Contact: Ellen Bank
843.792.2626
March 14, 2005
CHARLESTON -- John Robinson, M.D., the new director for
the Medical University of South Carolina (MUSC) plastic surgery residency program,
brings with him from Toledo Ohio, a modified facelift procedure, which gives
patients improved appearance after an approximately one-hour, out-patient procedure,
using local anesthetic and having less than a two-week recovery time.
SMILE Plus (Selected Micro Incision Lipo Elevation Plus) is the trademarked
name of procedure developed by Robinson. It is based on two other mini facelift
operations and uses a special instrument that he has designed specifically for
the procedure.
Robinson has done approximately 120 of these procedures during the past four
years in Toledo. He said that his patients have been very satisfied. The results
are a subtle change without the distorted appearance of the traditional facelift.
“The result is very natural looking,” he said. “My patients
have told me that following surgery they are told that they look less tired
and happier. One patient was told that she didn’t look grumpy anymore.”
Most patients can walk outside after two weeks, and no one would know they had
surgery. “I’ve had patients go back to work after 12 days,”
he said. “Patients having the traditional face lift don’t return
to public life until three to four weeks at the earliest, and some much longer
than that.”
The standard facelift takes between three and a half and six hours in the operating
room under general anesthesia, and the expanded facelift takes between six and
10 hours. Robinson’s procedure takes between one hour and one hour and
40 minutes. He said that some patients like to be completely alert and desire
only a local anesthetic. Others prefer to be less alert and are given a local
anesthetic along with mild sedation. General anesthesia is never used.
The surgery targets the cheeks, the jowls, and the lines the vertical creases
going down from the corners of the mouth, known as marionette lines.
The traditional facelift operation requires lifting skin off underlying tissue
over a large area, causing significant injury under the skin. With Robinson’s
technique, the skin is not elevated from the structures underneath it. As a
consequence, there is far less bruising and swelling.
During the procedure, Robinson places an instrument through small needle-like
incisions over the area he wishes to lift. With the instrument he designed and
trademarked, he retrieves a suture from an incision in the hairline. He lowers
the suture under the skin and loops it around the tissue to be lifted. The tissue
is lifted up to where it is supposed be, and the suture permanently holds the
tissue in the desired place.
Robinson feels that the approach of facelifts for many years has been wrong.
Rather than the pulling back and stretching of the skin, he feels that sagging
tissue needs to be lifted up. He said he has best illustrated this point with
two photographs of his own face side by side. The photographs were taken minutes
apart, but in one he looks 20 years younger than in the other. The difference,
he says, is that in one picture he is standing up and in the other his face
is photographed while he is standing on his head. It illustrates the effect
of gravity on the facial tissue. His surgical procedure counteracts the downward
pull of gravity by using sutures to hold the facial tissue up and in place.
Robinson explains that he adapted his technique from procedures done by two
other surgeons. One did a similar procedure to his, but only on the cheeks.
Most of Robinson’s patients preferred the additional work on the jowls
and under the marionette lines. Another surgeon did all three areas, but used
a barbed suture to hold the tissue in place. Robinson had reservations about
the type of suture as it failed in hand surgery. So he adapted the procedure
of doing three area of the face, but rejected the use of the barbed suture in
favor of looping the suture over the area to be lifted and drawing it up using
the instrument he designed for the purpose.
In addition to the aesthetic, safety and shortened recovery time advantages,
the cost of the procedure is about a fourth that of the traditional facelift
surgery.
Prior to coming to MUSC Robinson was director of the residency program at the Medical College of Ohio for four years and had a private plastic surgery practice for 30 years in Toledo. He plans to teach his procedure to MUSC plastic surgery residents.
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