Facial Volume Replacement is essential for keeping a youthful glow. There are temporary and permanent facial volume replacement options.
Treatment Options for Permanent Facial Volume Replacement:
- Permanent dermal filler known as Bellafill
- Facial fat transfer using your own fat
- Soft silastic implants (most commonly lip, chin and cheek)
Background:
We all appreciate facial beauty. The aging process steals our facial youthfulness by characteristically atrophying the skin, soft tissues and bony framework. Battling the aging process is a life-long endeavor. Procedures and technologies exists to lessen or fully correct facial wrinkles and volume deficiencies.
Goals of Facial Rejuvenation:
Fashion models are perceived as beautiful by displaying the following facial anatomical features:
- facial proportion, symmetry and balance
- appropriate forehead height and aesthetic brow shape
- lack of eyelid dermatochalasia (excess skin and herniated fat)
- high cheek bones
- appropriate nasal size and shape
- full, attractive lips
- straight, white teeth
- straight mandibular line
- acute cervicomental angle. and
- a smooth skin contour without wrinkles or blemishes.
Facial rejuvenation centers upon optimizing these treatment goals. To attain many of these stated rejuvenation treatment goals requires volume replacement. This volume enhancement is paramount to restoring and maintaining youthfulness. The decision to offer and choose a specific option of volume replacement is typically based on the experience and training of the physician and their personal bias.
Treatment options in detail:
Current therapeutic options include:
1. a silastic facial implants (temporal, tear trough, malar, submalar, combined midface, nasal, premaxillary, lip, chin and mandible angle)
The advantages of the soft silastic implants is that they are permanent, precise, modifiable, well-tolerated, simple surgical procedure under oral sedation with local anesthesia (can be performed under intravenous sedation or general anesthesia), with instant results, low complication rate and optimal aesthetics.
Silastic implants produced the best “facial lifting”” of any volume replacement option. Many patients who thought they would need a facelift to optimize there jowls and facial wrinkles, require only a mid face silastic soft implant.
2. facial autologous fat grafting with platelet rich plasma and/or autologous stem cell placement.
This is a short, out patient surgical procedure (about one hour), under oral and local anesthesia, in a surgery or procedure room with tumescent anesthesia under your skin, fat is removed typically from your abdomen or flanks, processed to concentrate and purify the fat, which is then injected with microcannulas into the anatomical sites of the face that will optimize one’s cosmetic appearance.
3. bone, or other biologic tissue transfers, with or without osteotomies and bony advancement.
Most commonly this is performed on the anterior lower jaw or mandible where the bone is cut and pulled forward to create a more pronounced chin projection. In most cases, a soft silastic implant is a better choice, less painful with less risks and better tolerated by patients. I have extensive maxillofacial surgery training, while at Stanford University and in private practice in Palo Alto, CA to provide the expertise and experience you seek.
4. dermal filler placement using Bellafill 
The chemical substances making up temporary dermal fillers are hyaluronic acid (HLA), such as Restylane, Juvaderm, and Voluma, calcium hydroxylapatite (CaHA) known as Radiesse, and poly-lactic acid (PLLA) or Sculptra. Unfortunately, the volume from these fillers remains for a maximum of two years.
The long-term filler is suspended polymethylmethacrylate (PMMA) microspheres in a bovine collagen gel, known as Bellafill, after a name change in 2015 from Artefill (ART). Most dermal fillers should be termed subcutaneous fillers, since they are injected subcutaneously as opposed to into the dermis of the skin. The amount of volume deficiency in a specific facial area may affect the recommendations for the optimal technique to treat the deficiency.
Dr Robert Troell’s Expertise:
Dr Robert Troell is one of three surgeons to be an instructor in the last three surgical workshops by Implantech, the leader in facial implant manufacturing in the world. He is in the top 1% of both Bellafill and Restylane dermal fillers in the Unites States, and has been the medical director of 19 live surgical CME physician instructional courses centering on facial fat transfer. He is a diplomate of five medical specialty boards after his Stanford University residency and fellowship training, followed by six years as a Clinical Professor.
I am considered an expert by my peers and I will works diligently to ensure each patient’s entire treatment experience is unsurpassed by making the treatment plan individualized to you, calling you myself before and after treatments and even performing house calls.
Permanent facial volume replacement with fillers, silastic implants or fat transfer will rejuvenate you and assist in increasing your self-esteem.
Please feel free to contact me for a consultation at 702-242-6488..
