, that Cleopatra would maintain her beautiful complexion by bathing her face in spoiled lambs milk. The lactic acid within the milk would exfoliate the upper layers of skin and thicken the dermal layers – or at least, that is what her dermatologist told her!

In the early 20th century, different and stronger acids were used to enhance complexion in the same way that cleopatra had done 5000 years before. Surgeons then came to realize that patients who had large scrapes or burns to there face (but not too deep) had smoother, less wrinkled skin when the wounds had healed. The surgeons imitation of these injuries was a process called Dermabrasion (not to be confused with microdermabrasion), which uses a rotating sander to carefully remove the top layer of skin. The result is a smoother less wrinkled complexion and it worked great. The only problem with dermabrasion was the technical skills required to perform this in a safe and reproducible manner.

Next came the CO2 Laser. In the early 1990’s, this laser was touted as an easy reproducible way to get the same results as the Dermabrasion technique without the risks of scarring. This technique immediately caught on with dermatologists and any other doctor interested in getting a foothold in the anti-aging market. The CO2 lasers virtues included ; 1) Good smoothing out of many skin wrinkles 2) Easy to control the penetration of the laser, so the risk of scarring was minimized for those who were not trained to perform the dermabrasion procedure 3) The hype of using a space age technology – the laser – was an overwhelming reason to sell and use it.

Almost everyone, including myself jumped on the CO2 bandwagon, albeit with a bit of reluctance, since it was not better than Dermabrasion, only more high tech!

But in the end, CO2 lasers were sent to the scrap heap. Why? 1) Almost everyone who had the treatment suffered with hypopigmentation – their skin became pale white. 2) The risk of scarring and burning was not that much different than dermabrasion. 3) the downtime – scabbing and redness was prolonged 3-6 weeks, and 4) the benefits only lasted from 6-18 months.

So where did the dermatologists who created an entire anti-wrinkle industry go from there? Read the rest of this entry…

Tear Drop Augmentation Mastopexy

Many people wonder what my Tear Drop Augmentation mastopexy is, and who needs it?

What it is good for:

1. Sagging breast where the nipple-areolar complex needs to be lifted 5 cm or less.
2. Breasts with upper or medial hollow. An example is a breast with all the breast tissue distributed below the nipple or when the breast tissue is too wide, or the nipples are too wide.
3. Patients who are sagging and want an augmentation of any volume.

Read the rest of this entry…

FDA Questions Filler Companies about Risks

Synthetic facial fillers are in for a little problem with the FDA. Seems several hundred patients have had untoward problems without adequate reporting and further, doctors have not adequately reviewed the risks and benefits with their patients.

My general feeling is that the problems focus around one particular filler called Sculptra and that the FDA is likely throwing out the baby with the bath water. In the meantime, I will be careful to describe all risks and benefits with each and every patient.

Read the rest of this entry…

Sleep ‘n Beauty

Early to bed,
Early to rise,
Makes a man
Healthy, Wealthy and wise.

But the saying should add—younger looking too!

I write this after a roller coaster ride on wall street this week. No one I know is sleeping well and everyone is afraid that their job is on the line.

One thing I am sure of: like all cycles, these bad times will end. However, the stress of the times and what it does to your skin may not! You see – every night when you go to bed, the levels of a stress hormone called Cortisol goes down. Conversely, diminished sleep and added stress makes the level in your bloodstream rise.

What does cortisol do to you? Well, Cortisol modulates many bodily functions: it effects your ability to think, to reason, to love, but most importantly it affects your skin and youthful looks. The most important thing to keeping your skin looking and feeling young is to keep the content of collagen and elastin in your skin high. When you were a baby, collagen and elastin levels were extremely high in your skin hence the term “soft as a baby’s bottom”. But if you can read this, those levels are getting lower each and every day. One of the enzymes that assists in reducing the levels of collagen and elastin is called metalloprotease. This bad enzyme which makes you look older, goes up as cortisol rises. Thus, lower the cortisol level and you lower the level of metalloprotease and subsequently collagen and elastin rise – this means healthier, younger looking skin. A great example of what not to do is to become the president of the United States. That sleepless, thankless, stressful job makes everyone age rapidly during their term. I guess the reason presidencies only last 4 years was to give president’s skin a chance to recover.

In the end, the more sleep you get the better you look.That advice is the cheapest advice on beauty that you will ever get on this Blog!

Calling all Patients with a wide space between implants

Last week, I had the opportunity to create a new technique that will improve breast lifts significantly for the future. The patient had implants placed under the muscle 3 years ago. The result was implants that were too wide, nipples too wide and a large hollow space between the two breasts. The incision for the previous procedure was under the breasts in the inframammary fold and were 3 cm long. the patient wanted them to look better, correct the hollow space in the middle and most of all she wanted no new scars. Voila! the Inframammary incision Breast Medialization procedure was invented. I hereby call this the IBM procedure.

Read the rest of this entry…

FDA Questions Filler Companies about Risks

Synthetic Facial fillers are in for a little problem with the FDA. Seems several hundred patients have had untoward problems without adequate reporting and further, doctors have not adequately reviewed the risks and benefits with their patients.

My general feeling is that the problems focus around one particular filler called Sculptra and that the FDA is likely throwing out the baby with the bath water. In the meantime, I will be careful to describe all risks and benefits with each and every patient.

I would also like to say that Fat injections will not be affected by any FDA reviews of synthetic fillers. More on the Viafill System from Lipose corporation in later posts. But this system increases the viable fat cells that are injected in fat transfers by 500%.

Sensible Weight Reduction Avoids Plastic Surgery

This post is not for the overweight – it is for those of us who have gained a few pounds over the years and are now interested in some kind of surgery to correct those newfound bulges above the pantlines or below the belly button.

Forget the surgery and treat your body well.

Here are some of the mistakes that are made in an effort to lose weight:

Read the rest of this entry…