Dr. Robert Troell - Las Vegas, NV
Las Vegas, NV & Irvine, CA
Cosmetic and Facial Plastic Surgeon
Adipose Derived Stem Cells and Regenerative Cells (ADSRC) – for Face & Body Fat Grafting (*)
The richest location of stem cells in the human body is not in the bone marrow, but interestingly, in the fat layer. Over 2.5% of the cells in a liposuction aspirate are stem and regenerative cells, while less than 0.003% of all the bone marrow cells are stem cells.
The technique in fat harvesting is vital to the final outcome of fat volume and fat survival in fat grafting. Fat can be grafted to virtually any part of the face & body.
Dr Troell is considered an expert for Facial Fat Grafting
These areas include:
- 1. temporal area of the forehead, lower brows and upper eyelid area
- 2. below the lower eyelid known as the tear trough, the mid-face area (includes the nasojugal groove, nasolabial fold, malar {cheek bone} and submalar areas)
- 3. lower face (mesolabial fold {marionette lines}, prejowl sulcus {lateral to chin area) and mental crease (below lower lip)
- 4. upper and lower lips for either augmentation or repairing a volume deficiency.
Dr Troell has vast experience with Body Fat Grafting, and these areas include:
- 1. Natural breast augmentation
- 2. Brazilian Butt Lift
- 3. Hands, forearm and elbows
- 4. Ankles and legs
- 5. Liposuction defects
Dr Robert Troell practices in Laguna Beach California and Las Vegas Nevada and is recognized by his peers as an expert in the field of body contouring as well as face & body fat grafting.
Dr Troell is a national instructor for Sound Surgical Technologies, the manufacturer of the VASER ultrasound system as well as being a national trainer for the Body-Jet or Water-Jet assisted liposuction and fat grafting method manufactured by HumanMed.
The Biology of Fat Grafting – Controversy exists!
Even in 2011, it is unknown exactly what cellular mechanisms are occurring in fat grafting. It is accepted that fat cells (adipocytes) need to be placed into the recipient area (area to be fat grafted to improve volume deficiency or to make an area larger) alive.
There is where the controversy starts, with two main theories. The fat cells are grafted to there new home alive. The adipocytes are weak cells and immediately send a distress signal to the local tissue as well as the stem cells and blood vessels cells (perivascular and endothelial cells) that were grafted with them that they are dying. The adipocytes dying process takes between one to three days.
Theory One:
The adipocytes signal the stem cells to transform into blood cells (perivascular and endothelial cells) into new blood vessels. These new blood vessels bring oxygen and nutrients to the grafted adipocytes in hopes of preventing there demise. With Dr Troell’s technique, which he presented at the American Academy of Cosmetic Surgery 2011 annual meeting, about 80% of the adipocytes survive the trip to there new home.
Theory Two:
About 95% of the grafted adipocytes die. The grafted stem cells transform into new fat cells. Local signals from dying cells stimulates new microscopic blood vessel formation (neoangiogenesis) and bone marrow cells circulate to the are of limited blood supply around the grafted adipocytes and grow new small blood vessels. The body subsequently cleans the area by absorbing (macrophagocytosis) the dead cells and debris.
The former theory (Theory One) seems more plausible and current cellular scientific data also supports this theory more. Continued research will soon prove that one or the other theory or a combination of these cellular mechanisms are indeed occurring during the fat grafting process.
The PUREGRAFT™ system by Cytori has been shown to improve fat survival using the Coleman syringe suction technique of fat harvesting by as much as 20%. This “lipodialysis” technology dialyzing the fat graft and removes impurities and cellular debris that acculmulate during liposuction. This process produces a clean and concentrated fat graft, which includes the adipocytes (fat cells), vascular cells and the stem cells. All these cells are naturally found in the donor site fat layer.
The VASER method is currently the best technique for fat grafting, increases the fat survival up to 80-90% of the grafted fat, compared to only 40-60% with other conventional techniques. Adding Puregraft stem cell and fat cell (adipocyte) washing further increases fat cell volume replacement of the face and body.
Dr Troell has presented his scientific study comparing Suction-assisted, Water-Jet assisted (Body-Jet) and Ultrasound-assisted (VASER) techniques for fat harvesting and subsequent fat grafting at the annual American Academy of Cosmetic Surgery conference in Phoenix, AZ in January 2011, revealing an 80% fat volume survival with both the VASER and Body-Jet techniques.
Contact Dr. Troell’s Office for Your Free Consultation:
Dr. Robert J Troell, FACS, FAAFPRS, FAACS, FAAOHNS, FAASM and his staff are happy to discuss Reconstructive Plastic Surgery procedures with you and answer your questions. Please feel free to call our offices in Las Vegas, Nevada (702) 242-6488 and Irvine, California (949) 325-2595.
For your free private consultation or appointment click here.
Photographs of people used on the following pages are before and after photos of patients who have undergone surgical and non-surgical cosmetic procedures described herein and that provide a reasonable indication of typical results of the advertised procedure. Results may vary and this may not be typical of every user. In the event that this Website uses the image of a non-patient model, we will make reasonably attempts to state that the photo used is of a non-patient model.