Dr Robert Freund

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 »

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 »

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%.