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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:

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 Without Scars

brow lift is necessary in these cases, when the angles of the face are facing down. The procedure aims to restore the eyes’ youthful expression. In order to create the correct aesthetic proportions and angles without scarring, we use the Serdev Sutures method. This atraumatic procedure has a double effect because, in addition to the eyebrows, it also raises the angle of the eyes. In addition, an effective brow lift elevates the upper eyelids and thus delays the need for blepharoplasty in older patients for years.


Brow Lift Without Scars

We perform the Serdev Suture eyebrow lifting only through 2 hidden skin punctures points, which allow for the specially designed instruments to enter and exit the skin. We lift the brow fascia (Serdev fascia) and stably fix it to the periosteum at at higher level. This ensures the longevity of the aesthetic result. There are no incisions and therefore – 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.

Please note that the ageing process cannot be stopped! After a brow lift, ageing continues, but from the new, higher and 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. They are also indirect, have insufficient effect and leave scars.



Why is the 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 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 lifting is most popular among patients aged 40-60, and can be combined with additional facelifts or an eyelid surgery. Blepharoplasty can be done simultaneously or a long time after lifting of the eyebrows.

The science of aesthetics remains eternal. It is fashionable that eyebrows rise upward and sideways, so as to reach a height of at least 1 cm above the upper edge of the orbit. In the world of fashion, the hight is 1.5 cm.

Besides rejuvenation, this method helps us to achieve beautification. 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. The atraumatic nature of Serdev Sutures Lifts, the lack of scars and prompt return to social life make this method very suitable for young people.


Patient Testimonial

  • Petya A.

    "After the operation [brow lift] I feel really comfortable. I can't believe it!" Video

Cheekbone Lift and Volume Creation via Serdev Suture®

Cheekbone Lift and Volume Creation Without Implants

By using Serdev Suture Lifting method, we can effectively achieve a cheekbone lift and in the same time create the necessary volume, without the use of implants. Thus, we also treat the nasolabial folds and tear troughs. Dr. Serdev performs the cheekbone lift through skin punctures only. Therefore, there is no cutting of skin and most importantly – no scars! The punctures disappear within 1-2 days. TV stars use such rejuvenation to appear on screen next day.

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”). In the same time, fillers add heaviness, which leaves the skin stretched after their absorption.The correct approach for cheekbone enhancement is to lift the soft tissue back to the zygomatic bone, restore cheekbone fullness, create the necessary volume – medially or laterally – and thus elevate the cheekbone. In this way, we eliminate the tear trough and nasolabial folds and improve the facial expression. Additionally, we achieve a youthful elongation of the “beauty triangle”, which is responsible for the beauty of the lower face.

Read more – Overall face beautification; Rhinoplasty


Cheekbone Enhancement 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 laterally but are flat in front. Vice versa – in Caucasians cheekbones are often more pronounced at the front, but quickly drop. They are almost absent in elderly.

Bichat’s fat pad (Corpus adiposum buccae) is of great significance in facial and cheekbone contouring. Often, after our 30s, the fat pads lose connection to the zygomatic bone and droop in, creating the tear troughs. Moreover, they hang over the nasolabial folds, making the latter deeper and more visible. This is why lifting the cheekbones back in their place is more aesthetic than filling the deep folds, which makes the face look obese and round. 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 enhancemet or chin lift without implant is one of the most popular suture lifting techniques, created by Prof. Dr. Nikolay Serdev. For this ambulatory procedure, Dr. Serdev uses only two skin punctures, in the supra- and submental folds. Using special instruments, he collects the whole available chin soft tissue, moves it to the correct position, and fixates it to the bone. The chin correction includes projecting one’s own tissues forward, but in cases of deformities, they can be moved up, down, left and right. Patients most often seek this procedure in cases of small chin (microgenia and retrogenia) and age-related ptosis (witch chin).

The aim of Serdev Suture chin lift is to position the chin in the central axis of the face, create the appropriate volume and correct facial 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.

Read more – VASER lipo of the face – double chin and cheeks


The entire procedure takes a few minutes. There are no incisions and 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 cover it with make up. The early post-op period swelling is almost invisible. Patients can return to their social life as soon as they wish.

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


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 it to the side, as well as up or down. Such cases are for example facial deformities and cleft lip. As a result, we achieve correct volumes, angles and proportions.

We can also create a chin dimple as an addition to the chin lift, or as a separate procedure.

Read more – Cheek dimple (smiling points) creation


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 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 chin plays an important role for defining facial aesthetic proportions. 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). Together, they form 1/3 of the face (golden ratio).

Dr. Serdev’s suture technique positions the chin on the line of the profile and restores the aesthetic proportions, angles and volumes of the face.


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

SMAS Mid-face lift via Serdev Sutures

The SMAS mid-face lift elevates 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 jawline. We lift and stably fixate the SMAS only through skin puncture points, using the Serdev Sutures Lifting method.

The SMAS mid-face suture lift is one of the internationally most successful and popular methods of Prof. Dr. Nikolay Serdev. It is most popular among middle aged and elderly patients. However, due to the lack of scars, we also often perform this procedure in young patients for tightening the sagging of the skin in middle and lower face and neck.

Ultrasound assisted liposculpture may be necessary in cases of fat deposits in the face. The goal is to suck out and remove the fatty deposits on the cheeks, causing the so called “bulldog” appearance. The procedure also tightens the skin on the lower jawline.

Serdev Suture Lifts are the most modern cosmetic surgery SMAS facelifts. Dr. Serdev needs only a few skin puncture points to lift any area of the face. Even the more central zones, unreachable for classic lifting methods, are successfully treated. We achieve this without skin incisions or excisions and therefore there are no scars. Hospitalization and nursing are not necessary. The postoperative recovery is short and does not affect patient’s ability to return to their daily duties.

Read more – Scarless Upper SMAS facelift; Overall face beautification; Lower Face and Neck Lift; Cheekbone lift


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 do not drop easily, thanks to their strong fixation to the SMAS. Therefore, if we separate the skin from the SMAS, it will elongate, because it will have lost its stable support. As a result, a subsequent SMAS lift will not be able to pull and lift the skin. The consequences of separating the skin from the SMAS are a mask-like stretched appearance, changed hairline position behind the ears etc. Naturally, we strongly oppose such this approach.


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