An Injectable Treatment for Fastoons

Under-eye bags are one of the most common signs of aging that effects both men & women. Lower Lid Blepharoplasty is one of the most common surgical approaches to treat this problem, but this surgical technique doesn’t treat festoons – one of the most common causes of puffy under-eyes which effects over 34% of the U.S. population. That’s because festoons are a medical condition where swelling occurs in the lowest portion of the muscle around the eye causing the overlying skin to permanently change.


Recently, Dr. Robert Freund began using an injectable to treat festoons that provides permanent results. In fact Dr. Freund’s results were recently presented at the American Society of Ocular Plastic Surgeons.

What Are Festoons?

Festoons are a medical condition where swelling occurs in the lowest portion of the muscle around the eye causing the overlying skin to change. Mild symptoms can come and go and get worse with fatigue, lack of sleep and excess salt consumption. Some patients, however, may have large bulges that stick around for a long time can change the overlying skin. These changes from temporary swelling to permanent swelling can be divided into 3 stages: Malar Edema, Malar Mounds, and Festoons.




The Ultimate Guide To Determining Which Breast Lift Technique Is Right For You

A Breast Lift, also referred to a mastopexy, is a surgical procedure designed to lift the breasts back to a more youthful position. However, there are multiple surgical techniques to achieve lifted, more youthful looking breasts. Deciding which breast lift technique is right for you depends on what type of candidate you are and your desired aesthetic goals.



The Two Questions to Consider During Your Breast Lift Consultation

When a patient comes in to inquire about cosmetic breast lift surgery there are two questions I ask them:


  1. Do you like the size of your breasts?
  2. Do you like the shape of your breasts?


The reason I start a consultation with these two questions is because the answers to these questions require a different surgical approach. If a patient feels their breasts are too large, they’re most likely a candidate for a breast reduction. If they’re too small, a breast augmentation is most likely needed. But what if they sag?


Some plastic surgeons will say, we’re going to increase the size breasts and that will take out the sag but that’s totally false. I’ve seen plenty of patients who have gone to doctors and had a breast augmentation when what they really wanted to be was lifted.


They wanted the shape of their breasts to be improved, but they didn’t want to be bigger. So the idea that increasing the size of the breasts with an implant will also lift the breasts is a falsehood. They only time you should get breast implants is if you want to go bigger. If you want a better shape, you should get a breast lift.


They Ideal Candidates For A Breast Lift May Surprise You

One of the biggest misconceptions about breast lift surgery is that it’s only ideal for older woman who having sagging breasts and are finished having children. There are actually 4 distinct groups of patients who are ideal candidates for a breast lift.


1. Young Women in Their 20’s

Some women in their early 20’s suffer with saggy or asymmetrical breasts even if they haven’t had children or large weight fluctuations. Unfortunately, this group of women have sagging breasts purely from genetics. They can be active, consume a healthy diet, but will still have sagging breasts because of genetics.

So the idea that you have to wait until after childbirth to have a breast lift is not correct. This group of women may not have children for another 10 years, but are still seeking a quality of life and a breast lift may be the right answer for them.

2. New Moms

When you have a child, your breasts will enlarge and shrink, just like your stomach. And oftentimes when the breasts shrink back down to size they become saggy. Even if you’ve had beautiful breasts prior to having children, sagging can still occur after childbirth.

3. Weight Fluctuations

Just like with pregnancy, large weight fluctuations can have the same effect on your breasts – the breasts will expand, contract, and then they become deflated in appearance.

4. Older Women

It’s no surprise that as you age, gravity can cause your breasts (and other parts of your body) to sag. Even if you’ve had beautiful breasts your entire life, you’re still not immune to the effects of gravity.

Wearing a bra will slow down the effects of gravity, but eventually your breasts will become saggy as you age. A breast lift can definitely lift and re-shape the breasts to a more youthful position, but unfortunately the results will never be as perky for this group of women compared to younger women. The reason is because aging also causes a loss of glandular breast tissue.


Some Candidates Have Better Results Than Others

Breasts are comprised of both fat and glandular tissue. Fat tissue expands and contracts when you eat too much or diet and lose weight. Glandular tissue expands and contracts when you’re having you’re having your period or during pregnancy. Glandular tissue has shape to it, whereas fat can be thought of more like quicksand.


The more glandular breast tissue you have, the more perky your breasts will be after a breast lift. Unfortunately, this is simply anatomy so it doesn’t matter who performs the breast lift. It also doesn’t mean you’ll have poor results if you have less glandular tissue. It just means the breasts won’t be as perky when compared to someone else with more glandular tissue.


Younger women and women who have recently given birth, generally have more glandular breast tissue. Whereas, women who have had large weight fluctuations or are older will have less.


The Two Breast Lift Techniques Which Provide the Best Results

There are multiple surgical techniques when performing a breast lift. At Dr. Robert Freund’s practice, we offer two options that we’ve found to provide the best results in terms of shape and lifting – The Le Jour Breast Lift and the Goes Breast Lift.


Technically, we also offer a third technique pioneered by Dr. Robert Freund called the Tear Drop Breast Augmentation Mastopexy. However, that breast lift technique also includes the placement of a breast implant. So if you’re considering only a breast lift, the Le Jour and Goes Breast Lift are the two options to consider.

Deciding which breast lift technique is right for you will depend on the location of the areola in relation to the inframammary fold.


The Göes Breast Lift Technique

The Göes Breast Lift Technique is ideal for candidates experiencing 2 specific categories of sagging breasts:


  1. Women whose areola is located at the same level as the inframammary fold.
  2. Women whose areola falls just below the inframammary fold.


The Göes Breast Lift Technique is the closest technique to a scarless breast lift. The scar is made just around the areola. If you’ve been doing your research on breast lifts, you’ll notice it’s similar to a “donut” or “doughnut” mastopexy. But unlike the donut mastopexy, the Göes Breast Lift doesn’t excise (i.e. remove) skin to create the lift. Instead, the Göes Breast Lift raises, sculpts, and stiches the breast tissue to the chest wall to create the lift. The nipple is also raised and the surrounding tissue is brought together and stitched.


Because this scar can be visible, some people tattoo round the edge of the areola and they can make the scar completely disappear.



The Lejour Breast Lift

The Le Jour Breast Lift is best suited for candidates experiencing 3 specific categories of sagging breasts:


  1. Women whose areola falls below the inframammary fold but wish to have a fuller, more youthful looking breasts.
  2. Women whose areola falls just below the inframammary fold AND the nipple points downward.
  3. Women whose areola is located above the inframammary fold, but the breast tissue beneath the areola sags below the fold. You may have heard of this condition during your research which is called, “psudoptosis”.


During the Lejour Breast Lift, Dr. Freund makes 2 incisions – around the areola and a straight line from the base of the areola to the bottom of the breast. This is referred to as a lollipop incision.


You might be thinking that the Goes Breast Lift technique is a better option because it’s one less incision (i.e. one less scar), but this second incision, albeit discreet, offers a benefit which you won’t achieve with the Goes Breast Lift technique – an improvement in the projection of the breasts to the point that it looks visibly fuller and larger.

How Can I Achieve a Scar-Less Breast Lift?

There is no such thing as a scar-less breast lift. Some people will try and present the lasers or radio frequency as a way to try to tighten and lift a breast, but if you want significant results and improvement anything that we do will have some version of a scar. They may be small scars, but everything will have a scar. When a breast lift patient comes to me and asks about a scar, I go through everything that we can do to minimize their scar. Granted genetics play a role and there are some people regardless of all the tools that I have to minimize the scars, they won’t have an excellent outcome. But a majority of my patients have a great outcome because:


  1. We can minimize through excellent, stress free surgery without any tension on the wound.
  2. After surgery the post op care is critical. We will start them on silicone gel. Some patients will start on steroids if they need to, but we make every effort possible to minimize their scars.


A lot of my patients, after they get their breast lifts or breast augmentations with breast lifts, they’re happier than their original expectations. I’ll often show them before and after photos, but in reality when they see it on themselves, when they see that improved breast lift…you see this shine light up their face. Because, everyone is a little suspicious they’re going to be that one person that doesn’t come out with a great result. But when they get those great results with minimal scars, and all of a sudden it feels like their own breast and they forget about the scar, they even forget about me. They’re just happy they look really good!


Meet Robert Freund MD

Meet Robert Freund, MD.

Dr. Freund Headshot2Dr. Robert Freund is a plastic surgeon with a thriving New York practice that has helped thousands of patients look and feel their very best.  He is the inventor of the teardrop breast lift, a groundbreaking procedure that lifts the nipple, enlarges the breast, and gives it a more natural shape. With minimal scarring and long-lasting results, the teardrop lift has been hailed as one the most impressive improvements in modern plastic surgery.

He is uniquely skilled to perform secondary rhinoplasty, the complex operation that fixes a nose that has already had cosmetic nasal surgery. His artful approaches to brow lifts, eye lifts, and other procedures on the face and neck led New York magazine to name him “One of New York’s leading plastic surgeons” in 2003.

Dr. Freund has been in private practice in New York City for 17 years and is a certified plastic surgeon by the American Board of Plastic Surgery. In 2003 he won the Best Scientific Exhibit Award from the American Society of Aesthetic Plastic Surgeons for his pioneering work on the lateral brow lift, which uses small incisions, does not raise the hairline, and maintains a natural, arched eyebrow.

Dr. Freund is a graduate of Brown University and Cornell University Medical School.

As an innovator and researcher…

Dr. Freund has developed a revolutionary technique of fat transfer which restores facial volume lost by age, which is considered the best new way to slow the aging process. In the past, fat transfer methods have been shown to be inconsistent. But new studies have shown that Dr. Freund’s technique may provide as many as 500% more live cells than other methods and that this can lead to more consistent results. This improved method eliminates the need to overfill fat, leading to better results that appear more quickly.

As an author…

original_cosmetic-breast-surgeryBoard-certified plastic surgeon Robert Freund serves patients from throughout New York and the entire Tri-State Area, as well as the rest of the United States and, indeed, the world. As a phenomenally skilled plastic surgeon, Dr. Freund is highly sought after by patients both nationally and internationally because of his exquisite skill, tender care, and top notch quality procedures. He is known for his willingness to candidly discuss the risks and rewards of cosmetic surgery.

His 2003 book, Cosmetic Breast Surgery: A Guide to Making the Right Choice-from A to Double D, was named Best Consumer Heath Book by Library Journal. His recent book, titled A More Beautiful You: Reverse Aging through Skin Care, Plastic Surgery, and Lifestyle Solutions, has been flying off the shelves since 2010.