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Serdev Clinic - MC "Aesthetic Surgery, Aesthetic Medicine". Rejuvenation and Beautification Without Scars.

Botulinum Toxin Treatment (Botox, Vistabel, Dysport)

About Botulinum Toxin (Botox, Vistabel, Dysport)

Botulinum toxin's first application was to treat strabismus (a condition in which the eyes are not properly aligned with each other). Later on, it became common practice in neurology, plastic surgery and as a treatment for excessive sweating.

Botulinum toxin's main action is to selectively paralyze the muscles that cause wrinkles. Thus, they can no longer react by excessive contraction. The transmission of nerve impulses at the synapses is blocked, the mucles become flaccid and the skin above them flattens.

In our practice we have used the following preparations, depending on their legalization/certification status:

  • DYSPORT (manufactured by Ipsen in the UK);
  • BOTOX (manufactured by Allegran in USA). Since 2006, Botox has been sold in the UK under the name VISTABEL, with identical formulation.

The concentration of toxin between the two is quite similar and most surgeons agree that there is no significant difference between them. 

Treatment Areas

Botulinum toxin can be injected to the following areas: 

  • The glabellar muscles of the forehead (they give an angry look);
  • The orbicularis oculi (it creates the wrinkles around the eyes):
  • The frontalis (it creates the wrinkles of the forehead).

Detailed knowledge in anatomy is required in order to prevent unwanted side effects and blocking different mucle groups. The injection itself takes a few minutes. The surgeon uses a special syringe and injects a small amount of botox to the muscles involved. Men usually require a larger amount, due to larger muscles. The pain involving the injection is usually well tolerated by most patients and there is no need for local anesthetics. In selected cases a sedative drug or local anesthetics can be used.

Effect and Duration

The effect takes place a day or two after the procedure and reaches its maximal effect about 10 days later. 

The full effect duration of the treatment is usually 3 months, and a partial effect lasts for 8 months. Longer action causes muscle fibers to degenerate and it is therefore recommended to repeat the treatment in 3-4 months. After several treatments, the periods of time with full effect last longer and usually much less botox is required to achieve it each time. Many patients enjoy even the partial effect for long periods of time. There is no permanent effect.

Permanent effect of blocking the glabella mucles can be achieved via Dr. Serdev's scarless suture method for glabella muscle ligation.

Precautions and Side Effects

The treatment with botulinim toxin proved to be relatively safe.

Precautions include: known allergies to botox or albumin, muscle weakness, use of aminoglicozide antibiotics, pregnancy or breastfeeding.

Common side effects include: bleeding around the injection sites, headache, flu like symptoms and local pain. Another unwanted effect is paralysis of adjacent muscles which may cause eyelid drop (usually partial), double vision and difficulty swallowing. Because only part of those muscles are paralyzed, there is usually a full compensation of the remaining muscle after 2-4 weeks.

Chemical and Laser Peels

What Are Chemical Peels

Chemical Peel is a procedure in which a controlled chemical burn is applied, using a chemical solution, in order to remove the outer layers of the skin. It can eliminate delicate wrinkles, pigmentation marks and other skin defects. Peeling also has some medical advantages, such as removal of pre-cancerous conditions and acne scars.

Types Of Peels

Depending on the substances used, chemical peels are devided in three groups - delicate, intermediate and deep peels.

Delicate Peels

Delicate peels give smooth and shiny skin, and it also treats delicate wrinkles, acne scars and pigmentation. They only remove the outer layer of dead cells and refresh the skin, but do not have a tightening effect. Several treatments are usually required on a weekly basis. The solution can also be incorporated into creams or facial wash, and can be used on a daily basis.

Intermediate Peels

Intermediate peels remove wrinkles, superficial skin defects, and pigmentation, and can be used in all body parts. Usually more than one treatment is required and it they have a longer healing time than delicate peels. They have a temporary rejuvenaiton and refreshment effect, because they are not as deep. 

We recommend the "universal peel" - the skin is treated for three days in a row and it peels off on the forth. Patients like it, because there is no pain during application and there is no redness after the skin peels off.

Deep Peels

Deep peels remove deep wrinkles, pre-malignant conditions, and skin defects caused by sun exposure. They are phenol-based and reach the deepest layer of the skin. The healing process leads to significant skin tightening and brighter skin color.  Deep chemical peeling can be used only in the face area, because facial skin has different structure, it is more stable and can sustain such treatment. 

Exoderm Peel

We highly recommend the deep chemical peel "Exoderm lifting". It gives excellent results, which in many cases surpass our expectations. This peel was created by Dr. Yoram Fintzi of Israel. The recovery period is 8 days, after wich the skin will be pinkish for 2-3 months. The peel is used for treating wrinkles, flaps and skin drooping without surgery. The skin tightens, but the effect should not be mistaken with lifting - liftings are used to fix tissues to a higher level, while chemical peels only have skin tightening effect. 

Laser Peel

Our clinic also has the most modern "cold" laser in its possession, which clearly refreshes the skin and has a tightening effect on it and the tissues below it. It creates a lifting effect without burning the skin. You can see how it works here.



How It Works

Most commonly used to treat the face and neck, microdermabrasion can successfully reduce the appearance of superficial wrinkles and scars, large pores, acne, and age spots, restoring a smoother, more youthful appearance. 

During the procedure the physitian uses a handpiece through which fine microcrystals are emitted. These microcrystals peel off the uppormost or superficial layer of the epidermis (known as stratum corneum) and are then sucked back into the device, along with the exfoliated skin particles, via vacuum. 

As microdermabrasion only causes superficial injury to the skin, the risk of scarring and pigmentation anomalies following microdermabrasion is extremely low, when compared with other resurfacing techniques. Therefore, microdermabrasion can be safely and effectively used on individuals of all skin types. 


Microdermabration has a rejuvenation effect - the damaged skin layers are removed and new skin cells are revealed in the treated area, with improved texture and overall appearance. This is the reason why this method is successfully used for stretch mark treatment, scar removal, etc.

Any secretion in the glands of the skin, caused by infection or otherwise, is sucked in by the vacuum and thus prevents the creation of conglomerate cavities in the skin. As a result, microdermabrasion is the best and most effective method for acne treatment.

Photoepilation using Spa-Touch


There are two new methods for hair removal - laser and photoepilation.

In laser epilation destroying the hair bulbs is achieved with single laser beams.The method has a couple of drawbacks - it can be successfully applied only on patients with dark hairs - white and blonde hairs are hardly affected by the treatment; patients with dark skin or with sun tan, diabetics, pregnant women etc. are not suitable for the treatment; there is redness and possible swelling after the procedure; there is a risk of depigmentation and direct sunlight should be avoided for about a month.

Photoepilation is the latest development of the idea of photo (light) hair removal - the pigment cells are influenced through intense pulse light that destroys the hair bulbs. The spectrum is wider and harmless. It is an inexpensive procedure. 

Photoepilation has a unique advantage - it is applicable to any type and color of hair and to all skin types. The energy and duration of the pulse are chosen according to individual characteristics of patient's skin and hair. The procedure is painless and does not cause complications. There is no redness, no cooling gels are applied. Photoepilation achieves the effect of thinning and reducing the number of hairs, as well as extending the period of hair growth, so that the interval  between sessions increases from 2-3 months to up to one year. 


We work with the best quality machine on the market - SpaTouch. The impulse of device is 11 square cm (5/2.2 cm). In comparison, an IPL impulse is 3 square centimeters.


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Stretch Marks Treatment

What Are Stretch Marks?

Stretch marks, or striae, are lesions that tend to form in the dermis during periods of hormonal flux, with weight gain or loss, pregnancy, and other periods of hormonal change. When our body's elastic fibers deep beneath the epidermis become damaged, these scars can appear. Women often tend to get stretch marks on their breasts, thighs, hips, abdomen, arms, around the belly button, buttocks, and back. This is especially true during puberty and pregnancy, when a rapid onset of marks can appear. Initially they may be red, but as the redness fades, they may turn white. However, contrary to conventional wisdom, and their unfortunate name, stretch marks are not caused solely by skin stretching.

Over time, the aging process and sun damage cause a decrease in the amount of collagen and elastin fibers. As this network of fibers breaks down, the skin loses its elasticity and becomes more lax. Together, aging, sun damage, and other factors contribute to wrinkle formation and other changes in appearance. 


Our practice has shown that the best method for stretch marks treatment is microdermabrasion - vacuum peeling with microcrystals that removes the superficial or uppermost layer of the epidermis, known as the stratum corneum. It is a simple, fast, and effective method.

During the procedure, the physician uses a device which emits pressurized crystals on to the surface of the skin. Using single strokes, the physician will guide the device over the treatment area to remove damaged skin layers. As microdermabrasion only causes superficial injury to the skin, the risk of scarring and pigmentation anomalies following microdermabrasion is extremely low, when compared with other resurfacing techniques. Therefore, microdermabrasion can be safely and effectively used on individuals of all skin types.

Treatment results

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In areas with more damage, the physician may increase the amount of pressure exerted by the device or the number of passes made in the area. This will cause the treatment to extend deeper into the skin. A vacuum sucks the used crystals and exfoliated skin particles back into the device, so that they can be removed and discarded. 

As the new skin cells are revealed, your skin will have an improved texture and overall appearance. It is important to realize that in order to maintain the results from a microdermabrasion procedure, you will likely have to undergo approximately five to ten treatments, depending on the severity of skin damage. Initially, you may receive treatments every one to two weeks. However, over time the frequency of treatment may decrease to once a month, and later to twice a year.

It is important to note that stretch marks cannot fully disappear, due to the altered anatomical structure of the skin.

Acne Treatment

What Is Acne?

Commonly known as pimples, acne is a skin condition that is caused by inflammation in the skin. The medical term for acne is acne vulgaris. It is one of the most common skin problems, which makes acne treatment one of the most sought after skin treatments. It had been estimated that about 17 million people had been affected by pimples. The majority of them - between the age of 12 and 25. 

Normally, acne occurs during the time of puberty and worsens during the period of adolescence. The oil producing glands (named sebaceous glands) lying under the surface of the skin, produce sebum. This oily secretion helps the skin preserve its moisture as well as hair flexibility. During puberty, the sebum excretion is much higher and clogs the pores in the skin. When the plugged follicle is invaded by a bacteria living on the skin (known as Propionibacterium acnes), or other microorganisms present in the skin, the enzymes and chemicals produced by the bacteria create inflammations.

Why You Must Not Squeeze Pimples Out

The worst possible method to treat acne is to squeeze pipmles out, either at home or in a saloon, as well as using a needle. The stretched out glands (in the form of cysts) burst and lose their anatomical structure. When there are a few glands in the same place, conglomerate cavities are formed, which do not have anatomical structure ans subsequently - no exit points for the secretion. Squeezing these conglomerates results in the repeated bursting of the cavities and expands them. Thus, a vicious circle is created that leads to chronic infection and impossibility to easy treatment, due to the continuous secretion without a way out and the creation of cavities, which leave deep scars.


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Acne Treatment

Our practice has shown that the most effective acne treatment methods are Microdermabrasion and Chemical peels

During microdermabrasion, fine crystals remove the superficial or uppermost layer of the epidermis, known as stratum corneum. In this way the infected secretion in the glands and conglomerates is sucked out.

The most severe cases are treated with mid- to deep chemical peels. We most often use the EXODERM peel, which gives magnificent results.

In order to determine the proper type of treatment, physicians should examine the face, shoulders, chest, upper neck, and back, as well as other affected areas, as well as take the medical history of the patient. Then, it should be determined whether the blemishes are inflamed, whether they are superficial or deep, and whether there is any skin discoloration or scarring. Blood and stool tests also need be done. Understanding the skin condition is very important in acne treatment.

Depending on the severity of the pimples, or acne, the physician would use also benzoyl peroxide or hydrogen peroxide. Additionaly, creams like azelaic acid or vitamin A derivates, like retinoid or retin A, could be used for acne treatment. Salicylic acid, accutane, antibiotics, and anti-androgens are also quite effective in the treatment of acne.


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