What is the so called Serdev Suture buttock lift without implants or transplans? Thanks to Serdev Sutures Lifting method, we collect buttock’s tissues, lift them and fixate them to a stable, higher position. This means that we achieve the lifting without the use of implants, but by patient’s own tissues projection, using only skin punctures. The procedure does not leave scars, because there is no cutting and excision of skin.

Lifing of the buttocks has the additional effect of legs elongation and achieves a better proportion for the entire body. 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 Buttock Lift

Butt lift without implants and without scars, using “sutures” (briging tissues closer togheter by sewing), is by far the most popular method of Dr. Nikolay Serdev worldwide. He performs the procedure through a few skin puncture points to stably lift the gluteal fibrosis layers to the Serdev sacro-cutaneous fascia (discovered by Dr. Serdev, and therefore bearing his name). This suture fixation maximally guaranties the longevity of the aesthetic effect. The buttock is lifted, rounded and projected.

We use semi-elastic surgical threads, which do not cause tissue trauma. The result is immediate, with short post-operative recovery. Surgery is done under local anesthesia with intravenous sedation. There is no necessity of hospitalisation or nursing care. Patients could even be able to travel by car to the clinic for follow-up and care on the day after surgery.

Fio Bulgaro. Fio Elastico…

Serdev Sutures Lifting methods have gained great popularity, especially in Latin America. Dr. Serdev demostrated them and trained a large number of plastic and cosmetic surgoens during courses and congresses in Argentina, Colombia, Venezuela, Ecuador, and especially – in Brazil. There, his methods became known as Fio Bulgaro and Fio Elastico Bulgaro. One of the many TV episodes with Dr. Serdev on the topic of beautification and rejuvenation with his mentods can be seen here – Brazilian TV series about Fio Bulgaro.

Butt Lift Without Implants and Without Scars

This technique gained worldwide popularity, due to the results of projecting patient’s own tissues and visual legs elongation – all without the need to use implants or transplants and without leaving scars. Back in 1994, this was the only butt lifting technique and it became a hit in Brazil, where the buttocks hold an aesthetic, sensual and sexual meaning. Due to the specific angle position of the tailbone (coccyx) in Afro-Americans, the buttock lifting procedure and the acquired form were called „Brazilian Buttock lift“. However, due to incorrect understanding, surgeons and patients use this term when they opt for augmentation of the buttocks using fat transplants, fillers and implants.

Unfortunately, on its own, augmentation is not a lifting. On the opposite, it leads to unnatural proportions and look of the buttocks, which droops (sags) because of the additional heaviness. Furthermore, drastic augmentations beyond the correct volumes and proportions are not aesthetic.

There are some complications after mass fat injections (which cannot be vascularised to survive) or other implants in big volumes. They are mostly fistulas, leaking and infections in a high percentage. This is why we do not recommend such injections to our patients after lifting their buttocks via Serdev Suture.

Read more – Body Liftings; Scarless Breast Lift

Fat Depots in the Buttocks

In the cases where there is an accumulated fat depot in the buttocks area, we might need to remove it. In our clinic we use VASER for ultrasound liposculpturing.

With quick alteration in pressure, ultrasound selectively targets fat cells, causing them to “implode” and liquefy. This allows us to suck the fatty liquid out, under low pressure. Thus, blood loss and tissue trauma are minimal. Hence, patients can return to work and social life almost immediately. We can remove the fat depots as a standalone procedure or in combination with Serdev Suture buttock lift.

After lifting of the buttocks (and/or in combination with VASER ultrasonic liposculpture), the patient wears elastic garments for a month during hot months, a month and a half in the cold ones.

Patient Testimonial

Tanya B.

“[The day after Serdev Suture buttock lift] With bigger self esteem, I am trying to recuperate faster. I have little pain, but hope it will go away very soon. I did not take painkillers, the pain is much less than I expected and is tolerable. Today I managed to see myself from the back and side for the first time, using a mirror, and to me the effect is breathtaking. My butt is lifted and has entered my jeans’ back pockets.”

Results

Breast augmentation is one of the most popular and requested procedures in cosmetic surgery. This is why patients must be well informed about the various approaches for implants placement. They influence the durability of the aesthetic result, scarring and the necessity of replacing the implants.

Jessica C. – Patient Testimonial regarding breast augmentation in Serdev Clinic [e-mail from October 2018]

“I am a past patient of yours, having undergone breast augmentation surgery in 2012. I must say, the procedure itself was fantastic, and I have not had any trouble since.” 

Placement Location of Implants

1. Under the pectoral muscle, without weighing on the skin (subpectoral implants)

We place the implants under the muscle and they 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. Regular movement of the implants maintains the free space (pocket) and when touched, they will feel and move as natural breast tissue.

NB!! Only the pectoral muscle can hold the heaviness of the implants! Implants should be smooth and able to move naturally, without irritating or hurting the muscle. Textured implants get blocked under the muscle.

2. Over the pectoral muscle and below the gland, adding heaviness on the skin (subglandular implants)

Many surgeons prefer placing the implants above the pectoral muscle (under the gland and skin). However, this approach has a major disadvantage – the implants are too heavy and the skin alone cannot support them. Thus, in a few years the skin loosens and lengthens, breasts sag. What could be done then? In most cases, surgeons propose replacement with bigger implants, scarring mastopexy, or both.

Mastopexy is a method for reduction (lifting) of the ptotic breasts by excising the excess skin. Patients, especially young women, should gather information about the disadvantages of subglandular breast augmentation and the subsequent, sometimes multiple surgeries!

3. Under the fascia of the pectoral muscle

This method was not able to achieve wide acceptance. It consists of placing the implants above the muscle, but under its facsia, which has to support the impltans’ weight. It is suitable when surgeon is introducing the implats via incision in the armpits.

4. Half under the muscle and half under the gland

There is also an approach for placing the implants from under the breast, half between the muscle and half between the gland (or even the skin, because the gland is often small). In these cases, when the muscle contracts, it squeezes the upper half of the implant while the gland and skin in the lower part do not offer stable support. Thus, the implants can move downward in another position. In some cases implants can prolapse though the infraglandular incision.

Composition of the implants

In our opinion, saline implants are the best choice – they consist of an absolutely harmless sterile salt water solution. This is the same solution, which is transfused to all patients. It is unclear why they are not always presented to patients, which is mandatory in the USA and saline implants are used in 52% of all cases.

According to a publication from the Amrican Society of Pastic Surgeons, FDA allows the use of saline implants for breast augmentation to all women over the age of 18, as opposed to silicone implants, where the minimum age is 22. Anatomycal (teardrop shape) implants are heavy in their wide lower part. They may rotate after a sudden push, which requires surgery for their repositioning. In addition, when lifted with a bra, their upper and narrower part may protrude unnaturally, unlike round implants.

Smooth saline implants placed in a wide pocket under the pectoral muscle are softer than silicone implants with cohesive matrix. As our patients say – they move quite naturally, as thout they are “alive”.

Breast augmentation surgery lasts about 40 minutes. The shape of the breasts remains permanent. Saline implants do not require replacement. In contrast, silicone implants may need to be removed or replaced periodically. Patients can safely travel by airplane, but should protect the breasts from injury, unnatural pressure etc.

It is not necessary to wear a bra when the breast implants are placed under the mucle. If the patient chooses to do so, she must remove the busks to avoid hurting the breast tissue and changing the form of the new infra-mammary fold.

Implant Placement Approaches

There are several approaches for breast augmentation. The incisions for placing the implants can be under the breast, in the armpit, around the lower half of the areola, or the navel.

Periareolar Approach

Most harmless and with least noticeable scars is the periareolar approach – incision on the border between the brown areola and skin. This is the most atraumatic access, going through the avascular plane (no blood vessels), without damaging any structures. The surgeon opens the muscle in its upper part, by separating its fibers without cutting. Therefore, there is no risk of postoperative prolapse (implant slipping out of position). The implants are placed in the free space under the muscle.

Surgery is bloodless and relatively fast. Due to the lack of trauma, pain is minimal and patients do not have social limitations. They can resume their regular daily activities on the day after surgery or within the following few days. Patients wear a tape in the wound between the areola and the skin for some days. Patients come for follow-up and post-op care, changing tapes and so on for 3-5 days. We recommend that patients do not wear bras, but rather elastic garments. in order the implants heaviness to keep and preserve the new lower folds of the pocket.

Incision under the breast

The approach with incision under the breast is most frequently used by the majority of surgeons. This is because the use of not sufficiently elastic, textured silicone implants requires a bigger excision. If the surgeon has to place the implants under the muscle with this approach, he must also cut the muscle. This makes healing more difficult, because the implant weighs on the stitches.

Incisions under the breasts and in the armpits are visible when the woman is in a laying position!

Possible complications

Rare complications, which you should be aware of, are the following:
– Early complications: bleeding around the area of the implant, infection, implant slipping under the incision or prolapse;
– Late complications: disturbances of touching sensation around the nipples, capsule contracture and dislocation of the implant (one-sided in most cases), implant rupture (in rare cases).

Breast Augmentation and Ptosis

In some cases of breasts ptosis after breast augmentation with implants, we can use scarless Serdev Suture method for Breast Lifting to elevate the breasts to a suitable level. The ptosis may be a result of giving birth and lactation, ageing etc. Dr. Serdev uses only a couple of skin puncture points to perform the procedure. There are no incisions and excisions of skin and therefore – no scars! In cases of more expressed ptosis, we may perform the procedure in stages.

The suture lift cannot be used however in patients with implants placed over the muscle (because of the implant heaviness), as well as in very large breasts.

Dr. Serdev’s method is also useful in corrections for treatment of Poland Syndrome, for lifting the developed breast and augmenting the underdeveloped breast.

Repositioning of Breast Implants in Symmastia and False Position

The Serdev Sutures method presents a new possibility for repositioning breast implants in cases of false position and symmastia. Symmastia is a condition defined as a joining of the breast tissue of both breasts across the midline anterior to the breastbone. It can be congenital or as a consequence of breast augmentation.

The surgeon performs this procedure through skin punctures only, in order to suture and fixate the stable fascias above and below the implant. Thus, we create a new, proper lower and medial line of the augmented breasts and also correct the implants’ position.

Wearing of elastic garments or a bra could be necessary for some weeks after surgery, in order to reduce the weight on the implants on the sutures.

Breast augmentation using fat transfer

This technique exists, but is not widely accepted.

Read more – Serdev Sutures Buttock Lift; Liftings of the body; Liftings of the face; VASER Ultrasonic Liposculpturing

Results

Flaccidity of the abdominal skin may occur as a consequence of weight-loss, as well as after pregnancy. Cases of mild flaccidity can be treated using Serdev Sutures lifting method.

Abdominal Flaccidity Tightening

Thanks to Dr. Serdev’s method, we can correct mild flaccidity of the abdomen and around the navel. There are no incisions or excisions of skin and therefore – no scars! In contrast to classic abdominoplasty, we only need a few skin puncture points to carry out the procedure.

The technique is mini-invasive, with minimal trauma, done under local anaesthesia. The postoperative recovery is short and patients can perform their daily 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. Thinner women, with less subdermal tissue, are more suitable for this method. The presence of larger amount of subdermal tissue with bigger flaccidity, including sagging in the lower part of the abdomen, requires surgical abdominoplasty.

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

Read more – Stretch Marks Treatment; Microdermabrasion; Liftings of the body

Results

Labiaplasty, also known as reduction or rejuvenation of labia minora, is a procedure for improving the appearance of the vulva. The aim is to obtain an aesthetic appearance of the genitalia, without adding unsightly scars or distorting normal anatomy. This procedure is necessary in cases of labial hypertrophy – disproportionate enlargement of the labia minora in relation to labia majora.

Lifting of the thighs, more specifically inner thigh lifting, is necessary in cases where there is sagging of skin. In our clinic, we use the Serdev Suture Lifting method to perform this procedure without leaving scars.

Inner thigh lift without scars

This lifting method is important for young women, due to the lack of scars. However, it is mostly done in elderly patients, due to changes in weight, elongation of skin, etc. The procedure gives a great result not only in the first and second youth, but also in the third age in non-obese women. Serdev Sutures method for inner thigh lifting is atraumatic and mini-invasive, with short post-op recovery. There is no skin cutting, only punctures and therefore, there are no scars.

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

When fatty deposits are present in the thigh area, we first perform VASER ultrasonic liposculpturing, prior to the lifting.

Inner thigh lift without scars using Serdev Suture Lifting method.

Liposuction is a method for removing the accumulated fat depots in various face and body areas. To conduct this procedure without trauma, we use the so called ultrasound assisted liposculpture (UAL) using VASER. This is the best liposuction and body contouring method available today. There is almost no blood loss and recovery is fast. Patients can immediately resume their regular activities. Additional benefits are the skin tightening and weight loss. This is why we don not recommend losing weight with skin sagging prior to the procedure.

Application of VASER Ultrasound Liposculpturing

In the past, traditional tumescent liposuction has been effective in young patients with tight skin and mild to moderate amounts of fat. Post-op recovery with this method is slow, because of the trauma, irregularities and loss of blood.

Ultrasound assisted liposculpture however has expanded the scope of patients suitable for face and body sculpting. We can now include patients with larger amounts of fat and less elastic skin tone. We are also able to treat areas, which were not easily or effectively treated earlier with classic methods. These include fibrous areas such as the back, male breast and upper abdomen, as well as the buttock.

Ultrasonic liposculpture is a more advanced form of both regular lipoplasty and tumescent liposuction, and is used to get precise body contouring results. VASER lipo has the effect of skin tightening and slimming in the first six months after the operation. Therefore, if you consider liposculpturing via VASER technique, you do not need to try dieting with skin flaccidity as a result.

Like every other intervention in cosmetic surgery, ultrasound liposculpture also carries certain risks. In most cases, in the first few days we have to prevent the possibility of seroma retention in the treated areas. For this reason we conduct patient follow up in the first 5-7 days, when complications are most likely to appear. In this way we can be sure that patients from abroad can travel safely back home and have no complications after that.

Please refer to the table below for comparison between VASER lipo and other liposuction methods.

Due to the lack of trauma, liposuction in our clinic can be combined with liftings of the face and body (buttock lift, inner thigh lift, etc.) using Serdev Sutures Lifting technique, rhinoplasty or other beautification procedures.