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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 Suture Lifts are methods for scarless lifting and/or volumizing of different face and body areas. We achieve beautification / rejuvenation and longevity of the aesthetic result by lifting the mobile (hanging) tissues and stably attaching them to immobile structures.

For example - in mid-face, this scarless method allow us to lift and suture the loose zygomatic SMAS extension to the firm temporoparietal tendon insertion (and underlying temporal periosteum). The result is middle and lower face SMAS lifting, as well as cheekbone lift to a higher position. Tear trough, nasolabial and marionette folds are also resolved.



Dr. Serdev performs the procedures only through skin punctures, with the help of specially designed instruments. There are no incisions and excisions of skin. 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, 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 Suture Lifts have gained huge popularity, epecially in Latin America. After Dr. Serdev introduced them to cosmetic surgeons in Brazil, his methods have become known as Fio Bulgaro or Fio Elastico Bulgaro. Dr. Serdev presented on Brazilian TV about Fio Bulgaro here.


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:

Overall Face Beautification Without Scars

Many of us dream of changing something in our face - some do not like the nose, others the lips, or want and need to completely transform it. There is nothing wrong with striving for beauty and perfection, if a change would make us happier and complete, and would raise our confidence.

Nonetheless, realistic assessment is needed and patients must have motivation to undergo the procedures. 

What defines the beauty of the face?

Face beautification means arrangement in order to bring the face in aesthetic proportions, angles, and volumes while in the same time maintaining individuality. Imagine your room tidy and then imagine it disorderly. It is surely more beautiful when it is structured and has an individual character. 

The complex face is properly divided into three equal parts: forehead, nose, and lower part (where the upper lip forms a ratio 1:2 to the lower lip and chin). The profile forms a straight line. The size and shape of the nose are also very important - it must be straight, with an angle of 90 degrees at the tip and 110 degrees to the upper lip.

The volume of the lips must conform to the volume of the eye and eyebrows. Both eyes and eyebrows must have a higher angle laterally. Eyebrows usually end a little away from the lateral canthus of the eye, at 1 cm above the orbital rim. Beautiful cheekbones are slightly higher than the average person, forming a hollowing of the cheeks (hungry cheeks). The cheeks and chin shape an expressed "triangle of beauty". We emphasize it when smiling for a photograph.

Ears are properly situated with an angle of 30 degrees to the face oval.

Serdev Suture Lifts

The Scarless Serdev Suture Lifts create such perfect proportions, volumes and angles. These methods are particularly important in young people, where beauty is important but should be achieved without scars. Therefore classic excision lifts are not suitable and not allowed. Serdev Sutures methods are used for lifting, as well as to create the correct volume, proportions, and angles. These the only methods in cosmetic surgery that create a complete beautification only by skin punctures, which leave no scars.

The results are stable because mobile fascias are stably fixed (sutured) to immobile periosteum or fascia. Of course, the ageing process cannot be stopped. However, after surgery it will continue from the new, rejuvenated and beautified position.


Fillers, botulinum toxin, chemical peels, blepharoplasty, laser rejuvenation, hair implantation, photoepilation, mesotherapy, antiaging procedures and other techniques are applied to complete and maintain beauty.

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.

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.

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

Brow Lift via Scarless Serdev Suture

Scarless Brow Lift

In order to create aesthetic proportions and angles, we use the Serdev Suture method for scarless brow lift, which elevates the brow and also raises the angle of the eyes (the effect is doubled).

We achieve this higher fixation with only 2 skin punctures, which allow for the specially designed instruments to enter and exit the skin. There are no incisions and threfore no scars. The skin puncture points disappear within 1-3 days. There is no downtime, return to social life is immediate or within 2-3 days, depending on the person.

The stable fixation of the brow tissue to the periosteum assures the longevity of the result. The ageing process continues, but from the new, higher, more youthful position.

We do not practice classical and endoscopic methods in our clinic, due to their traumatic and scarring nature, as well as long recovery period.


Why is a scarless brow lift important? When communicating, we look each other in the eyes. A beautiful, youthful expression is one, where the angles of the face are pointing up. They express a joyful, fresh radiation - "mask of comedy". When the angles are pointing down the face looks tired and sad - "mask of tragedy".

With age, brows drop below the eye line and wrinkles appear on the forehead. These make a person look angry, sad and constantly tired. Brow lift is most popular among ages of 40-60, and you can combine it with a facelift or an eyelid surgery. The science of aesthetics remains eternal. It is fashionable eyebrows to rise upward and sideways to reach a height of at least 1 cm above the upper edge of the orbit. Many young people also seem serious and tired. This is due to the low lateral position of their eyebrows. Such position may be congenital or acquired. 

Information on classic and endoscopic brow lift.

Classic Approach

Using the classic technique, the surgeon cuts ear-to-ear through the scalp behind the hairline. This allows access to the forehead while releasing the muscles, to remove extra skin and lift the eyebrows to a higher position. The method is modified for patients with high forehead and retreat in their hairline. Then, a cut is made in the front of the hairline, so that brow lift does not cause additional retreat.

Endoscopic Approach

Under the endoscopic approach, 3-5 small incisions are made on the scalp, from ear to ear behind the hairline. Then, using special tools, the excessive skin and tissue are removed from the forehead and sometimes attached to the scalp from the inside. With time the wrinkles disappear. In some case the surgeon inserts a special hook through the endoscop, to attach the tissue onto the desired location. The hooks melt over time and the forehead reshapes. With another technique, a smaller cut is made through the temple areas, and the excessive skin is removed as described. This approach is used when the outer portion of the brows needs to be lifted. The operation can be performed using local anesthetics with deep sedation.

Complications and results

Every operation has its complications. Excision techniques may include:

Damage to the forehead nerves, which results in inability to move the forehead or brows; loss of sensation, usually temporarily, around the scar; hair loss in the scar margins and wider scar; infection and bleeding. Endoscopic complications may force the surgeon to perform an open surgery, which has longer recovery duration.

After the surgery (of the classic approach) has been performed, there might be an uncomfortable feeling of ant crawling and pain around the scar. These usually disappear over time, while the pain can be managed with painkillers. It may be difficult to open the eyes due to eyelid swelling. The endoscopic approach has less pain and alter sensation.

You can return to work 10-14 days after surgery, however, the final results can be seen only after a few weeks. For several weeks you must avoid vigorous activities that can elevate your blood pressure. Also avoid prolonged heat or sun exposure. Most marks of the surgery resolve after 3 weeks, minimal swelling and small hemorrhages can be covered with make up.

Cheekbone Lift and Volume Creation via Serdev Suture®

Cheekbone Lift and Volume Creation

By using Serdev Suture Lifing method, we can effectively achieve a cheekbone lift and in the same time create the necessary volume, without the use of implants.

Wrongly, many physicians try to fill the nasolabial folds in order to create volume. Thus, they create a total projection of the lower part of the face (the so called “primate face”). However, the correct approach is to lift the soft tissue back to the zygomatic bone, restore cheekbone fullness, create the necessary volume – medially or laterally – and elevate the cheekbone. We thus eliminate the tear through fold and improve the facial expression. Additionally, we achieve a youthful elongation of the so called “beauty triangle”, which is responsible for the beauty of the lower face.

We perform the procedure through skin punctures only, which disappear within 2-3 days. Therefore, there is no cutting of skin and most importantly – no scars! TV stars use such rejuvenation to appear on screen next day.


Cheekbones and the “Beauty Triangle”

Cheekbones are relevant to nearly all aesthetic norms. Unfortunately, pronounced, high, and youthful cheekbones are rare.

The chin and cheekbones create the so called “beauty triangle”. Asian cheekbones are pronounced lateraly but flat in front. Vice versa – in Caucasians cheekbones are often more pronounced at the front, but quickly drop. They are almost absent in elderly.

The Bichat’s fat pad (Corpus adiposum buccae) is of great significance in facial contouring. After our 30s, the fat pads loose connection to the zygomatic bone and droop in, the skin forming deep nasolabial folds. The Serdev Suture cheekbone lift without scars and without implants can easily restore the “Beauty Triangle”.


Chin Lift Without Implants. Enhancement and Form Correction via Serdev Suture®.

Chin Lift Without Implant

Chin lift is one of the most popular and preferred suture lifting methods, created by Prof. DR. Nikolay Serdev, MD, PhD.

The aim of Serdev Suture® chin lift is to position the chin in the central axis and establish correct proportions, without the use of implants. We perform the procedure in cases of ageing or sagging chin (the so called “witch chin”), small chin (micro- and retrogenia), and other deformities.

For this ambulatory procedure, Dr. Serdev uses only two skin punctures in order to insert the needle and thread. Then, he collects the whole available chin soft tissue and moves it to the correct position.

The entire procedure takes a few minutes. We do not use dermal closure or bandages. Patients should perform facial washing on the following day. The skin puncture in the supra-mental fold may be visible for 2-3 days and patients can use make up to cover it. The early post-op period swelling is almost invisible. Patients can return to their social life as soon as they wish.


Chin Enhancement and Position Correction

We use this method not only to lift the sagging chin, but also for chin enhancement and position correction. We can move the chin to the side, as well as up or down. Thus, we achieve correct volumes, angles and proportions.

A dimple can also be created along with the chin lift.

The results are durable and patients prefer it to the alternative method of using foreign bodies (implants), which requires incisions, wearing bandages and involves swellings.


Disharmony and Proportions

Profile deficiencies are due to congenital, traumatic and ageing factors, with different degree of deformity. Loss of volume or a genetically small mandible affect the aesthetics and expression of the mouth, chin, and neck. Disharmony between the skeletal support and the soft tissue envelope is a common cause of aesthetic concerns.

The chin is an important feature of the face. It plays an important role for defining facial aesthetic proportions. It is part of the noble profile (which is a straight line), as well as the “beauty triangle” – expressed chin and cheekbones. When we smile, the triangle is more visible and the face looks more beautiful. The lower part of the face should be divided into 3 parts – one part for the upper lip and two parts for the lower lip and chin (1:2 proportion).

With the help of the suture technique, the chin can be positioned on the line of the profile, up or down, left or right, face deformities can be corrected and chin dimple can be created.


Mid-face SMAS Lift via Serdev Suture. No Visible Scars

SMAS Mid-face lift via Serdev Suture

The mid-face suture lift is one of the internationally most successful and popular methods of Prof. Dr. Nikolay Serdev. It lifts and stretches the middle and lower parts of the face, as well as the neck. Also, it stretches the cheeks, nasolabial and marionette folds, highlights the so called “hungry cheeks” and restores the youthful jaw line.

Mid-face lift is most popular when we need to beautify middle aged and elderly patients. However, we also often perform this procedure in young patients for tightening the sagging of the skin in middle and lower face and neck.

In cases of fat deposits in the face, ultrasound assisted liposculpture may be required. The goal is to remove the fatty deposits on the cheeks, causing the so called “bulldog” appearance, which also leads to tightening the skin on the lower jaw line.

Serdev Suture Lifts are the most modern cosmetic surgery SMAS facelifts. Dr. Serdev needs only a few skin puncture points to lift any area, without skin incisions or excisions. Therefore, there are no scars. Hospitalization and nursing are not neecessary. The postoperative recovery is short and does not affect patient’s ability to go to work.


What is SMAS?

Back in 1972, surgeons demonstrated that after classic face lifting the skin is not stable and elongates in minutes. Since then, lifting of the Superficial Muscle-Aponeurotic System of the face (SMAS, described by Mitz and Peyronie in 1976) became the obligatory method for surgical face lift (including mid-face lift), in order to maintain a long lasting result.

The skin and soft tissue are strongly fixed to the SMAS in the temporal area. Therefore, if we separate it from the SMAS, the skin will elongate, because it has lost its stable support. Naturally, we strongly oppose such this approach. Also, in a subsequent SMAS lifting, the skin will not be lifted, because it is not well attached. The consequences of separating the skin from the SMAS are a mask-like stretched appearance, changed hairline position behind the ears etc.


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