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

What are Serdev Suture® Lifts?

serdev suture lifts

Serdev Suture Lifts - Concept

Simply put - Serdev Sutures Lifts are methods for lifting and/or volumizing of different face and body areas, without scars. We achieve beautification / rejuvenation and longevity of the aesthetic result by lifting the mobile (hanging) tissues and stably attaching them to immobile structures. This is done through skin punctures only, without cutting and detachment of the skin from its support - the superficial muscular aponeurotic system (SMAS).



Dr. Nikolay Serdev performs the procedures only through skin punctures, with the help of specially designed instruments. There are no incisions and excisions of skin. Therefore, there are no scars! The marks from the needle punctures disappear and are no longer visible after a few days.


Atraumatic. No downtime.

Serdev Sutures Lifts are mini-invasive and do not cause trauma, bruising or bloodloss. Subsequently, swelling is minimal to non-existant. Patients can resume their social and working activities on the day after surgery.


Fio Bùlgaro. Fio Elastico...

Serdev Sutures Lifts have gained huge popularity, epecially in Latin America. During courses and congresses, Dr. Serdev introduced his methods and trained cosmetic surgeons in Argentina, Colombia, Venezuela, Ecuador, and especially in Brazil. There, Serdev Sutures have become known as Fio Bulgaro or Fio Elastico Bulgaro. One of the many TV episoses with Dr. Serdev on the topic of beautification and rejuvenation with his mentods can be seen here - Brazilian TV about Fio Bulgaro.



Dr. Serdev has developed over 20 techniques and their variations for the face and body.

For example, Serdev Suture techniques in the face include: lifting of eyebrows and corners of eyes, cheekbone lift, upper, mid-face, lower face and neck lift, chin enhancement, narrowing of the tip of the nose or the nostrils, and more.

Without a doubt, the most popular lifting is the scarless buttock lift, widely used accross the world, especially in the Americas. Other Serdev Suture body lifts are breast lift, inner thigh lift, abdominal flaccidity tightening.

Combining these cosmetic procedures ensures a beautiful and harmonious face, aesthetic volumes, angles, and proportions. Most importantly, surgeons can achieve these immediate results without scarring, with extremely short postoperative period and no "operated on" appearance.

Serdev Suture Lifts vs Thread Lifts

The word "suture" in Serdev Suture Lifts comes from the Latin Sutura and means "to bring tissues together". Surgeons and patients sometimes confuse our techniques 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 mostly non-absorbable. They are inserted in the subdermal fat, where they hang freely, without stable fixation. Therefore, 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 instruments. They aim to capture and lift the mobile tissues, then stably fix them (by suturing) to non-mobile structures. This fixation guarantees a durable aesthetic result. The human body absorbs the threads within 2 years, after the final fibrosis formation. Their limited elasticity is cruicial, because it permits the sutured tissues to move naturally, without cutting them (rigid threads act like scalpels).

"Liftings of The Third Millennium"

Prof. Dr. Nikolay Serdev, MD, PhD is a recognized master of face beautification not only in Caucasians, but also in Asians, African Americans, etc. Hence, 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. Notably, during the International cosmetic surgery congress in Spain 2001, these lifting methods were called "Liftings of The Third Millennium". 

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 does not involve no implants. Instead, we encircle and project the patient’s own tissues. The buttock lift makes the legs look longer and also adjusts the proportions between the lower and upper body.

Serdev Suture butt lift is a highly specialized cosmetic surgery procedure. It 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, we gather the buttock tissues, lift them and fix them to a stable higher position. As our patients evaluate the procedure – we lift the flattened and loose form “into the pockets of the jeans”, and even further – over the pockets.


Serdev Suture Lift

In our clinic the scarless butt lift is performed suing the Serdev Suture Lifting method. This means there is no cutting of skin, and subsequently – no scars. Dr. Serdev needs only a few skin puncture points to stably lift the buttock. The fixation of the suture to the stable inelastic Serdev fascia maximally guaranties the longevity of the aesthetic effect.  We achieve the scarless butt lift result immediately, with short post-operative recovery and short downtime. Patients are even able to drive their cars the day after the operation, despite some pain.

We perform the operation under local anesthesia with intravenous sedation. Patients do not need hospitalization or nursing care.


Scarless Breast Lift via Serdev Suture

Scarless Breast Lift

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. Dr. Serdev uses only skin puncture points to perform the procedure.


Serdev Suture® Lift

This Serdev Suture breast lift method can achieve a lifting of up to and over 14 centimeters. It 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 we combine the technique with subpectoral implants. In sagging breasts, surgeons should not place the implants over the pectoral muscles. Doing so 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 surgeon should remove the implants, along with the capsule – a difficult, but 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. They should be smooth and able to move naturally, without hurting the muscle.

Modern anaesthetics and new atraumatic methods have reduced postoprative pain and swelling. 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, we can repeat the Serdev Suture breast lift to maintain the aesthetic appearance of the breasts, even in advanced age. We cannot operate cases of gigantomastia (i.e. very large, very heavy and drooping breasts) in this manner, because of gravity and overskin.

NB!! We strongly prohibut exercises with the arms and weight lifting 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.

Surgeons can use different techniques, which involve different incisions. The choice depends on the amount of breast lifting they need to accomplish:

  • 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 necessary, the larger the incision (therefore, the larger the scar). 

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 surgeon removes the appropriate amount of skin and tightens the breast tissue 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, patients wear a special bra to support the breast for up to three months. The compression bra is an important part of the recovery process. It 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 surgeon removes excess skin and provides firmness to the breasts. Though mastopexy can be 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. Patients who do not smoke and have normal body weight are the best candidates for surgery, without many side effects. Those 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?

Many surgeons prefer subglandular implants, because they are easier to place. There is, however, a major disadvantage – the implants are too heavy and the skin cannot support them 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 the patient chooses to do so, she must remove the busks. 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 surgeon uses only a couple of skin puncture points to perform the procedure and therefore leaves 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, we can solve most problems without scarring.

The method is also used for treatment of Poland Syndrome.


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.

Just like the breast lift described above, the surgeon performs this procedure through skin punctures only, in order to suture and fix the stable fascias above and below the implant. Thus, he creates a new, proper lower and medial line of the augmented breasts, and also corrects 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.

Poland Syndrome. Unilateral 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. Dr. Serdev places the implant 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 using his suture lifting methods.  There are no incisions or excisions of skin and therefore – no scars. In fact, he needs only a few skin puncture points to carry out the procedure.

The abdominal flaccidity tightening procedure does not distort work and professional efficiency. Patients can perform their daily personal and business duties without interruption.

Abdominal wall tissue lifting leads to aesthetic changes and results. This means that we turn the “sad navel” into a normal looking, “happy navel”. With a few manipulations, wrinkled and loose skin can become so acceptable that patients can wear their belly 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

Inner thigh lift without scars

In our clinic we use Serdev Suture Lifting methods to perform the inner thigh lift. Therefore, there is no skin cutting but only skin punctures.

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, we perform ultrasonic removal of fat (Vaser liposelection) prior to the thigh lift.

We perform the lifting under local anaestasia, combined with IV sedation. Trauma is minimal and there is no downtime, hospitalization is not necessary. The skin punctures heal within 1-3 days.


inner thigh lift

Liposuction – VASER Ultrasonic Assisted Liposculpture (UAL), Body Contouring

VASER Ultrasonic Assisted Liposculpture - UAL

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

Tumescent liposuction has been very effective even 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.

VASER ultrasonic assisted liposculpture is a more advanced form of both regular lipoplasty and tumescent liposuction, and 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 VASER lipo. 

Apart from carrying the risks associated with all cosmetic surgery procedures, UAL also carries specific risks. In all liposuction methods, the body produces excess fluid to fill the fat cavity, which we have to remove for a number of days.

We require a physical examination in order to verify whether you are a candidate for this procedure. 

Comparison between VASER lipo and other liposuction methods can be seen below.

VASER Lipo - How does it work?

In our clinic we use VASER lipo - 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 cut and aspirate fat tissue, producing tunnels in the fat depots.

Ultrasonic waves actually target fat cells specifically, causing them to “implode” and liquefy for suction removal. Thus, blood and tissue loss is minimal. Traditional liposuction causes more tissue trauma, blood loss 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, we first inject an aqueous solution of lidocaine, epinephrine and saline water into the area from which we will remove fat. We then make small incisions on the sides and insert thin ultrasound probes to transmit sound waves to the fat, in order to liquefy it. The liquefied fat is then sucked out with the use of thin cannulas.

Comparison Table - VASER vs Other Liposuction Methods

VASER Ultrasonic Assisted Liposculpturing

It only targets fat cells and leaves neighbouring tissues intact.

Reduces blood loss and post-operative pain and has a skin tightening effect.

Male breast, upper abdomen and fatty deposits on the back easier to treat.

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

Traditional (Suction Assisted) Liposuction

Most common form of liposuction.

Performed by manually breaking up the fat (pushing and pulling a probe through the fat area, using negative vacuum pressure). Causes greater blood loss, trauma and bruising than ultrasonic techniques.

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

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

Laser-Assisted Liposuction/Laser Lipolysis

Uses thermal energy to destroy fat cells and seal off surrounding vessels.

It can cause thermal damage to important tissues.

The extracted fat cannot be used for lipo transfer.

Usually can treat only small fat deposits.

Power-Assisted Liposuction

Fastest liposuction method.

Similar to traditional liposuction, PAL uses a specialized tube and mechanized movements to help break up the fat tissue.

Surgeons can have difficulties controlling the device.

Can result in contour irregularities.


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