The author has invented and performs the following scarless transcutaneous closed approach suture lifts:
#XPRESSIVE THREADS SALISBURY MD SKIN#
The techniques consist of passing closed sutures, by needle perforations only, to lift mobile fascias supporting the skin and fix them to immobile skeletal structures (such as periosteum) in several facial and body areas. Operations are ambulatory, without hospital stay. There are no visible scars and the needle perforations on the skin are no longer visible after days. The trauma is minimal and the follow-up period is no longer than 3 days with fast and mostly immediate return to work and social life. Operations were ambulatory with excellent results, reported by the patients. The author’s contribution is that the transcutaneous closed approach suture techniques lift the SMAS and the facial skin attached to it, without traditional incisions. In 1994, at the Second annual meeting of the National Bulgarian Society of Aesthetic Surgery and Aesthetic Medicine, most of the scarless suture techniques for correction of early ptosis and flabbiness in areas of face and body were presented, as well as the initial results with 54 patients, operated during the period from 1993 to 1994. The long term absorption of the sutures is crucial in the author’s method. For sutures stretch, elasticity and cut through tests were performed. Needle preparation and selection of surgical sutures was experimental. The anatomy study, instrument creation and surgical suture selection commenced in 1990 and the entire understanding of local topographic anatomy, instrumentarium and technique of this new method was ready in 1993. Sutures are the same as in open surgery, but with much more variations and even in areas not reachable in open surgery. Scarless closed approach Serdev Suture ® lifts present skeletal fixation using skin punctures, without incisions and excisions, as a first alternative to classic excision lifts. Changing SMAS position by sutures can restore aesthetic angles, shape, volume and proportions as a basis for beautification and rejuvenation, imparting a happy, youthful appearance and a smiling expression. Beautification is most important in youth and rejuvenation incl. Unaesthetic face angles, volumes and proportions are responsible for lack of beauty in young patients as well. The structuring and positioning of different face elements is not limited to facial ptosis and elderly cases. 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 elements in the same direction. to uplift the subcutaneous facial mask – the SMAS. The concept of scarless suture lift in face is to convert the “mask of tragedy” into a “mask of comedy”, i.e.
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. In addition to the possibility of lifting, Serdev Sutures ® follow aesthetic principles of beautification: adaptation of aesthetic proportions, volumes and angles.
It is fixed by suture to stable, immobile tissues, such as periosteum, temporal fascia, zygoma, coli fascia, mastoid, occipital bone etc. This enables stable fibrotic fixation before suture degradation.įixed 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. 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). Polycon surgical sutures are preferred for these techniques. These techniques use curved semi-blunt semi-elastic needles and smooth surgical sutures to elevate and fixate mobile fascial tissue. Serdev Sutures ® are scarless and uncomplicated in the post-operative period. Closed approach transcutaneous Serdev Suture ® lifts encompass the principale concept of stable suturing and fixation of mobile fascias to immobile periosteum, tendons and fascias, resulting in suture suspension and/or volume augmentation and/or repositioning.Ģ1 techniques and individual modifications are used on face and in body areas, even where open surgical techniques cannot be directly applied.
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