Dr. Robert Troell - Las Vegas, NV
Cosmetic and Facial Plastic Surgeon
Revision Liposuction (*) is one of the most challenging body sculpting procedures in body cosmetic surgery. Previous liposuction procedures have either did not achieved the desired outcome, the surgeon was overly aggressive with areas of indentations or skin contour irregularities or a complication occurred, all of which have produced a less than optimal result.
Approximately, one quarter of Dr. Troell’s body contouring surgeries are revisions from colleagues. All patients undergo a comprehensive physical examination in standard and down lighting. Dr. Troell will identify the exact anatomical changes that the patient is striving to achieve and determine with current technology if that is a reasonable expectation. He will educate you on the possibility of reaching this aesthetic goal and the techniques that will be required. Preparation for surgery is essential. Acquiring your previous description of the surgery or “operative report”, may provide valuable information.
Sometimes, only non-invasive or non-surgical technologies are necessary to resolve the skin contour irregularities. VASERshape non-focused ultrasound alone.
Benefits Of A Combination Treatment
Some patients may benefit from a combination treatment of VASEREshape with Mechanical Massage (Endermologie) can and have improved the skin to a smooth appearance. The chances of these non-invasive procedures being successful are best the closer they are performed to the time of the initial liposuction procedure.
Nearly all of these cases require exact mapping of the areas to be treated. Some areas require volume replacement and other areas need additional removal of excess fat. The best two techniques to undermine a scarred area are with either laser energy or ultrasound energy. Dr. Troell uses and teaches physicians in both of these technologies. He prefers ultrasound or VASER (Vibration Amplification of Sound Energy at Resonance) to undermine the scarred areas and may sometimes utilize a new method known as VASERsmooth. The VASERsmooth probe can cut fibrous bands and is used in woman with cellulite.
In most patients, to achieve a smooth skin contour, fat transfer to areas of indentations is necessary.
Improving The Fat Transfer Survival
Also, to improve the fat transfer survival, stem cells are harvested and processed to concentrate them using the Maxstem/Celltibator fat and stem cell processing unit. This procedure is followed by combining your own fat cells together with your stem and regenerative cells to improve fat grafting survival rates by an additional 10-15%. Fat survival rates can reach 80-90% using this protocol.
Alternatively, patients prefer to use platelet rich plasma (PRP). A small amount of blood is taken from your arm (only about four teaspoons or 20 cc), directly harvested into special patented test tubes, which separate the platelets and growth factors manufactured by your body. This fluid can either be injected into the area of fat transfer in advance of the procedure (6-8 weeks) or combined together with the harvested fat cells to improve fat survival with rates varying from 10-20%.
Most patients can undergo the liposuction revision surgery with fat transfer using oral sedation and a superwet wetting local anesthetic solution, occasionally supplemented with mild intravenous sedation. General anesthesia can also be performed.
A knowledge of the skin and muscle anatomy, biotechnology, an artistic eye and understanding the limitations are essential qualities of the surgeon to achieve the optimal outcome.
Dr. Robert Troell Credentials & Qualifications
Dr. Robert Troell has superior education and training to ensure he’s adequately qualified to treat these challenging revision liposuction procedures with the following board certifications:
- American Board of Otolaryngology-Head & Neck Surgery
- American Board of Facial Plastic & Reconstructive Surgery
- American Board of Cosmetic Surgery
The later two board oral examinations Dr. Troell received the highest score on the certifying board examination.
Dr Troell has presented ten live surgical workshops teaching other surgeons techniques in face and body liposuction, fat and stem cell grafting, platelet rich plasma preparation and use, non-invasive and minimally invasive body contouring and cellulite treatments. A recent teaching surgical workshop was in October 2012 with continuing medical education (CME) credits through Touro University Nevada.
Dr. Troell was a Clinical Professor at Stanford University Medical Center in Palo Alto, California from 1995 to 2001 and is currently Adjunct Professor of Otolaryngology of Touro University Nevada, College of Osteopathic Medicine.
He has published fifteen book chapters, nearly forty peer-reviewed medical article publications, and has been a guest lecturer in over 140 presentations throughout the United States and abroad.
Dr Robert Troell has taught ten live surgical workshops on liposuction, fat grafting and non-invasive body contouring techniques, the last in October 2012 with continuing medical education (CME) credits through Touro Medical School in Las Vegas, Nevada. He continues to do research in the fields of both non-invasive and invasive body contouring, fat and stem cell transfer and facial plastic surgery topics.
Dr Troell is a certified national instructor for both Water-Jet assisted liposuction (Body-Jet) and the ultrasound assisted liposuction (VASER) technologies
He produced the physician teaching video on the application of the Body-Jet liposuction and fat collection devices. His practice uses a multitude of liposuction, fat harvesting and non-invasive body contouring technologies. He is a trainer for both Cytori’s Pure Graft system and Medi-Khans Adivive fat processing unit and Maxtstem/Celltibator stem cell processing unit.
In 2011, at the American Academy of Cosmetic Surgery annual meeting, Dr. Troell prepared two presentations comparing liposuction techniques and fat grafting techniques in terms of outcome, limitations and benefits as well as complications. At the January 2012 American Academy of Cosmetic Surgery Annual meeting, Dr. Troell subsequently presented his results with the first world-wide blinded crossover study comparing four non-invasive body contouring devices: Endermologie, Velashape, Coolsculpt and Vasershape.
He presented at the 2012 National Society of Cosmetic Physicians annual meeting and at the 2012 California Society of Facial Plastic Surgery on comprehensive fat and stem cell grafting techniques.
Dr. Robert J Troell is considered an expert by his peers, the medical device manufacturers and his patients. His goal is a satisfied patient with them enjoying the entire cosmetic experience.
Contact Dr. Troell’s Office for Your Free Consultation:
Dr. Troell 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.
For your free private consultation or appointment click here.
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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.
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Dr. Robert J. Troell, MD, FACS (Las Vegas)