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

What are Serdev Suture® Lifts?

serdev suture lifts


Simply put - Serdev Suture Lifts are methods for scarless lifting and/or volumizing of different face and body areas by lifting the mobile (hanging) tissues and attaching them in a stable and durable way to immobile structures, thus achieving beautification/rejuvenation. 

For example - in mid-face lifting, this scarless suture method lifts and sutures the loose zygomatic SMAS extension to the firm temporoparietal tendon insertion (and underlying temporal periosteum), which results in middle and lower face SMAS lifting, cheekbone lifting to a higher position, resolving tear trough, nasolabial and marionette folds. 



Procedures done only through skin punctures, with the help of specially designed instruments, so that there are no incisions and excisions of skin. We this achieve the desired effect and longevity of the aesthetic result. There are no scars! The marks from the needle punctures disappear and are no longer visible after a few days.


Atraumatic. No downtime.

Serdev Suture Lifts are mini-invasive and do not cause trauma. There is no bruising and no bloodloss. Swelling is minimal to non-existant. Patients can resume their social and working activities on the day after surgery.

Serdev Suture Lifts vs Thread Lifts

The word "suture" in Serdev Suture® Lifts comes from the Latin Sutura and means "to bring tissues together". Our lifting techniqhes are often mistaken to be "Thread lifts", due to the use of threads. However, the two methods have distinctive differences in their concepts and the used materials.

Threads in Thread lifts are non-absorbable. They are inserted in the subdermal fat, where they hang freely, without stable fixation. This is why they rely on "barbs" or "hooks" to keep them in place. The lack of stable fixation leads to short-lasting effects.

In contrast, Serdev Suture Lifts use semi-elastic surgical threads and specially designed curved, semi-elastic needles, in order to lift the mobile tissues (such as SMAS) and stably fix them (by sutuing) to non-mobile structures (such as periosteum). This fixation guarantees the longevity of the aesthetic result. The threads are absorbed in the human body within 2 years (after the final fibrosis formation). Their limited elasticity is cruicial, because it permits the sutured tissues to move, without cutting them (rigid threads perform like scalpels).

"Liftings of The Third Millennium"

There are more than 20 different Serdev Suture techniques in face area: lifting of eyebrows; corners of eyes; cheeks; upper, middle and lower part of the face; neck; narrowing of the tip of the nose or the nostrils; and more. During the International cosmetic surgery congress in Spain 2001, these lifting methods were called "Liftings of The Third Millennium". The combination of these cosmetic procedures ensure a beautiful and harmonious face, proper volumes, angles, and proportions. 

Honorary Professor of the New Bulgarian University, Dr. Nikolay Serdev, MD, PhD is a recognized master of face beautification not only in Caucasians, but also in Asians, African Americans, etc. He is frequently invited to lecture and demonstrate the beautification of the face on the base of the aesthetics philosophy in almost all continents and countries. Мost interesting are the changes using his methods without scarring, with immediate result, extremely short postoperative period, without "operated on" appearence.

Many TV programs have taken advantage of the opportunity to display the live demonstrations and immediate results. 

Watch the Travel TV Documentary about Serdev Suture® lifts below:

Scarless Buttock Lift via Serdev Suture

Scarless Butt Lift

Thanks to the scientific development made by Prof. Dr. Nikolay Serdev, we can now do a scarless butt lift. The procedure involves no implants. Instead, patient's own tissues are encircled and projected.

It is a highly specialized cosmetic surgery procedure, which assures a higher fixation of the gluteal fibrosis layers of the lower part of the buttock to the Serdev sacro-cutaneous fascia (discovered by Dr. Serdev, and therefore bearing his name) near the sacrococcygeal area.

In other words, the tissues are gathered, lifted and fixed to a stable higher position.

The operation is done under local anesthesia with intravenous sedation. Flattened and loose form will be lifted up, "into the pockets of the jeans", as patiens evaluate the procedure, and even - over the pockets. 

The buttock lift changes the body proportions - legs look longer and the proportions between the lower and upper body are adjusted.

The procedure takes 10-15 minutes per side and is performed through skin punctures. This means there is no cutting of skin, and subsequently - no scars. The fixation of the suture to the stable inelastic Serdev fascia maximally guaranties the longevity of the aesthetic effect. No hospitalization or nursing care are needed. The result is achieved immediately, with short post-operative recovery and short downtime. Patients are even able to drive thier cars the day after the operation, despite some pain.


Scarless Breast Lift via Serdev Suture

Scarless Breast Lift via Serdev Suture®

This scarless breast lift procedure is a novelty that has changed the cosmetic surgery world and its application for young patients since 1994. The technique is especially important in Asia and Latin America, for Asians, African-Americans, Indians, and others who form keloids and lumpy scars after operations. Serdev Suture Lifts do not involve skin incisions or excision, but are performed only through skin puncture points.

Serdev Suture® Lift

This Serdev Suture® method can achieve a scarless breast lift of up to and over 14 centimeters and is most suitable for the following types of breasts:

  • not very heavy full breasts;
  • in the presence of subpectoral implants with subsequent drooping of the breasts (after childbirth and lactation); 
  • empty and loose breasts (after childbirth and breastfeeding) - in such cases the technique is combined with subpectoral implants. In sagging breasts implants should not be placed over the pectoral muscles, because this will lead to even more drooping. Therefore, breast lift requires breast fixation to the level of the pectoral muscle (the normal position in young women), and then placement of appropriate implants under the muscle, to hold them in the appropriated position (see breast augmentation);
  • in drooping breasts after subglandular augmentation (over the muscle) - in such cases, patients should not wait until the skin elongation becomes visible. The implants should be removed, along with the capsule - a difficult but a necessary operation, preventing post-op seromas and infection. Implants should be placed under the pectoralis muscle. Patients should advise the cosmetic surgeon at what level they want their nipples - in the middle of the implant, higher or lower.

NB!! Implants should be generally replaced below the muscle - implants should be smooth and be able to move naturally, without hurting the muscle.

Because of modern anesthetics and the new methods without trauma, pain and swelling after surgery are reduced and are not significant. In half a week patients can return to their social life and if necessary - even the day after surgery. However, it is preferable to rest for 2-3 days.

Social Life

Due to lack of scars, the breast lift using Serdev Sutures® can be repeated to maintain the aesthetic appearance of the breasts even in advanced age. Gigantomastia, i.e. very large, very heavy and drooping breasts can not be operated in this manner, because of gravity and overskin. 

NB!! Exercises with the arms and weight lifting are prohibited for a month and a half after surgery!

Serdev Suture® is also used for repositioning of breast implants in cases of symmastia and false positon.

Other Surgical Methods

Existing excision methods:

Previously existing methods are characterized by unpleasant scars that, despite surgeons promises, remain for life.

Depending on the amount of breast lifting which needs to be accomplished, different techniques may be used which involve different incisions:

  • Around the areola (Round block) - leading to a flat areola, often unpleasant hypertophic skars, skin rippling. 
  • Inverted T (around the areola, vertically down and in the fold under the breast). 
  • Vertical (around the areola and vertically down) - due to the excess skin, incisions often turn into inverted L or T. Rearrangement of glandular tissue and skin changes the shape of the breasts and results may be different from the expectations. Scars worry patients and sometimes cause disturbances in the relationship with their partner.

Generally, the more lifting that is required, the larger the incision (therefore, the larger the scar would be). 

Breast Lift Vertical Incision

The vertical incision achieves a greater amount of breast lifting, however, it involves an incision that not only surrounds the aereola but also extends vertically onto the lower portion of the breast.

Breast Lift T-Incision

The T-incision usually achieves the greatest amount of breast lifting. However, it also requires the largest incisions, which go around the aereola, down the breast and under the breast. The appropriate amount of skin is removed. The breast tissue is tightened with internal sutures. External suture is used to close the skin around the areola, down the breast, and under the breast. 

Healing time may take several weeks. Usually, a special bra is worn to support the breast. That takes up to three months. The compression bra is an important part of the recovery process. The bra provides support, comfort and helps minimize the swelling.

Excision Mastopexy

A lot of people are opting for various breast procedures and one of the most common among them is “mastopexy”. This is the surgery that involves uplifting of sagging breasts and, in certain cases, repositioning of the nipple and areola in order to restore normality and beauty. The excess skin is removed and firmness is provided to the breasts. Though mastopexy can be done as a stand alone surgery, many people combine it with breast augmentation. This involves inserting implants inside the body in order to get the desired effect. Unfortunately though, the effects of mastopexy are not permanent. As a person ages and due to effects of gravity there are chances of descensus.

This breast procedure is best recommended for people whose breast development has stopped. Women who have given birth and are not considering further pregnancies can also opt for this surgery. A person who does not smoke and has a normal body weight is considered to be the right candidate for surgery without many side effects. People who opt for this procedure should have a good understanding and realistic expectations. They have to be emotionally strong and understand that the effects are not permanent.

Breast Augmentation

Subglandular or Subpectoral (Under The Muscle) Implants?

Subglandular implants are preferred by many surgeons because they are easier to place. However, they have a major disadvantage - they are too heavy to be supported by the skin alone. Thus, in a few years the skin loosens and lengthens, breasts sag. What could be done then? Bigger implants or scary mastopexy? And after that - ptosis again. Patients, especially young women, should think about the disadvantages of subglandular breast augmentation!

NB!! Only the pectoral muscle can hold the heaviness of the implants!!!

When placed under the muscle, the implants do not drop, because the muscle holds them in place. Due to the larger "pocket", the result is natural. The bust is soft to touch and takes the natural body movement.

In our clinic, we predominantly do subpectoral breast augmentation. We use saline implants, which consist of an absolutely harmless water-salt solution. These implants, especially when placed in a wide “pocket” below the pectoral muscle, are softer than silicone cohesive gel implants. As patients say, they move quite naturally - "as though alive".

The operation lasts about 40 minutes. The shape of the breast remains permanent. The saline implants do not require replacement. Patients can safely travel by airplane, but should protect the breasts from injury, unnatural pressure etc.

It is not necessary to wear a bra, but if used, busks should be removed. This is because they can hurt the breast tissue and change the form of the new infra-mammary fold.

Periareolar Approach

There are several approaches for breast augmentation. However patients complain that in most of them marks remain visible, especially in supine position and with arms up. The most harmless and least noticeable (in terms of scars) is the periareolar approach (around the lower half of the areola). It is the most atraumatic access and bloodless surgery, going through the avascular plane. There is no significant pain or unnecessary loss of time. Patients are not limited socially and may appear in their social environment on the next day. 

Rare complications, which you should be aware of, are the following - bleeding around the area of the implant, infection, disturbances of sensation and touch around the nipples, rejection of an implant, some degree of irregularity on the surface of an implant.

Breast Augmentation and Ptosis

In several cases of breasts ptosis, the closed Scarless Serdev Suture® Breast Lift could be used to lift the breasts to the level suitable for subpectoral augmentation. The procedure is performed only through needle punctures and therefore leave no scars.

Another important application of this lift is in cases of ptosis after subpectoral breast augmentation (after giving birth and lactation, aging process etc.). Thus, most problems can be solved without scarring.

The method is also used for repositioning of breast implants in cases of symmastia and false positon.

Repositioning of Breast Implants in Symmastia and False Position

This Serdev Suture® method presents a new possibility for repositioning breast implants in cases of false position and symmastia after problematic breast augmentation. 

The procedure is performed through skin punctures only, in order to suture and fix the stable fascias above and below the implant. A new and proper lower and medial line of the augmented breasts is created, thus correcting the position of the implants.

Wearing of elastic garments or a bra could be necessary for some weeks after surgery.

Poland Syndrome. Unilateral Underdevelopment or Absence of Breast Tissue.

Unilateral Serdev Suture Breast Lifting and Augmentation of The Other Breast

Poland syndrome (also Poland's syndrome, Poland's syndactyly, Poland sequence, and Poland's anomaly) is a rare birth defect. It is characterized by unilateral underdevelopment or absence of breast tissue, chest muscle (pectoralis) on one side of the body. Sometimes, but not always, webbing of the fingers (cutaneous syndactyly) of the hand on the same side (ipsilateral hand) can be present. The syndrome is mostly common on the right side of body and found more in males than females.

It is usually considered a unilateral condition. 

The adjustment is difficult, but the suture lifts created by Dr. Nikolay Serdev help lift the ptotic breast to the level of pectoral muscles. The other one can be augmented, using an appropriate implant. The implant is placed under the muscle of the underdeveloped breast, so as to balance the volume and level of both breasts, as well as the level of both areolas.

Abdominal Flaccidity Tightening via Serdev Suture

Abdominal Flaccidity Tightening

Dr. Serdev performs abdominal flaccidity tightening through skin puncture points and thus leaves no scars. There are no incisions or excisions of skin. Perfect knowledge and understanding of human anatomy is essencial for performing this procedure.

Work and professional efficiency are not distorted - patients can work and perform their daily duties. 

Abdominal wall tissue lifting leads to aesthetic changes and results. This means that "sad navel" is modified into a normal looking, "happy navel". With a few manipulations, wrinkled and loose skin can become so acceptable that the belly can be worn open over the summer. 

In case that fatty deposits are present in the area and weigh in the skin, ultrasonic liposculpture is performed first. This gives an additional skin tightening effect. 

Aesthetic Correction of Labia Minora. Labiaplasty.

Reduction of Labia Minora.

Labial hypertrophy is a disproportionate enlargement of the labia minora on the labia majora. Our aim with labiaplaty is to obtain aesthetic appearance of the genitalia, without adding unsightly scars or distorting normal anatomy.

Which cases are indicative for labiaplasty?

There is no universally accepted definition or classification system for hypertrophy of the labia minora. However, an enlargement of 3-5 cm is generally considered as such. In these cases women complain of difficult care - secretion that makes underwear dirty (due to failure of retracting the labia minora), discomfort in tight clothing, pain in cycling and other sports. Even capturing the labia in zippers or painful intercourse. Perhaps the most common reason is the notion that the labia minora are too visible. Another indication for surgery is disturbing asymmetry.

The operation

The operation is bearable and does not affect patient's daily life. Sex life can be resumed 10-14 days after surgery.

Labiaplasty can be performed after puberty, but the preferable minimum age is 18 years. This procedure can be performed before or after pregnancy. The patient must not be in a cycle, in order to reduce the possibility of hormonal effects and the risk of postoperative infection.

Patients who reported unsatisfactory aesthetics, hygiene problems, chronic inflammation, painful intercourse, and problems with tight clothing are considered as suitable for the procedure.


Relative contraindications

Reduction of the labia minora is relatively contraindicated in patients with active gynecological diseases, such as infection or malignancy. Patients who are current smokers and do not want to temporarily or permanently quit in order to optimize wound healing, can be excluded. Perhaps most importantly - patients with unrealistic goals or expectations should be appropriately counseled or excluded from the operation.

In Bulgaria and in the practice of Dr. Serdev, the minimum age requirement for operation is 18 years. Minors could be accepted in very rare exceptions, only with the requirement of the consent and signatures of both parents.

Inner Thigh Lift via Serdev Suture

Smooth and tight thighs without scars

Another invention of Professor Dr. Nikolay Serdev to perform inner thigh lift only through skin punctures, without cutting it (subsequently, without leaving any scars). 

This Serdev Suture method is especially important for young women, due to the lack of scars. It gives a great result not only in the first and second youth, but also in the third age in non-obese women. When fatty deposits are present, ultrasonic removal of fat (Vaser liposelection) is performed prior to the inner thigh lift.

inner thigh lift

Liposuction – Ultrasonic Assisted Liposculpture (UAL), Body Contouring

Ultrasonic assisted liposculpture (UAL) is the best liposculpture and body contourring method in our hands. No bloodloss, fast recovery, immediate return to social and work life. Additional positives are the skin tightening and weight loss.

Traditional tumescent liposuction has been very effective in young patients with mild to moderate amounts of fat. Ultrasonic assisted liposculpture however has expanded the number of patients suitable for body sculpting. This includes patients with larger amounts of fat and less elastic skin tone. It also allows us to treat areas, which were not easily or effectively treated in the past. These include fibrous areas such as the back, male breast and upper abdomen.

Ultrasonic assisted liposculpture is a more advanced form of both regular lipoplasty and tumescent liposuction, which is used to get precise body contouring results. In case you are a healthy individual with fat deposits that are not going away even after continued exercise and dieting, then you can consider UAL. 

Apart from carrying the risks associated with all cosmetic surgery procedures, UAL also carries specific risks. In most cases, excess fluid produced by the body to fill the fat cavity needs to be removed for a number of days.

A physical examination is required in order to verify whether you are a candidate for this procedure. 

Comparison between UAL and traditional liposuction methods can be seen below.

VASER Ultrasonic Assisted Liposculpture - How does it work?

In our clinic we use VASER - the best UAL technology on the market.

Ultrasonic waves, delivered through the cannula, emulsify or liquefy the fat, while traditional liposuction requires manual effort to pulverize adipose tissue.

Ultrasonic waves actually target fat cells specifically, causing them to “implode” and liquefy for suction removal. Because fat cells alone are selected, blood and tissue loss is minimal. Traditional liposuction causes more tissue trauma and bruising than ultrasonic techniques due to tissue destruction necessary to manually break up the fat. Ultrasound emulsifies fat without damaging adjacent tissue. 

During the procedure, an aqueous solution of lidocaine, epinephrine and saline water is first injected into the area from which fat is to be removed. Small incisions are made on the sides and thin hollow tubes are inserted inside. Sound waves are transmitted to the fat with the help of this cannula, which is also used for sucking out the fat that liquefies due to the effect of the tumescent solution and ultrasonic waves.

Comparison Table - UAL vs Traditional Liposuction

Ultrasonic Assisted Liposculpturing

It only targets fat cells, wich makes male breast, upper abdomen and fatty deposits on the back easier to treat.

It emulsifies fat without damaging adjacent tissue. Reduces bloodloss and post-operative pain.

Due to the skin tightening effect and the reduced bloodloss, UAL can also be performed on overweight patients.

It minimizes the ”wavy areas" side effect. Because ultrasound is so smooth and precise, contouring is more achievable. 

Traditional Liposuction

Difficult fibrous areas, such as the male breast, upper abdomen and fatty deposits on the back are hard to treat.

Traditional liposuction causes more tissue trauma and bruising than ultrasonic techniques, due to the tissue destruction necessary to manually break up the fat. 

Best suited for women and men close to their ideal weight, with good, i.e. youthful skin tone and texture.

Higher chance of getting the side effect of "wavy areas" of fat.

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