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

What are Serdev Suture® Lifts?

serdev suture lifts


Simply put - Serdev Suture Lifts are methods for scarless lifting and/or volumizing of different face and body areas by lifting the mobile (hanging) tissues and attaching them in a stable and durable way to immobile structures, thus achieving beautification/rejuvenation. 

For example - in mid-face lifting, this scarless suture method lifts and sutures the loose zygomatic SMAS extension to the firm temporoparietal tendon insertion (and underlying temporal periosteum), which results in middle and lower face SMAS lifting, cheekbone lifting to a higher position, resolving tear trough, nasolabial and marionette folds. 



Procedures done only through skin punctures, with the help of specially designed instruments, so that there are no incisions and excisions of skin. We this achieve the desired effect and longevity of the aesthetic result. 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. There is no bruising and no bloodloss. Swelling is minimal to non-existant. Patients can resume their social and working activities on the day after surgery.

Serdev Suture Lifts vs Thread Lifts

The word "suture" in Serdev Suture® Lifts comes from the Latin Sutura and means "to bring tissues together". Our lifting techniqhes are often mistaken 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 non-absorbable. They are inserted in the subdermal fat, where they hang freely, without stable fixation. This is why 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 curved, semi-elastic needles, in order to lift the mobile tissues (such as SMAS) and stably fix them (by sutuing) to non-mobile structures (such as periosteum). This fixation guarantees the longevity of the aesthetic result. The threads are absorbed in the human body within 2 years (after the final fibrosis formation). Their limited elasticity is cruicial, because it permits the sutured tissues to move, without cutting them (rigid threads perform like scalpels).

"Liftings of The Third Millennium"

There are more than 20 different Serdev Suture techniques in face area: lifting of eyebrows; corners of eyes; cheeks; upper, middle and lower part of the face; neck; narrowing of the tip of the nose or the nostrils; and more. During the International cosmetic surgery congress in Spain 2001, these lifting methods were called "Liftings of The Third Millennium". The combination of these cosmetic procedures ensure a beautiful and harmonious face, proper volumes, angles, and proportions. 

Honorary Professor of the New Bulgarian University, Dr. Nikolay Serdev, MD, PhD is a recognized master of face beautification not only in Caucasians, but also in Asians, African Americans, etc. 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. Мost interesting are the changes using his methods without scarring, with immediate result, extremely short postoperative period, without "operated on" appearence.

Many TV programs have taken advantage of the opportunity to display the live demonstrations and immediate results. 

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 involves no implants. Instead, patient's own tissues are encircled and projected.

It is a highly specialized cosmetic surgery procedure, which 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, the tissues are gathered, lifted and fixed to a stable higher position.

The operation is done under local anesthesia with intravenous sedation. Flattened and loose form will be lifted up, "into the pockets of the jeans", as patiens evaluate the procedure, and even - over the pockets. 

The buttock lift changes the body proportions - legs look longer and the proportions between the lower and upper body are adjusted.

The procedure takes 10-15 minutes per side and is performed through skin punctures. This means there is no cutting of skin, and subsequently - no scars. The fixation of the suture to the stable inelastic Serdev fascia maximally guaranties the longevity of the aesthetic effect. No hospitalization or nursing care are needed. The result is achieved immediately, with short post-operative recovery and short downtime. Patients are even able to drive thier cars the day after the operation, despite some pain.


Scarless Breast Lift via Serdev Suture

Scarless Breast Lift via Serdev Suture®

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, but are performed only through skin puncture points.

Serdev Suture® Lift

This Serdev Suture® method can achieve a scarless breast lift of up to and over 14 centimeters and 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 the technique is combined with subpectoral implants. In sagging breasts implants should not be placed over the pectoral muscles, because this 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 implants should be removed, along with the capsule - a difficult but a 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 - implants should be smooth and be able to move naturally, without hurting the muscle.

Because of modern anesthetics and the new methods without trauma, pain and swelling after surgery are reduced and are not significant. 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, the breast lift using Serdev Sutures® can be repeated to maintain the aesthetic appearance of the breasts even in advanced age. Gigantomastia, i.e. very large, very heavy and drooping breasts can not be operated in this manner, because of gravity and overskin. 

NB!! Exercises with the arms and weight lifting are prohibited 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.

Depending on the amount of breast lifting which needs to be accomplished, different techniques may be used which involve different incisions:

  • 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 required, the larger the incision (therefore, the larger the scar would be). 

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 appropriate amount of skin is removed. The breast tissue is tightened 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, a special bra is worn to support the breast. That takes up to three months. The compression bra is an important part of the recovery process. The bra 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 excess skin is removed and firmness is provided to the breasts. Though mastopexy can be done as 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. A person who does not smoke and has a normal body weight is considered to be the right candidate for surgery without many side effects. People 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 through skin puncture points and thus leaves no scars. There are no incisions or excisions of skin. Perfect knowledge and understanding of human anatomy is essencial for performing this procedure.

Work and professional efficiency are not distorted - patients can work and perform their daily duties. 

Abdominal wall tissue lifting leads to aesthetic changes and results. This means that "sad navel" is modified into a normal looking, "happy navel". With a few manipulations, wrinkled and loose skin can become so acceptable that the belly can be worn 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

Smooth and tight thighs without scars

Another invention of Professor Dr. Nikolay Serdev to perform inner thigh lift only through skin punctures, without cutting it (subsequently, without leaving any scars). 

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, ultrasonic removal of fat (Vaser liposelection) is performed prior to the inner thigh lift.

inner thigh lift

Brow Lift via Scarless Serdev Suture


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. 

Serdev Suture® Scarless Brow Lift

In order to create the aesthetic proportions, described above, we use the Serdev Suture® method for eyebrow lift, which lifts the brow and also raises the angle of the eyes (the effect is doubled).

The higher fixation is made with only 2 skin punctures, allowing 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.

Information on classic and endoscopic brow lift.

These methods are not practiced in our clinic.

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.

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®

Cheekbones and the "Beauty Triangle"

Pronounced, high, and youthfull cheekbones are rare. Cheekbones are relevant to nearly all aesthetic norms. 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, and 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".

Cheekbone Lift and Volume Creation

Many physicians try to fill the nasolabial folds in order to create colume, thus creating a total projection of the lower part of the face (the so called "primate face").

The correct approach is to lift the soft tissue back to the zygomatic bone, restore cheekbone fullness, create the necessary volumize and elevate the cheekbone. We thus eliminate the tear through fold, improve the facial expression and achieve a youthful elongation of the so called "beauty triangle", which is responsible for the beauty of the lower face.

Dr. Serdev's author lifting method (Serdev Suture®) raise and fix the fascias surrounding the Bichat fat pads to the zygomatic bone, in order to create volume in the cheekbones where needed - medially or laterally. The cheerful facial expression is restored. No scars remain as the specially developed instruments leave only punctures on the skin, which disappear within 2-3 days. TV stars use such rejuvenation to appear on screen next day.

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

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 smiling 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).

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.

Chin Lift Without Implant. Enhancement and Position Correction via Serdev Suture® method.

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

The aim of Serdev Suture® method for chin lift without impant is to position the chin in the central axis and establish correct proportions. It can be used in aging or sagging chin (the so colled "witch chin"), small chin (micro- and retrogenia), and other deformities. 

For this ambulatory procedure Dr. Serdev uses only two skin punctures in the supra- and sub-mental folds to insert the needle and thread, after which the whole available chin soft tissue is tightened into the roundness of the suture circle. The entire procedure takes a few minutes. No dermal closure and no bandages are used. Facial washing should be done on the following day. The skin puncture in the supra-mental fold may be visible for 2-3 days and patients may use make up. The early post-op period swelling is almost invisible and patients can return to their social life as soon as they wish. 

Chin dimple can also be created with this procedure.

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. For comparison, read about chin implants below.


Information about use of chin implants

There are many types of implants made of different material. They can emphasize the jaw line, the checks and create  better proportions between the chin and the checks.

Surgeons use implants to achieve a better balance and create a younger look. Chin augmentation is also called mentoplasty. The operation aims to shape the chin by making it smaller or bigger. A larger chin can be created by an implant insertion or by surgery, which elongates the lower jaw. Smaller chin is made by reducing the size of the lower jaw. In many cases the surgeon will recommend mentoplasty for patients undergoing nose surgery in order to fit the new nose to the face, creating more harmonic appearance. When looked from the side the nose size should fit the chin.

The implant insertion may last from 30 minutes to one hour. The surgeon will design the implant that fits your chin and then insert it into a "pocket" located in front of the chin. A small cut for the insertion can be made inside the mouth near the lower lip or from the outside, just below the chin. After the procedure, the chin is bandaged using plasters to prevent swelling and implant movement. Bandages also help prevent unpleasant sensations. The stitches can be removed after 5-7 days. In case the cut is made inside the mouth, melting stitches are used and there is no need to remove them. The surgery can be done using local anesthetics with sedative drugs and sometimes with general anesthesia.

Every operation has its ricks. The implant may move from its original place. Then you need to undergo additional procedures to replace it. Infection is rare, it can be treated with antibiotics and in some cases the infected implant will be removed and replaced by a new one.

There is a strange feeling around the chin after surgery. It is normal to feel difficulties while talking, smiling and eating. Blue marks around the chin and neck might occur. It is advisable not to participate in activities which may harm the chin. The surgeon will instruct you regarding dental hygiene and eating.

The final results may take weeks and even month to notice, therefore you must be patient.

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

What is SMAS?

In 1972 it was 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 it in the temporal area.

Separating the skin from the SMAS leads to elongation of the skin, which has lost its stable support, and should not be performed. Also, in a subsequent SMAS lifting the skin is not affected any more, 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.

Mid-face lift via Serdev Suture®

This 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. It also stretches the cheeks, nasolabial and marionette folds, highlights the so called "hungry cheeks", restores the youthful jaw line.

Mid-face lift is most popular for beautification in middle aged and elderly patients, but also in some 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, cosmetic surgery SMAS facelifts. They are performed without skin incisions or excisions, only through skin puncture points. There are no scars. No hospitalization and nursing are needed. The postoperative recovery is short and does not affect patient's ability to go to work. 

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