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

What are Serdev Suture® Lifts?

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serdev suture lifts

Serdev Suture Lifts - Concept

When speaking of cosmetic surgery, patients have mostly heard of read about open surgery liftings. In 1993 Dr. Nikolay Serdev introduced his method of transcutaneously sewing (suturing) SMAS to periosteum. 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:


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facelift surgery without scars

Beautification and rejuvenation of are achieved by restoring correct proportions, volumes and angles. In our clinic, we perform facelift surgery without scars. We use Serdev Suture® Lifts - the most modern, mini-invasive and atraumatic methods, which in the same time give great results and very high patient satisfaction. The procedures are carried out through skin puncture points, which heal in 1-3 days. There is no skin excision and subsequently no scars. Also, due to minimized trauma, patients can quickly resume their social life.

The Serdev Suture® methods for facelifting surgery without scars are:

In Rhinoplsty:

With the exception of humpectomy, the listed procedures are Dr. Serdev's author methods in rhinoplasty, leaving no trauma and bruisingNo intranasal packings or casts are required even in humpectomy, only skin-colored tape is places to suck out any swelling.

 Other face procedures:


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scarless body lift

Beautification and rejuvenation are achieved by restoring correct proportions, volumes and angles. We do this by lifting and creating volume where needed, using patient's own tissue. More specificly, via a scarless body lift.

We perform Serdev Suture® Lifts - the most modern, mini-invasive and atraumatic methods, which in the same time give great results and very high patient satisfaction. The surgeon carries out the procedures through skin puncture points, which heal in 1-3 days. There is no skin excision and subsequently - no scars. Also, due to minimized trauma, patients can quickly resume their social life.

The Serdev Suture® methods for scarless body lifts are:

Other body procedures:

Artificial Hair Implants. Biofibre®

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In cases of thinning hair, we offer hair implantation as well as transplantation methods. We achieve best results for our patients by implanting Biofibre artificial hair. Hair loss can be due to combination of multiple factors such as ageing, hormonal changes, and a genetic history of baldness. The earlier hair loss begins, the more severe the baldness. It can also be the result of trauma or burns.


Biofibre Artificial Hair Implantation

Unlike transplantation, in which we take natural hair from the back of the head to make grafts, hair implantation is a method in which we cover the head with biocompatible fibers (Biofibre) to immediately achieve the desired appearance.

In transplantation cases, new hair grows about 4 to 6 months after surgery. In cases of improper technique, visible scars can occur and make further transplantation difficult.

Biofibre are the most advanced organic fibers, adapted for hair implantation. They have all necessary certificates based on the requirements of European Directive 93/42/EEC on medical devices for implantation. Many clinical and histological studies confirm the effectiveness and safety of Biofibre for treating alopecia (baldness) in men and women.

Biofibers are soft, flexible, fine, and resistant to color change. The result is natural, immediate and aesthetic. For this purpose, Biofibre comes in a variety of 13 colors, 3 different lengths (15, 30 and 45cm), and three styles (straight, wavy or curly). Under appropriate selection and blending, these characteristics will satisfy almost all patient requirements. Of course, this artificial hair is washable and has a natural look.


The procedure

The Biofibre hair implantation procedure is quick and painless, done under local anesthesia. The aesthetic result is immediate and patients leave the clinic rejuvenated, with brand new hair. 40-50 fibers per square centimeter create a natural density of hair. The average annual loss of fibers ranges from 5 to 20% and depends on the type of skin, hair and most importantly – patient skin care. The loss of fibers does not leave scars and we can repeat the thickening procedure at any time if necessary. Due to high surgical sterility, we do not have infections.

The sensation of movement of the implanted hair is the same as with natural hair. Patients describe the pleasure of the wind in their hair immediately after the procedure.

Read moreFrequently Asked Questions regarding Biofibre Hair Implantation

Read moreOverall Beatification of the Face Without ScarsVASER Lipo of Belly, Breasts, Back, Love Handles


Hair Transplantation. Methods.

Transplantation of hair consists of resurfacing bald areas of the scalp with patient’s own hair (hair follicles). The follicles are taken from the back of the head and are transplanted to a new location, in the skin of the bald area. The number of grafts and the duration of transplant sessions depend on the degree of balding. Several sessions can be necessary.

One way of obtaining the hairs is to excise plugs of scalp from hair-bearing areas, containing groups of 2 to 4-5 hair roots for transplantation. This is an older method. More modern methods are:


Follicular Unit Extraction (FUE) Hair Transplant

Follicular unit extraction (FUE) is a hair transplant technique in which we extract follicular units from a patient's bald resistant donor areas. We then transplant these hair follicular unit grafts into patient's balding areas.

Given the time consuming and tedious nature of this procedure, we are often cannot transplant more than 500 to 600 follicular unit grafts in one day, with a maximum of 2000 follicles. The cost per graft of FUE is also typically twice the cost of the standard follicular unit hair transplant procedure, in which we remove a strip of donor tissue from the back of the head and trim it under magnification into individual follicular unit grafts.

Scalp Reduction (Serial Excision)

This is the removal of as much of the bald section as possible. The adjacent hair bearing areas of scalp are pulled in close to the bald section, with the understanding that some bald areas will remain. We repeat this technique one or more times at a later date to eventually reconstruct the bald area.

Tissue Expansion

The surgeon places a device called "tissue expander" under a hair growth area, adjacent to a bald area. After several weeks, the tissue expander causes the skin to grow new skin cells. Then, another operation is necessary to place the newly expanded skin over the ajoining bald area.

Almost everyone believes that follicular units are the best size grafts for hair transplantation, but reality is a bit different. In our clinic, we use 3 sizes of grafts: single hair follicular units, follicular units with 2-3 hairs, and modified follicular units with 4-5 hairs. We use single hair follicular units mostly for the hairline, while follicular units could be the basic size for the rest of the grafts. 

Ideal candidates for hair replacement must have a healthy growth of hair at the back and sides of the head. The hair on the back and sides of the head will be the donor sites, from where we will surgically remove the flaps and grafts.

To achieve the desired fullness, several surgical sessions are needed. There is a healing period of several months recommended between each session. The final result with a full transplant series may take up to 2 years. 

A month or two after surgery, the grafted hair falls out (which is normal and temporary). It takes another month or more before hair growth starts. To create more natural-looking results, a surgical touch-up procedure may be necessary.

Gallery - Biofibre Artificial Hair Implantation (above); Hair Transplantation (below).

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VASER Lipo – General Information

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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 resultsVASER 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.


UAL Procedures

We perform ultrasound liposculpture in one or more face and body areas. Due to the lack of bloodloss, they can be done as standalone procedures or in multiple combinations, depending on the case. The procedures are:

VASER Lipo - How does it work?

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

Selected lenghts of ultrasonic waves, delivered through a cannula, emulsify or liquefy the fat. In contrast, traditional liposuction requires manual effort to cut and aspirate fat tissue, producing tunnels in the fat depots.

In fact, ultrasonic waves specifically target only the unstable giant fat cells, causing them to “implode” and liquefy for suction removal under low pressure. These are the cells which deposit and store calories as fat. Because the waves only target fat cells without impacting other tissues and vessels, blood and tissue loss is minimal. Fat is emulsified with no damage to adjacent tissue. The stable microscopic cells of the superficial subdermal layer of fat tissue (which makes the skin smooth) do not react to these waves. Therefore, there are no surface irregularities after the procudure.

In comparison, traditional liposuction causes much more tissue trauma, blood loss and bruising than ultrasonic techniques. This is due to the tissue destruction necessary to manually break up the fat. Ultrasound emulsifies fat. 

Comparison Table - VASER vs Other Liposuction Methods

VASER Ultrasonic Assisted Liposculpturing

It only targets fat cells without trauma to adjacent tissues.

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

Male breast, upper abdomen, back and buttock areas are treated more easily.

It minimizes the "wavy areas" side effect and makes contouring more precise.

Traditional (Suction Assisted) Liposuction

Most common form of liposuction because it does not require expensive apparatus.

Performed by manually breaking up the fat (pushing and pulling a probe blindly through the fat area, using negative vacuum pressure). Causes greater blood loss, trauma and bruising, and has the longest recovery period.

Fibrous areas, such as the male breast, upper abdomen, backa nd buttocks are hard to treat.

Higher chance of irregularities as a side effect of the so called "surperficial liposuction".

Laser-Assisted Liposuction/Laser Lipolysis

Uses the thermal energy of the thin laser beam to destroy fat cells and seal off surrounding vessels.

It can cause thermal damage to important tissues if not carefully applied.

The extracted fat cannot be used for lipo transfer.

Usually can treat only small fat deposits as the laser beam makes random tiny "tunnels" in the fat tissue, similarly to traditional liposuction.

Power-Assisted Liposuction

Surgeon's arm movement is used in combination with a vibrating cannula.

Similar to traditional liposuction, with added vibration aiming to help break up the fat tissue.

Surgeons can have difficulties controlling the device.

Can result in contour irregularities.


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The purpose of rhinoplasty (also known as nose correction, nose reshaping, or simply nose job) is to create correct aesthetic proportions of the nose and face. It is the most frequently requested cosmetic surgery procedure for face beautification. In 1/3 of all cases we only work on the tip of the nose, to reduce it’s length, refine and project it. Rhinoplasty requires accurate and precise movements with excellent knowledge of the anatomy.

As a central part of the face, the nose has a major role in defining aesthetic proportions. It has an individual structure and has to fit in the overall aesthetic proportions, volume and angles of the face.

Rhinoplasty can only correct the outer appearance of the nose! If there is an impairment of the nasal function (ex. deviated septum, polyps, deviation of ethmoid bones, mucosal edema etc.), we work ENT specialist, when necessary, prior to a cosmetic nose job.



A surgeon cannot make your nose like it looks on the face of another person. Your bones, cartilages, skin, individual characteristics and proportions are different!!!

Many patients ask whether Michael Jackson’s nose should be considered as an ideal. Such thinning is impossible without removing bone structures, which disturbs the function of the nose. However, nose’s function is much more important than its appearance! Not everyone can afford to buy and use a hyperbaric oxygen chamber at home to saturate the body with oxygen.

The goal of rhinoplasty is to beautify without disrupting the function!


What are the correct proportions of the nose?

The aesthetic standards for correct proportions of the nose are: 1/3 the length of the face (golden section rule), straight or slightly curved dorsal line, 90 degree angle at the tip, possibly thinner dorsum and tip, narrow alar base.


Why do we use Closed, instead of Open Rhinoplasty?

We practice closed rhinoplasty to perform the necessary correction of the nose, and more specifically – Dr. Serdev’s author techniques. This approach prevents the traumatic “opening” of the nose, it is mini-invasive and without bloodloss. Instead, the manipulation and sutures are made inside the nose. In addition, casts, plasters and intranasal packings become unnecessary. There is no swelling, no “black eyes” and no scars.

In open rhinoplasty the surgeon would make an incision across the columellar area (the skin-covered barrier between the nostrils) and pulls the skin upward. In this way he can see the cartilages and bone structure of the nose. Then, he reconstructs the cartilage to alter the shape and size of the nose. In the end, the surgeon puts sutures in place to close the incision and inserts intranasal packings for a few days. A cast would be set on the nose for a week so that the new shape stabilizes. The real shape of the nose becomes visible only after one year. However, the scar on the underside of the nose will remain visible.

In our clinic we do not like the open rhinoplasty, due to a lot of negatives (loss or necrosis of cartilage, great percentage of secondary corrections, etc.) and visible scars. Therefore, we use closed rhinoplasty techniques, without visible scars.


Patient Testimonial

“I am coming out of surgery just now. For me, the anxiety before the operation was very big, I had fear. But it actually it was not an intervention, according to me – as if I was going to the dentist. There was no pain, it was very quick to me. The difference before and after is so huge… exactly what I wanted! Most importantly, I am not dizzy, there is no pain,  I feel very good. Such a painless surgery, after all others that I’ve had… [3 days after surgery] I don’t have any problems. In short, I can say that the feeling cannot be better. As if there hasn’t been a surgical intervention.”



The techniques used in our clinic can be used for primary, as well as for secondary rhinoplasty. They are:

Secondary Rhinoplasty

The most common causes of secondary nose job are:

  • Disproportionately long nose and hanging tip or columella after the first operation;
  • Loss of alar cartilage due to excessive work on the extracted cartilages, trauma, loss of blood supply and necrosis;
  • Deformation of the tip of the entire nose;
  • Adhesions;
  • Regrowth of hump fibrotic tissue, growth cysts or bone spikes (osteophytes, exostoses) from the medial osteotomy area.

The Operation

The asthetic correction of the nose is one of the most tolerable procedures for our patients. This is because most of the stages of the operation are Dr. Serdev's author techiques in rhinoplasty. Nose correction in our clinic is an outpatient procedure with local anesthesia, combined with IV sedation. Rhinoplasty is relatively short at his hands but can last for hours with other surgeons, which causes too much trauma to the tissues.

No Trauma, No Casts, No Bleeding and No Intranasal Packing

Due to the minimal trauma in our operations, a minimal stripe bruise can appear linearly under the eyes in only about 30% of cases of hump removal but it only runs for about 5 days. After the operation and only after humpectomy, the patient wears skin-color tape for three days. Intranasal packing is not necessary (and even traumatic) because it is placed in the inner nose, while cosmetic corrections deal with the external nose. Full return to social life is possible from the first day due to the lack of bruises. Only in cases of humpectomy, it may be postponed to the 5th postoperative day.

After surgery, the patient has the obligation to appear at the designated follow-up sessions, which are generally as follows:
- on the day after surgery - cleaning the nose;
- on the third day - taking the skin-colored tape off (only in cases of humpectomy);
- two weeks after surgery - removing any remaining stitches, if necessary.

We do not recommend operations before the legal age. However, in rare cases of severe generated complexes, we can perform rhinoplasty upon request and signatures by both parents. In such cases, minor adjustments could be necessary after the completion of nasal growth, usually bewteen the ages of 18 and 21.

Serdev Techniques in Rhinoplasty

Rhinoplasty is one of the most effective operations. Thanks to the methodology of Prof. Dr. Serdev it is also one of the lightest in cosmetic surgery, with very short recovery period. In some cases patients may wear a tape for only 3 days after surgery. Furthermore, there are no visible signs of intervension - no casts, no intranasal packing and no "black eyes" bruising. 

The methodology is based on the achievements of the first president of the American Academy of Cosmetic Surgery - Dr. Julius Newman, surgeon in Hollywood, called "Dr. Nose" and improved by Dr. Serdev through basic techniques known in the world as Serdev Tehcniques in Rhinoplasty - "T-zone excision", "columella sliding", as well as the well-known Serdev Suture methods for nasal tip refinement (narrowing) and alar base narrowing

T-excision rotates the tip upwards and the columella sliding gives projection. When we have to correct a hump, we perform a medial resection to the bone-cartilage pyramid. To close the open roof after humpectomy, a very atraumatic methodology exists - the digital fracture - created by Dr. Hernandez from Ecuador. We use it to prevent from bleeding and formation of bone steps on the side of the nose, also known as "crow's feet" .

Read more – journal review of the book "Serdev Techniques in Rhinoplasty"

Serdev Techniques in Rhinoplasty explained

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