Temporal SMAS Lift Using Serdev Sutures

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. 21 techniques and individual modifications are used on face and in body areas, even where open surgical techniques cannot be directly applied. Serdev Sutures in the temporal area are scarless and uncomplicated in the post-operative period. These techniques use curved semiblunt semi-elastic 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 absorption (in 2-3 years, after the fibrosis is finalized). This enables stable fibrotic fixation before suture degradation. Fixed mobile facial tissue using Serdev Sutures is SMAS in all face areas: In Temporal SMAS lift it is the galea aponeurotica, which is fixed by a transcutaneous suture to the stable periosteum at the upper temporal line and the temporal fascia. 54 Nikolay P. Serdev In addition to the possibility of Temporal SMAS 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 elements in the same direction. The structuring and positioning of different face elements is not limited to facial ptosis and elderly cases. Unaesthetic face angles, volumes and proportions are responsible for lack of beauty in young patients as well. Beautification is most important in youth and rejuvenation incl. beautification in elderly. 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.