SERDEV: Serdev

Scarless, closed approach Serdev Suture techniques for augmentation and lifting of cheekbones were introduced by the author in 1994. They use the mobile cheek SMAS flap or fascial tube of the buccal fat pad (also called Bichat’s fat pad) to elevate and attach it to the immobile, stable zygoma periosteum, and in selected rare cases - to the orbital rim periosteum, or temporoparietal tendon insertion and underlying periosteum, or the upper temporal line periosteum and temporal fascia. The idea is to lift the SMAS and fat pad via its fascial tube at the level of the zygomatic bone; restore cheekbone fullness; volumize and elevate the cheekbone; eliminate the tear trough fold; improve facial expression; and achieve a youthful elongation of the so-called “beauty triangle”. To achieve the cheekbone lift, the author uses special semi-blunt and semi-elastic curved needles with lengths of 50 mm, 60 44 Miniinvasive Face and Body Lifts – Closed Suture Lifts or Barbed Thread Lifts mm, 100 mm, and 140 mm with an eye at the tip, and prefers semi-elastic Bulgarian polycaproamide (Polycon) USP 2 sutures with prolonged resorption (2-3 years). The Serdev Suture® lifting techniques are ambulatory, performed under local anesthesia, very well tolerated by patients, produce immediate results, with an extremely short post operative period, fast recovery and nearly immediate return to social life.

Complications are under 0,1% and patient satisfaction is high, especially in the aesthetic aspects of rejuvenation and beautification. There were no known specific surgical methods

for simultaneous direct cheekbone lifting, enhancement and volumising without the use of implants or transplants before 1994. The superficial muscle-aponeurotic system, or SMAS, was described by Mitz and Peyronie in 1976 and the SMAS facelift became the gold standard. Earlier procedures developed into a large rotation-advancement skin flap for indirect lifting of this area.

Classic rhytidectomy progressed into sub-fascial, tri-plane, deep-plane, composite, subperiosteal, multiplane, “enbloc” and other extended surgical methods, with a progressively increasing rate of complications and downtime. Nowadays, minor operations with reduced risks and faster recovery time have become more common, but the SMAS lifts without undermining remain the best long-term suspension, affecting the overlying skin. Later techniques, such as barbed “thread lifts”, are placed subdermally and naturally cannot include the SMAS in the lift. They are free floating, not sutured, nor stabilized by attachment to immobile anatomical structures. Therefore, in the author’s opinion, they are different from suture lifts and cannot guarantee a safe prolonged outcome.

Wednesday, August 12, 2015

Serdev

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