**Meet the editor**

Prof. Dr. Nikolay Serdev, MD, PhD is a renowned cosmetic doctor and surgeon. He has trained hundreds of doctors globally, in minimally invasive aesthetic surgery and medical procedures. He is a founding member of the European Society of Aesthetic Surgery and the International Board of Cosmetic Surgery. He is a Honorary President of the Bulgarian Society of Aesthetic Surgery

and Aesthetic Medicine, Honorary Professor of the New Bulgarian University, the International College of Cosmetic Surgery, the South East Asia College of Cosmetic Surgery, Honorary member of the Australian College of Cosmetic Surgery, South American Academy of Cosmetic Surgery, French Society of Aesthetic Surgery and numerous other international societies. Dr. Serdev is the author of "Scarless Serdev Suture® lifts" of face and body and pioneer in many mini-invasive cosmetic surgery techniques: ultrasound liposculpture of face, body; leg elongation and beautification; T-excision and columella sliding in rhinoplasty; non-surgical body contouring; and combination approaches to facial volumising and rejuvenation. He is also a world authority in ultrasound-assisted (VASER) body contouring and has trained doctors from around the world in its basic and advanced techniques. Dr. Serdev divides his time between his clinic, the New Bulgarian University in Sofia and short travels for hands-on courses in countries of all continents. He is editor of the most comprehensive textbook in Liposuction and has authored many chapters in aesthetic surgery and medicine, as well as original papers in leading medical journals.

Contents

**Preface IX** 

Chapter 1 **Serdev Sutures® in Upper Face:** 

Chapter 2 **Serdev Sutures® in Middle Face 43** 

Chapter 3 **Serdev Sutures® in Lower Face and Neck 95** 

Chapter 4 **Serdev Sutures® Lifts in Body Areas 127** 

**to Change the Nasal Tip 153** 

Chapter 6 **Chin Enhancement Using Serdev Suture: Five Case Reports 163** 

Chapter 8 **Suture Lifting and Liposculpture Integration** 

Meity Hidayani, Syarief Hidayat and Dali Amiruddin

Chapter 7 **Serdev Technique for Cervicoal Flaccidity and Mandibular Definition Utilizing "Serdev Sutures" 173** 

> **in the Creation of Facial Esthetic Harmony 185** Ronald Feiner and Chedly Bouzouaya

Chapter 9 **The Holistic Scarless Rejuvenation of the Face 195** 

Chapter 5 **Percutaneous Suspension Sutures** 

M. B. Des Fernandes

Nikolay Serdev

Nikolay Serdev

Nikolay Serdev

Nikolay Serdev

Roberto Tulli

M. B. Des Fernandes

**Section 1 Transcutaneous Suture Lifts and Suspensions 1** 

**Brow and Temporal Lift; Glabella Muscle Ligation 3** 

## Contents

#### **Preface XI**


M. B. Des Fernandes


#### **Section 2 Barbed Thread Lifts 249**


## Preface

Both Suture lifts and Thread lifts present closed scarless techniques of tissue suspension, but they fix different tissue and use different type of fixation. These are totally dissimilar techniques and should be differentiated.

The number of such techniques is growing without precise understanding and formulation. Presently, there is no clear description and definition of the differences, results, and longevity of these two mini-invasive techniques. They use different instruments and materials in different areas and layers, and give different results.

Both suture and threads are scarless, the downtime is shortened. In some countries they are called "coffee break" or "lunch procedures".

This will be the first scientific book that could clear the false public beliefs that both suture and thread lifts are one and the same method:


The growing public interest in mini-invasive interventions in cosmetic surgery requires clear description and differentiation of these two techniques and their results, as well as scientific information about the different instruments and materials used. This clarification will be hugely beneficial both for patients and doctors, having in mind the increasing number of such interventions.

#### **Prof. Dr. Nikolay Serdev**

National Consultant of the Ministry of Health in the Specialty of "Cosmetic (Aesthetic) Surgery" 2006-2008, Director of University Program in Cosmetic Surgery at New Bulgarian University, Head, Medical Center "Aesthetic Surgery, Aesthetic Medicine", Bulgaria

**Section 1** 

**Transcutaneous Suture Lifts and Suspensions** 

**Transcutaneous Suture Lifts and Suspensions** 

**Chapter 1** 

© 2013 Serdev, licensee InTech. This is an open access chapter distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use,

distribution, and reproduction in any medium, provided the original work is properly cited.

© 2013 Serdev, licensee InTech. This is a paper distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

**Serdev Sutures® in Upper Face: Brow** 

Additional information is available at the end of the chapter

Nikolay Serdev

**1. Introduction** 

http://dx.doi.org/10.5772/55673

before suture degradation.

elements in the same direction.

zygoma, coli fascia, mastoid, occipital bone etc.

**and Temporal Lift; Glabella Muscle Ligation** 

Closed approach transcutaneous Serdev Suture**®** lifts encompass the principale concept of stable suturing and fixation of mobile fascias to immobile periosteum, tendons and fascias,

21 techniques and individual modifications are used on face and in body areas, even where open surgical techniques cannot be directly applied. Serdev Sutures® are scarless and uncomplicated in the post-operative period. These techniques use curved semi-blunt semielastic needles and smooth surgical sutures to elevate and fixate mobile fascial tissue. Polycon surgical sutures are preferred for these techniques. They are characterized by short elasticity to prevent mobilized tissue from rupture and are characterized by delayed resorption (in 2-3 years, after the fibrosis is finalized). This enables stable fibrotic fixation

Fixed mobile facial tissue using Serdev Sutures® is SMAS in all face areas: upper facial SMAS (galea aponeurotica), zygomatic SMAS extension, cheek SMAS, platysma and others. It is fixed by suture to stable, immobile tissues, such as periosteum, temporal fascia,

In addition to the possibility of lifting, Serdev Sutures**®** follow aesthetic principles of beautification: adaptation of aesthetic proportions, volumes and angles. In art and theatre, face masks called "mask of tragedy" and "mask of comedy" are well known and used to express age, status and emotions. The concept of scarless suture lift in face is to convert the "mask of tragedy" into a "mask of comedy", i.e. to uplift the subcutaneous facial mask – the SMAS. As soft tissue and skin are attached to the SMAS by a trabecular system, an intrinsic consequence of SMAS lifting is reflected in the lifting of the face and its most important

resulting in suture suspension and/or volume augmentation and/or repositioning.
