Many of us dream of changing something in our face – some do not like their nose or lips, others want  to completely transform the way they look. There is nothing wrong with striving for beauty and perfection, if a change would make us happier and complete, and would raise our confidence. We can achieve an overall face beautification without scars, in accordance with patients’ needs.

Sometimes, however, patients have requests which are unnecessary and/or will not help in getting the required result. We always conduct a discussion and realistic assessment, regarding what is needed for beautification and rejuvenation in the specific case. Patients must have proper motivation and be certain in their wish to undergo these changes.

What defines the beauty of the face?

We achieve beautification of the face by arranging facial details in accordance with aesthetic proportions, angles, and volumes while in the same time maintaining individuality. Imagine your room tidy and then imagine it disorderly. It is surely more beautiful when it has structure and an individual character.

The complex face is properly divided into three equal parts: forehead, nose, and lower part (where the upper lip forms a ratio 1:2 to the lower lip and chin). The noble profile forms a straight line. The size and shape of the nose are also very important – it must be straight, with an angle of 90 degrees at the tip and 110 degrees to the upper lip.

The volume of the lips must conform to the volume of the eyes and eyebrows. Both eyes and eyebrows must have a higher angle laterally. Eyebrow’s tail should be 1-1.5cm above the upper orbital rim and usually end a bit to the side from the lateral canthus of the eye. Beautiful cheekbones are slightly higher than the mid-face line and form hollow, “hungry cheeks“. The cheeks and chin shape an expressed “triangle of beauty“. We emphasize it when we smile for a photograph.

Ears are properly situated with an angle of 30 degrees or less to the face oval.

Read more: Facеlifts; Rhinoplasty; Biofibre – Artificial Hair Implant System

Serdev Suture Lifts for Face Beautification

The Scarless Serdev Suture Lifts help us in the overall face beautification, by restoring perfect proportions, volumes and angles. These methods are particularly important in young people, because of their atraumatic nature, lack of scars and durability of the aesthetic result. This makes them superior to other methods. Patients return to social life within 1-2 days. The suture methods of Dr. Nikolay Serdev can lift tissues, as well as create volume in places where it lacks. Furthermore, we can use them to correct the tissues position in cases of deformities.

The results are stable because we stably fixate (suture) mobile tissues to immobile periosteum or fascia. Of course, the ageing process cannot be stopped. However, after surgery it will continue from the new, rejuvenated and beautified position.

Vaser Lipo

VASER ultrasonic liposculpturing of double chin and cheeks is also is also in our arsenal for beautifying the face and can be added at different stages.

Patient Testimonial - Total SMAS Lift via Serdev Sutures Method

Results

A brow lift is necessary in these cases, when the facial angles are facing down. The procedure aims to restore the eyes’ upward angles and youthful expression. In order to create the correct aesthetic proportions and angles without scarring, we use the Serdev Sutures method. This atraumatic procedure has a double effect. In addition to the eyebrows, it also raises the angle of the eyes and works as a local lift on the cheekbone skin. In addition, an effective brow lift stretches the upper eyelids and thus delays the need for blepharoplasty in older patients for years.

Brow Lift Without Scars

We perform the Serdev Suture eyebrow lifting only through 2 hidden skin punctures points, which allow for the specially designed instruments to enter and exit the skin. Fixating selected tissues and structures is done below the skin. We lift the brow fascia (Serdev fascia) and stably fix it to the periosteum at a higher level. This ensures the longevity of the aesthetic result. There are no incisions and therefore – no scars, no bleeding, no recovery adhesion. The skin puncture points disappear within 1-3 days. There is no downtime, return to social life is immediate or within 2-3 days, depending on the person.

Please note that the ageing process cannot be stopped! After a brow lift, ageing continues, but from the new, higher and more youthful position.

We do not practice classical and endoscopic methods in our clinic, due to their traumatic and scarring nature, as well as long recovery period. They are also indirect, have insufficient effect and leave scars. These methods don’t give such satisfying results like the direct transcutaneous Serdev Suture® technique.

Aesthetics

Why is the scarless brow lift important?

When communicating, we look each other in the eyes. A beautiful, youthful expression is one, where the angles of the face are pointing up. They express a joyful, fresh radiation – “mask of comedy”. When angles are pointing down, the face looks tired and sad – “mask of tragedy”.

With age, brows and upper lid skin drop below the eye line and wrinkles appear on the forehead. These make a person look angry, sad and constantly tired. Brow lifting is most popular among young patients and models. However, it is also popular among patients aged 40-60, where it can be combined with additional facelifts or an eyelid surgery. Blepharoplasty can be done simultaneously or a long time after lifting of the eyebrows.

The science of aesthetics remains eternal. It is fashionable that eyebrows rise upward and sideways, so as to reach a height of at least 1 cm above the upper edge of the orbit. In the world of fashion, the hight is 1.5 cm.

Besides rejuvenation, this method helps us to achieve beautification. Many young people also seem serious and tired. This is due to the low lateral position of their eyebrows. Such position may be congenital or acquired. The atraumatic nature of Serdev Sutures Lifts, the lack of scars and prompt return to social life make this method very suitable for young people.

Serdev Suture Brow Lift – Shop The World for Beauty Secrets TV Series

Results

Cheekbone Lift and Volume Creation Without Implants

By using Serdev Suture Lifting method, we can effectively achieve a cheekbone lift and in the same time create the necessary volume, without the use of implants or transplants. Thus, we also treat the nasolabial and tear trough folds. Dr. Serdev performs the cheekbone lift through skin punctures only. Therefore, there is no cutting of skin and most importantly – no scars! The punctures disappear within 1-2 days. TV stars use such rejuvenation to appear on screen next day.

Wrongly, many physicians try to fill the nasolabial folds in order to create volume. Thus, they add heaviness, which leaves the skin stretched after the fillers’ absorption. The correct approach for cheekbone enhancement is to lift the soft tissue back to its normal position at the zygomatic bone, restore cheekbone fullness, create the necessary volume – medially or laterally – and thus elevate the cheekbone. In this way, we eliminate the tear trough and nasolabial folds and improve the facial expression. Additionally, we achieve a youthful elongation of the “beauty triangle”, which is responsible for the beauty of the lower face.

Read more – Overall face beautification; Rhinoplasty

Cheekbone Enhancement and the “Beauty Triangle”

Cheekbones are relevant to nearly all aesthetic norms. Unfortunately, pronounced, high, and youthful cheekbones are rare.

The chin and cheekbones create the so called “beauty triangle”. Asian cheekbones are pronounced laterally but are flat in front. Vice versa – in Caucasians cheekbones are often more pronounced at the front, but quickly drop. They are almost absent in elderly.

Bichat’s fat pad (Corpus adiposum buccae) is of great significance in facial and cheekbone contouring. Often, after our 30s, the fat pads lose connection to the zygomatic bone and droop in, creating the tear troughs. Moreover, they hang over the nasolabial folds, making the latter deeper and more visible. This is why lifting the cheekbones back in their place is more aesthetic than filling the deep folds, which makes the face look obese and round. The Serdev Suture cheekbone lift without scars and without implants can easily restore the “Beauty Triangle”.

Results

Chin Lift Without Implant

Chin enhancemet or chin lift without implant is one of the most popular suture lifting techniques, created by Prof. Dr. Nikolay Serdev. For this ambulatory procedure, Dr. Serdev uses only two skin punctures, in the supra- and submental folds. Using special needle instruments, he collects the whole available chin soft tissue, moves it to the correct position, and fixates it to the bone. The chin correction includes projecting one’s own tissues forward, but in cases of deformities, they can be moved up, down, left and right. Patients most often seek this procedure in cases of small chin (microgenia and retrogenia) and age-related ptosis (witch chin), other deformities, as well as unsuccessful placement and removal of implants.

The aim of Serdev Suture chin lift is to position the chin in the central axis of the face, create the appropriate volume and correct facial proportions, without the use of implants.

Read more – VASER lipo of the face – double chin and cheeks

The entire procedure takes a few minutes. There are no incisions and we do not use dermal closure or bandages. Patients should perform facial washing on the following day. The skin puncture in the supra-mental fold may have a microscopic crust for 1-2 days and patients can cover it with make up. The early post-op period swelling is almost invisible. Patients can resume their social life as soon as they wish.

The suture chin lift results are durable and have a big price advantage over short-term injectables. Patients prefer it to the alternative methods of using foreign bodies (implants) or even transplants, which requires incisions, wearing bandages and involves swellings, as well as possibilities of displacement and infection.

Chin Enhancement and Position Correction

We use this method not only to lift the sagging chin, but also for chin enhancement and position correction. We can move it to the side, as well as up or down. Such cases are for example facial deformities and cleft lip. As a result, we achieve correct volumes, angles and proportions.

We can also create a chin dimple as an addition to the chin lift, or as a separate procedure.

Read more – Cheek dimple (smiling points) creation

Disharmony and Proportions

Profile deficiencies are due to congenital, traumatic and ageing factors, with different degree of deformity. Loss of volume or a genetically small mandible affect the aesthetics and expression of the mouth, chin, and neck. Disharmony between the skeletal support and the soft tissue envelope is a common cause of aesthetic concerns.

The chin is an important feature of the face. It is part of the noble profile (which is a straight line), as well as the “beauty triangle” – expressed chin and cheekbones. When we smile, we enhance the triangle and the face looks more beautiful. The chin plays an important role for defining facial aesthetic proportions. The lower part of the face should be divided into 3 parts – one part for the upper lip and two parts for the lower lip and chin (1:2 proportion). Together, they form 1/3 of the face (golden ratio).

Dr. Serdev’s suture technique positions the chin on the line of the profile and restores the beauty triangle, aesthetic proportions, angles and volumes of the face.

Results

Transcutaneous SMAS Mid-face lift via Serdev Sutures

The SMAS mid-face lift elevates and stretches the middle and lower parts of the face, as well as the neck. Also, it stretches the cheeks, nasolabial and marionette folds, highlights the so called “hungry cheeks” and restores the youthful jawline. We lift and stably fixate the SMAS only through skin puncture points, using the Serdev Sutures Lifting method.

The SMAS mid-face suture lift is one of the internationally most successful and popular methods of Prof. Dr. Nikolay Serdev. It is most popular among middle aged and elderly patients. However, due to the lack of scars, we also often perform this procedure in younger patients, mostly models, for tightening the initial sagging and asymmetry of SMAS and skin in middle and lower face and neck.

Ultrasound assisted liposculpture may be necessary in cases of fat deposits in the face. The goal is to suck out and remove the fatty deposits on the cheeks, causing the so called “bulldog” appearance. The procedure also tightens the skin on the lower jawline.

Serdev Suture Lifts are the most modern cosmetic surgery SMAS facelifts. Dr. Serdev needs only a few skin puncture points to lift any area of the face. Even the more central zones, unreachable for classic open approach lifting methods, are successfully treated. We achieve this without skin incisions or excisions and therefore there are no scars. In addition, the skin is not separated from its underlying support. Hospitalization and nursing are not necessary. The postoperative recovery is short and does not affect patient’s ability to return to their daily duties.

Read more – Scarless Upper SMAS facelift; Overall face beautification; Lower Face and Neck Lift; Cheekbone lift

What is SMAS?

Back in 1972, surgeons demonstrated that after classic open approach face liftings, the skin is not stable and elongates in minutes. Since then, lifting of the Superficial Muscle-Aponeurotic System of the face (SMAS) became the obligatory method for surgical face lift (including mid-face lift), in order to maintain a long lasting result.

The skin and soft tissue do not drop easily, thanks to their strong fixation to the SMAS. Therefore, if we separate the skin from the SMAS, it will lose its stable support. As a result, a subsequent SMAS lift will not be able to pull and lift the skin. The consequences of separating the skin from the SMAS are a mask-like stretched appearance, changed hairline position behind the ears etc. Naturally, we strongly oppose such approach.

Results

What is Temporal Lift / Upper Face Lift?

With age, the cranium shrinks and facial fat volume changes (it increases in most cases). Ptosis occurs (including the SMAS), along with skin laxity and non-elasticity. These factors change the facial expression into a sad and tired looking face. Fortunately, we can reposition the soft tissue facial structures and skin, which are fixed to the SMAS, by lifting the latter and attaching it at a higher position. We achieve this with a temporal lift without scars (also called upper face lift).

Aesthetically incorrect face angles make young people look sad. Therefore, the objective of the temporal SMAS lift in this young population is simply beautification, based on facial aesthetics. Our goal is the restoration of correct proportions and angles of the eyes, eyebrows and lips.

Read more: Brow lift; Lip augmentation; Cheekbone lift; Overall face beautification

What is SMAS and why do we use it?

Back in 1972, surgeons demonstrated that after classic face lifting, the skin is not stable and elongates in minutes. Since then, lifting of the Superficial Muscle-Aponeurotic System of the face (SMAS, described by Mitz and Peyronie) became the obligatory method for surgical face lift (including mid-face lift), in order to maintain a long lasting result.

The skin and soft tissue are strongly fixed to the SMAS in the temporal area. Therefore, if we separate them from the SMAS, the skin will elongate, because it has lost its stable support. As a result, in a subsequent temporal SMAS lifting, we will not be able to lift the skin. The consequences of separating the skin from the SMAS are a mask-like stretched appearance, changed hairline position behind the ears, etc. Naturally, we strongly oppose this approach.

Procedure and Results

In our clinic, we use the “Serdev Sutures” lifting method for temporal SMAS lift without scars. It is a less traumatic experience for the patient, and is carried out under local anaesthetic, without incisions or excisions of skin. We perform the upper face lift only through skin puncture points to suture (sew) the SMAS to the skull periosteum. The pinpricks are not visible and disappear within 1-3 days.

Pain is subjective and of variable intensity, depending on the person concerned. Patients usually sleep tranquilly after the operation. Pain can be present mostly by pressure, for which we  prescribe analgesics as necessary. Recovery is rapid. There is less swelling than associated with other methods. It is not visible to others and the patient can quickly resume normal activities.

The results are immediate. The main outcomes of the temporal SMAS lift are: total face lift, change of angles of the eyes and lips, fresh look, younger and more beautiful appearance, cheekbone recovering, as well as skin texture improvement.

After surgery, the patients must take medications exactly as prescribed and must not expose their face to direct sunlight. They can go to the beach, as long as they cover the face with sun screen.

Supra-Temporal SMAS Lift

After a temporal SMAS lifting, there is a further opportunity of lifting the SMAS in the supratemporal area. We recommend the scarless Serdev Sutures Lifting method.

Patient Testimonial

Gallery

The purpose of rhinoplasty (also known as nose correction, nose reshaping, or simply nose job) is to create correct aesthetic proportions of the nose and face. It is the most frequently requested cosmetic surgery procedure for face beautification. In 1/3 of all cases we only work on the tip of the nose, to reduce it’s length, refine and project it. Rhinoplasty requires accurate and precise movements with excellent knowledge of the anatomy.

As a central part of the face, the nose has a major role in defining aesthetic proportions. It has an individual structure and has to fit in the overall aesthetic proportions, volume and angles of the face.

Rhinoplasty can only correct the outer appearance of the nose! If there is an impairment of the nasal function (ex. deviated septum, polyps, deviation of ethmoid bones, mucosal edema etc.), we work ENT specialist, when necessary, prior to a cosmetic nose job.

Attention!

A surgeon cannot make your nose like it looks on the face of another person. Your bones, cartilages, skin, individual characteristics and proportions are different!!!

Many patients ask whether Michael Jackson’s nose should be considered as an ideal. Such thinning is impossible without removing bone structures, which disturbs the function of the nose. However, nose’s function is much more important than its appearance! Not everyone can afford to buy and use a hyperbaric oxygen chamber at home to saturate the body with oxygen.

The goal of rhinoplasty is to beautify without disrupting the function!

What are the correct proportions of the nose?

The aesthetic standards for correct proportions of the nose are: 1/3 the length of the face (golden section rule), straight or slightly curved dorsal line, 90 degree angle at the tip, possibly thinner dorsum and tip, narrow alar base.

Why do we use Closed, instead of Open Rhinoplasty?

We practice closed rhinoplasty to perform the necessary correction of the nose, and more specifically – Dr. Serdev’s author techniques. This approach prevents the traumatic “opening” of the nose, it is mini-invasive and without bloodloss. Instead, the manipulation and sutures are made inside the nose. In addition, casts, plasters and intranasal packings become unnecessary. There is no swelling, no “black eyes” and no scars.

In open rhinoplasty the surgeon would make an incision across the columellar area (the skin-covered barrier between the nostrils) and pulls the skin upward. In this way he can see the cartilages and bone structure of the nose. Then, he reconstructs the cartilage to alter the shape and size of the nose. In the end, the surgeon puts sutures in place to close the incision and inserts intranasal packings for a few days. A cast would be set on the nose for a week so that the new shape stabilizes. The real shape of the nose becomes visible only after one year. However, the scar on the underside of the nose will remain visible.

In our clinic we do not like the open rhinoplasty, due to a lot of negatives (loss or necrosis of cartilage, great percentage of secondary corrections, etc.) and visible scars. Therefore, we use closed rhinoplasty techniques, without visible scars.

Patient Testimonial

“I am coming out of surgery just now. For me, the anxiety before the operation was very big, I had fear. But it actually it was not an intervention, according to me – as if I was going to the dentist. There was no pain, it was very quick to me. The difference before and after is so huge… exactly what I wanted! Most importantly, I am not dizzy, there is no pain,  I feel very good. Such a painless surgery, after all others that I’ve had… [3 days after surgery] I don’t have any problems. In short, I can say that the feeling cannot be better. As if there hasn’t been a surgical intervention.”

Results

Many of the rhinoplasty procedures used in our clinic are done using the so called “Serdev Rhinoplasty Techniques“. These techniques help us achieve the correct proportions of the nose using a closed approach, without trauma. Thanks to the developments made by Dr. Nikolay Serdev in the field of nose correction, our patients leave the clinic with their new desired look, without plasters, casts or intranasal packing.

Read more – journal review of the book “Serdev Techniques in Rhinoplasty”

Serdev Rhinoplasty Techniques

The methodology is based on the achievements of the first president of the American Academy of Cosmetic Surgery – Dr. Julius Newman, surgeon in Hollywood, called “Dr. Nose” and improved by Dr. Serdev.

The internationally recognised scarless Serdev techniques in rhinoplasty are:

– T-zone Excision – for shortening the length of the nose. Protects cartilages from separation/cutting/shortening during surgery, which in older methods often resulted in necrosis (after their separation, processing and returning back to place, cartilages do not always get well vascularised);

– Nasal Tip Rotation by suture – shortens the length of the nose (alternative of the T-zone Excision);

– Columella Sliding by suture – used to correct the tip projection (decreases or increases the height of the tip). The aim is to obtain the aesthetic 30 degree angle of dorsum to profile line;

– Nasal Tip Refinement (narrowing) by suture – narrows and makes a finer tip;

– Alar Base Narrowing by suture – narrows the width of the nostrils;

– Digital fracture instead of lateral osteotomy – closes the open dorsum roof after medial osteotomy (humpectomy) without visible step deformity;

– Medial and/or lower dorsum narrowing by suture.

Patient Testimonial

“I am coming out of surgery just now. For me, the anxiety before the operation was very big, I had fear. But actually it was not an intervention, according to me – as if I was going to the dentist. There was no pain, it was very quick. The difference before and after is so huge… exactly what I wanted! Most importantly, I am not dizzy, there is no pain,  I feel very good. Such a painless surgery, after all others that I’ve had… [3 days after surgery] I don’t have any problems. In short, I can say that the feeling cannot be better. As if there hasn’t been a surgical intervention.”

Benefits

Dr. Serdev’s rhinoplasty techniques reduce operation time to 15-40 minutes, depending on the difficulty and number of procedures. Due to the minimal trauma in our operations, small linear bruises under the eyes appear in only about 30% of hump removal cases. The lack of trauma and blood loss make intranasal packing unnecessary. Packings are placed in the inner nose, while cosmetic corrections deal with the external nose. Full return to social life is possible from the first to the 5th postoperative day, depending on the presence or absence of minor bruises.

When we only correct the tip, there is no necessity of plaster or cast. No bruising can appear and swelling is not visible to the uninitiated observers, there are no scars. Therefore, patients return to social life almost immediately, without signs of surgery. No one will know that the nose has been operated. Most of our TV presenter patients work on the next day – the team and TV viewers do not even realise that there has been an intervention. The presenter only looks refreshed, rejuvenated and more beautiful.

Of course, the patient has the obligation to appear at the designated check-ups after surgery.

In combination with Serdev Suture Lifts for face and body, we can achieve an overall aesthetic beautification and rejuvenation, without trauma and without scars.

Serdev Techniques Explained

Results