How Serdev lifting and volume suture techniques were created
TTVI, 18 January 2009, 13:33
The specialty Aesthetic cosmetic surgery and medicine in Bulgaria is the fastest developing separate specialty in the medicine with a great international prestige. It is the only medical specialty that concentrates on clinically healthy patients and on improving their outlook. To meet the high requirements and the standards of beautification, in 1993 we founded in Bulgaria the National Bulgarian Society of Aesthetic Surgery and Aesthetic Medicine. In 2001 the Ministry of Health approved the profile specialty Aesthetic Cosmetic Surgery and Medicine with the purpose of specialization in this field and forming a staff with a good medical practice.
My idea creating “closed” methods of face and body lifts is based on the fact that some movable tissues can be catched, lifted and sutured to other stable, non movable structures without to cut skin, but only through punctiform openings in it. I use semi-elastic threads for sewing up that allow the sewed tissues to move to some extent. This is the meaning when my methods in Brazil are called “fio elastico Bulgaro”.
The start of these methods was in 1994. Later the idea spread out with different understanding and about in 2000 there appeared other methods like the Russian threads “Aptos”. In 2002 the Latino-Americans introduced similar methods that looked like these methods, but they could not create elastic threads, they missed the stable anchoring. They transformed the method missing the stable fixation of movable to nonmovable tissue that creates longevity because of stable and elastic fixation. These are some disadvantages of the non-original methods, reflecting in short longevity.
Today the presence of Bulgaria in the cosmetic surgery world is very strong in the field of the miniinvasive and beautification cosmetic surgery.
I often make parallels with the intravenous injections in comparison to venesection, that before decades was done by cutting the skin in order to expose and find the vein. Nowadays invasive scaring venesections are allowed in very rare cases only in urgent medical cases.
In 1993-1994 being the Director of the Clinic of Burns at the Military Medical Academy in Sofia, I was asked, and we organized some congresses in Sofia and in Europe, about teaching in the specialty of Cosmetic aesthetic surgery.
All our work was aiming reducing the trauma during the operation. Let make an example with the ultrasonic liposculpture. In 1994 I bought the most modern device for this time that allow performing the assisted liposuction without loss of blood, shortening the postop recovery and having additional effects like tightening the skin and weight loss to normal. We have to facilitate surgery and make patient’s live easier.
Many International congresses followed, where we presented the Bulgarian achievements in the miniinvasive methods in this specialty. In the world professional societies there started talking about Bulgaria and the Bulgarian methods.
Other people` s favorite topic was my idea about beautifying the face based on the aesthetic proportions. I demonstrated results from my sutures lifts, as well as some news in aesthetic corrections of the nose, correction of the profile, etc. It appeared that foreigners are not so good familiar with all the aesthetics we study here even at the school. I received more and more invitations for demonstrations, because my methods were so different from the known classical invasive and scaring methods, with less trauma and faster recovery. Moreover, there were no scars left and skin keloid formation is avoided that is very important for Asians and Afro-Americans. The Bulgarian methods are mostly ambulatory and after surgery patients can stay at home. Very often colleagues, coming to learn are so amazed by the immediate results so that they or their spouses become my patients and after the operations they continued attending the demonstrations and working. Many doctors changed their points of view and concepts about the cosmetic interventions. In general, I am one of the doctors who are introducing and requiring beautification without unnecessary cutting of skin and without scars promoting this at international level.
In the aesthetics we cannot change a lot the rules that are dogmas for beauty from the time of establishing the aesthetics as a science. Of course, in obesity and advanced age we cannot create complete beauty. Young and middle age people are our real candidates for beautification. That is why the aesthetic surgery in 82 % of our patients is done in young patients at the age of 18 – 25 - 35.
Foreign doctors showed interest to my methods of beautification and there were many invitations from all continents for presentations and demonstrations, for teaching courses.
For example in Asia I was invited to the Philippines five times. There I made demonstrations on ultrasonic assisted liposculpture for beautification of face and body and whole beautification and elongation of legs, and also sculpturing the face in Asians.
At the courses held in Sofia, there arrive many foreign colleagues friends – from America, from Asia, from the Asian ethnos and from the ethnos of the African race, because, surgeries with cuttings of skin on the face leave unwanted scars and keloids in these races. The suspension methods and the lifting sutures are necessary for these ethnoses and maybe that is why they became so popular internationally.
During my visit in Australia the national television broadcasted reportage for a live total lifting of the face with my lifting sutures, that means upper or temporal lifting, mid face lift, creating and lifting upwards the cheek-bones as well as a lower lifting. This was live, 40 minutes broadcast of the demonstration for the colleagues from the Australian Academy of Cosmetic Surgery with live connection, questions and answers, comments during the demonstration.
I am proud with the fact that my signature is on the first page of the Declaration of Tokyo 2000, where it was proclaimed that the Aesthetic Cosmetic Surgery is dedicated to the perfecting the beauty and in keeping with the free development of all scientific thought and because of the extremely specialized nature of the field of surgical beautification, this specialty is declared as an autonomous and independent.
After taking part at the Congress in Philadelphia, I had the perfect chance to visit my colleague and good friend Dr. Julius Newman who was one of the most interesting cosmetic surgeons and who has created very much about this surgery. He was the first President of The American Academy of Cosmetic Surgery. He had one of the best methods operating the nose. And I remember that the registration number of his car was “Dr Nose”. Thanks to his knowledge, his findings, only two or three details helped me to transform my operating methods on the nose.
The teaching of Chinese doctors in the field of the aesthetic surgery started in 2000. By that time this discipline as in many socialist countries was suppressed or not appreciated properly, or criticized. We set great store by teaching because of the huge interest in this country. That time I had the chance to visit the Great Chinese Wall, Tibet and Nepal.
After this exotics, followed my visits to Rome, and Spain. We held both live demonstrations and theoretical teaching in the form of congresses and courses. For the same period in Sofia there arrived many our friends of importance and dear guests – for example professor Maurizio Checcarelli, whose very important studies lead to founding and approving the ultrasound liposculpture, and who with the help of other colleagues introduced the method in Italy and world wide. Professor Pierre Antonio Bacci paved a visit to Bulgaria as well. He is a professor in aesthetic surgery in Sienna and Florence.
The interest to my miniinvasive suture methods is huge at international level. I have to travel to different continents and countries, as well as I am teaching many foreign specialists in Sofia.
The cosmetic surgery is bases on a bride basis of specialties and uses their knowledge but its goal is not healing –it is beutification that is an art. My clinic is angaged in the international university program for training and speciaslization of doctors in cosmetic surgery together with other internationally accredeited clinics.
Everything, like instruments, threads in my methods is a Bulgarian production and it is difficult to resemble. It could be made to look like, but is difficult to resemble.
The rank Honorary professor of the New Bulgarian University was given to Dr. Nikolay Serdev, MD, PhD., a surgeon with practical and research contribution in the field of Aesthetic and Cosmetic surgery.
“I would like to show my deep gratitude to the honored Professor Bogdanov, to the Rector and to all my dear colleagues and guests. Thanks to the New Bulgarian University, that has the well-deserved fame of a modern university with a brilliant enterprise spirit and that first in Bulgaria gave a great academic attitude to one of the most modern and prosperous specialties in the world – the Cosmetic (Aesthetic) Surgery and Medicine.”
In Asia most people have different haracteristics of faces and it is a fashion to make their faces look more Caucasian
2004- Sao Paolo
At the Fifth Panamerican Congress of Cosmetic surgery among the guests there is the football star Pele. He shows a special attitude towards the aesthetic surgery and keeps up with the fresh news. In the presence of 12 professors from different continents professor Serdev operates a close friend of him – Martha Sobral – a basketball legend and a world champion for Brazil.
The idea to create methods that can replace in young and middle aged patients the classic lifting methods, that use shaving of hair, excision and pulling the skin, was suggested by many young patients many years ago, for example: a lady of high standing after a Mask lift surgery, told me a day after the operation that she has not warned her husband about the operation and that she was afraid to meet him the next day. This had to change my opinion in the methods that time and to understand that nowadays patient do not have weeks of time for recovery.
Patients wishes are making me think over new challenges.
For example: why we shave patient’s hair – in a week or two we take the stitches out but the hair grows with months. Why to cut so much when stable tissues are fixed mainly on small number of important places? Why to separate skin from fascia, if we need the lifted fascia to hold the skin by the trabecular system? There are so many questions a surgeon must think about.
So gradually step by step I replaced unnecessary and complicated steps of the classic operations and created the suture methods as a close surgery but doing same or more fixations of stable tissue like in the open surgery methods. At the beginning – with doing minimal incisions and later, after creating the new instruments even these small incisions dropped out as unnecessary. But in cosmetic surgery we do not lift only. We have to create beauty and for this reason we play with aesthetic proportions, volums and angles as artists.