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I have a vast experience performing botulinum toxin injections (Botox, Dysport, Xeomin) & dermal filler procedures for improving wrinkles and lines as well as volume replacement of facial and body areas of fat absorption. I completed a residency and fellowship at Stanford University Medical Center, remaining as a clinical professor for seven years.
The dermal fillers most commonly used for facial lines and wrinkles are hyaluronic acid (HLA) fillers, such as Restylane, Perlane and Juvaderm. The benefit of these fillers is that the procedure is minimally invasive, with only a small needle placed in the skin to deliver the dermal filler. The procedure can be made more comfortable using anesthetic techniques, such as ice, topical anesthetic solutions or nerve blocks. All of these substances are designed to make the procedure minimally uncomfortable and limit the potential for bruising. These HLA fillers last about 6 months, before a repeat injection is indicated.
When repair of volume loss or for enhancing or augmenting areas, Radiesse, a long-term filler lasting 10-12 months or to the use of Artefill, which is a permanent dermal filler, are preferred. Using a blunt tip cannula, Dermasculpt or the Magic Needle, reduces the risk of bruising, blood vessel thrombosis or embolization, making it a safer injection. Dr Troell is one the highest users of Artefill in the USA.
The most common areas of the face that are treated with volume enhancement are the space below the lower eyelid (tear trough), the line that extends diagonally from the inner eye area to the cheek bone (nasojugal groove), and the laugh line laterally to one’s mouth (nasolabial fold), the space below the cheek bone (submalar space), and the upper and lower lips.
The Vampire Facelift or Ageless lift uses a combination of a microdermabrasion, micro-needling of the skin, a dermal filler placement followed by administering your bodies own healing growth factors, known as platelet rich plasma, to rejuvenate your skin.
Face Fat Grafting allows permanent volume replacement. It is performed by taking your own fat and placing it in areas of volume loss. New developments in fat harvesting and fat grafting have yielded the highest fat survival rates, as much as 80%. Dr Troell has taught hundreds of surgeons his technique.
Some lines or wrinkles are better treated with muscle relaxing agents, such as BOTOX or Dysport. Dr Troell is one of the leading Dysport uses in the USA. The injection can be performed without any anesthesia, the procedure takes less than one minute, and there are minimal risks and possible complications. The procedure needs to be repeated every 3-6 months.
Vascular and skin pigmentation lines, lesions and blemishes, such as fine and medium blood vessels, freckles and age spots are best treated with an intense pulse light (IPL). Wrinkles, skin tightening, acne scarring, and overall skin rejuvenation is best treated with a resurfacing laser. DEKA’s Smartxide DOT fractional carbon dioxide (CO2) laser has been determined to be the Best CO2 laser in a scientific study (Waibel J, J Drugs in Derm May 2009). Dr Troell is a physician trainer for both companies.
During your initial free consultation, we will discuss your aesthetic concerns and discuss your treatment options. Please continue browsing our website.
I look forward to meeting you in my office.
Sincerely & Respectfully,
Robert J Troell, MD, FACS