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).

Scarless

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.

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).

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". 

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:

• Temporal SMAS lift, Supra-temporal SMAS lift;
• Brow lift;
• Lateral cantus lifting;
• Mid-face SMAS suture lift;
• Cheekbone lift and/or augmentation;
• Lower SMAS-platysma face and neck lift (by sutures only or by using hidden retro-lobular incision);
• Chin lift without implant. Enhancement, form and position correction;
• Creation of Chin dimple;
• Creation of Smiling dimples;
• Ear Pinning. Protruding ears correction;
• Permanent blocking of glabela corrugation.

In Rhinoplsty:

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

• • Humpectomy (hump removal);
  • Tip rotation in cases of long noses;
  • Tip projection (to obtain the aesthetic 30 degree angle dorsum to profile line);
  • Closing of the open dorsum roof (without visible step deformity);
  • Tip refinement (narrowing);
  • Narrowing of the nostrils;
  • Narrowing of the mid and lower third of the nasal dorsum.

 Other face procedures:

• Blepharoplasty;
• Permanent Lip Augmentation (WY or VY plasty);
• Lip Augmentation (fillers, implants, transplantation);
• Botulinum Toxin;
• Microdermabrasion.

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:

• Breast lift;
• Buttocks lift;
• Abdominal flacidity tightening;
• Inner thigh lift;
• Repositioning of breast implants in symmastia and false position;
• Poland syndrome, unilateral underdevelopment or absence of breast tissue.

Other body procedures:

• Breast augmentation;
• Labiaplasty;
• Penis enlargement.

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. 

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.

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.

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 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.

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.

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"