Rhinoplasty

Rhinoplasty in London with Centre for Surgery and our years of experience dedicated to achieving the best nose jobs London has to offer. We provide all forms of rhinoplasty surgery including primary and revision rhinoplasty. Our surgeons employ highly refined surgical techniques which brings patients from London, throughout the UK and from overseas to our London Rhinoplasty Centre. Our rhinoplasty surgeons agree that facial symmetry is a major aesthetic goal. Whether its straightening a dip, narrowing the nasal bridge or refining the tip of your nose – we’ve got the expertise to transform lives.

Rhinoplasty in London with Centre for Surgery, otherwise referred to as a “nose job”.

What is Rhinoplasty ?

Rhinoplasty is a surgery which involves reshaping or resizing the nose. As the nose is a central feature of the face, even minor changes can make a big impact. Rhinoplasty surgery is one of our most commonly performed facial plastic surgery procedures.

Our top London surgeons are fully trained in the Preservation Rhinoplasty technique which we are able to use for selected patients for extremely precise correction with minimal bruising and swelling and reduced downtime.

All surgeons have special expertise in all aspects of nose-related surgery including open rhinoplasty, closed rhinoplasty, primary and revision rhinoplasty, ethnic rhinoplasty & rhinoplasty for men which can help men with any breathing problems, improve their aesthetics and attain balance in the face. You can be rest assured in having one of the very best rhinoplasty surgeons in London to manage your care from start to finish. Our specialist centre at 106 Crawford Street was recently inspected and rated by the Care Quality Commission as good across all five domains of care.

For those who are not quite ready to undertake a surgical procedure or would like to gain an idea of how a surgical rhinoplasty could look, we also offer a non-surgical nose job, otherwise known as ‘rhinofiller’.

What is non-surgical rhinoplasty?

All our plastic surgeons are on the GMC specialist register. The Royal College of Surgeons of England has an excellent information resource on cosmetic surgery.

This video below gives a detailed overview of the rhinoplasty procedure from start to finish. It has been prepared by the European Academy of Facial Plastic Surgery.

• Significant experience with all types of rhinoplasty surgery – open, closed, aesthetic, reconstructive and revision.
• We regularly receive patients from overseas at our rhinoplasty centre of excellence.
• Our surgeons are UK trained NHS consultant plastic surgeons who live and work in London. We don’t work with ‘fly-in, fly-out’ surgeons from Italy. This is very important because whilst your surgeon takes all precautions to minimise complications, complications can and do occur and our surgeons are readily available to manage any issues if and when they arise.

Risks of going abroad for cosmetic surgery

• We own and manage our own surgical facilities. Properly performed rhinoplasty surgery takes time and should not be rushed. Dr Gilleard performs a maximum of two rhinoplasty procedures in a day. We do not cram 5-6 procedures into one day like other providers. You want your surgeon to be well-rested and mentally and physically sharp to perform rhinoplasty surgery which is a very intensive procedure to get the very best results. Dr Gilleard is a Consultant Plastic Surgeon in the department of Plastic Surgery at the world famous Royal London Hospital in Whitechapel. You can be assured of being in the very best hands for your rhinoplasty procedure.

The benefits of outpatient cosmetic surgery

What makes our rhinoplasty surgeons different?

Patients who choose Centre for Surgery are getting a completely different level of service compared to other providers. First of all, both of our surgeons are true specialists in rhinoplasty surgery. This means that they perform surgery exclusively on the nose and facial region. Although they trained as plastic surgeons and were trained to perform breast and body surgery, they no longer perform breast augmentation, liposuction or tummy tucks. Patients who choose Centre for Surgery for their rhinoplasty procedure do not do so based on price. We are not inexpensive but are reasonable and fair. Our surgeons take their time to perform surgery utilising advanced surgical techniques which are continually refined with knowledge gained from attending international conferences. Very importantly, our surgeons are ethical, 20-30% of patients are turned away – they do not need a rhinoplasty procedure!. Of course no surgeon can guarantee results but the very high number of satisfied patients are testament to the skill of the surgeons. Do not choose Centre for Surgery if you looking for a bargain. Choose us if you want a surgeon like Mr Gilleard or Mr Sadri with the super-specialisation by operating only on the nose and exceptionally high degree of ethics and professionalism to take care of you from start to finish.

Mr Onur Gilleard is a Consultant Plastic & Reconstructive Surgeon at the world famous Royal London Hospital and is on the GMC Specialist Register for Plastic Surgery. Mr Amir Sadri is a specialist facial plastic surgeon based in central London.

Mr Gilleard and Mr Sadri perform surgery exclusively on the nose and facial region. They do not perform breast or body surgery.

How to choose your plastic surgeon

Mr Gilleard qualified as a doctor in 2005 following his studies at Guys and St Thomas Medical School, London and was ranked first in the specialist training application process for plastic surgery. He then went on to undertake his plastic surgery training at some of the most prestigious teaching hospitals in London during which time he was awarded the craniofacial Society medal for his work on the treatment of cleft lip and palate. Mr Gilleard has completed rhinoplasty training at one of the world’s most renowned rhinoplasty centres in Istanbul, Turkey. Mr Gilleard continues to attend international rhinoplasty conferences including the annual rhinoplasty symposium in Bergamo, Italy to keep his knowledge and skills up to date.

In his everyday practice as a consultant plastic surgeon at the Royal London teaching hospital he undertakes complex reconstruction surgery following complex cancer and major trauma.

Mr Gilleard specialises in a wide variety of cosmetic procedures of which aesthetic and reconstructive rhinoplasty surgery has always been his passion. He is a keen believer in attaining natural results from utilising cutting edge plastic surgery techniques to obtain the best outcome for each individual.

Beyond the operating theatre, Mr Gilleard is a keen sportsman participating in both triathlons and long distance running events.

A rhinoplasty can be performed for both aesthetic and functional reasons which often be addressed in the same procedure. Whilst restoring nasal function and correcting a deviated septum are commonly performed, by far the most common reason for nose reshaping surgery is to improve the aesthetics of the nose.

The Rhinoplasty procedure can achieve the following objectives:

• Narrow the bridge or middle third of the nose
• Reshape the nostrils by widening or narrowing
• Nose tip reshaping and refinement
• Sculpt the bridge or nasal dorsum of the nose
• Reducing the size of the nose with the removal of cartilage and bone
• Nasal profile contouring

Functional objectives:

• Rhinoplasty for noses previously damaged through trauma (car accidents, sport etc)
• Septum deviation or a bent nose
• Breathing difficulties

Unique to Centre for Surgery, we are proud to offer the amazing Crisalix 3D imaging experience to all our patients. Visualise in incredible detail how your could look after your rhinoplasty procedure.

In addition to Crisalix 3D imaging, preoperative assessment of the rhinoplasty patient includes an assessment of the patient’s mental and psychological condition and the top 3 goals to be achieved from surgery, as well as a critical evaluation of all aesthetic and functional aspects of the nose. This highly thorough systematic evaluation process is a critical first step to determine if the patient is a good rhinoplasty candidate and if their aesthetic and functional goals are achievable. The surgeon will spend a great deal of time listening to your ideas, concerns and expectations to develop a suitable treatment plan.

Crisalix 3D imaging is offered as standard at your rhinoplasty consultation.

Centre for Surgery are one of the few centres in London and the United Kingdom to use the Piezotome method of shaping the nasal bones with extreme accuracy and precision.

The traditional method of rhinoplasty involves the use of mallets, chisels and bone files which often leads to a significant degree of bruising and swelling and what can often be a lengthy recovery.

Concentrated ultrasonics emitted from a specially designed handpiece precisely sculpt the bony framework whilst respecting the nasal soft tissues. This means less swelling, less bruising, less discomfort and a quicker recovery. The technology is truly groundbreaking with significant benefit for the nose reshaping patient.

READ MORE ABOUT ULTRASONIC RHINOPLASTY

Nose job surgery or rhinoplasty is one of the most popular procedures in the UK. There are several common reasons why patients choose to have a rhinoplasty. These include:

Traumatic injuries of the nose: slips, trips and falls are common causes of injuries to the nose. To correct deformities to the nose, rhinoplasty will be required to restore the structure and function of the nose. 

Aesthetic: the nose plays a major role in balanced facial aesthetics. For patients who are unhappy with their nasal structure, this can be corrected with a rhinoplasty procedure.

Airflow through the nose: many patients experience problems with breathing through their nose and depend heavily on mouth breathing. Plastic surgeons have specialist expertise in correcting the airflow pathways of the nose. A rhinoplasty procedure can be performed with surgery of the partition of the nose or septum (septoplasty) to address airflow problems.

Case 1:

Closed rhinoplasty with dorsal hump reduction. All incisions are hidden within the nose.

Case 2

Open rhinoplasty with dorsal hump reduction and tip-plasty.

Cases 3 and 4:

Both patients above had open rhinoplasty with dorsal hump reduction and rhinotip correction.

VIEW MORE RHINOPLASTY BEFORE AND AFTER IMAGES HERE

Ethnic rhinoplasty aims to create a more natural appearance by modifying the components of the nose whilst simultaneously aiming to maintain harmony with your natural ethnicity. The most commonly requested enhancements include modifications of the nasal bridge, adjusting the size of the nostrils or adjustment of the angle of the nose.

Case 1:

Open rhinotip correction with no bony work and alar base reduction. After photos are 5 weeks later.

Case 2:

Open ultrasonic rhinoplasty with dorsal hump reduction and tip-plasty. After photos are 2 months later.

Case 3:

Open rhinotip correction (no bony work). After photos 6 weeks later.

Case 4:

Cephalic trim, transdomal and interdomal suture tip refinement + alar base reduction (nostril narrowing)

Case 5:

Open rhinoplasty with small dorsal hump reduction and tip-plasty.

Everything you need to know about ethnic rhinoplasty

VIEW MORE RHINOPLASTY BEFORE AND AFTER IMAGES HERE

Whether you choose to have a rhinoplasty because of aesthetic reasons, previous trauma or airflow problems – there are some fundamental prerequisites to make sure you get the best possible outcome from your procedure:

• Patients must be over the age of 18
• Healthy – physically and mentally
• Realistic expectations of what can be achieved
• Aware of the recovery process and the need to follow postoperative instructions

Are you interested in undergoing a rhinoplasty but are not sure if you can afford it upfront? Take a look at what finance options we have available.

Thinking about having cosmetic surgery?

Advice on optimum preparation for surgery

The Rhinoplasty procedure has evolved over time, away from cartilage destructive techniques to preservation of your cartilage and utilising minimally invasive surgical approaches to minimise downtime.

The preservation rhinoplasty technique means surgeons no longer need to break the nose during surgery. The dorsal height can be corrected via an internal access approach to sequentially reduce the height. This incremental approach means the nose will become smaller as the height is reduced internally and the hump will be removed.

Approximately 1 in 5 patients will still require a traditional procedure and your surgeon will be able to advise you on the most appropriate surgical method.

Case 1:

This patient below had a rhinoplasty in Bulgaria. Unfortunately too much septal cartilage was removed leading to internal nasal valve collapse. Mr Onur Gilleard performed a revision rhinoplasty and reconstructed the nose with the use of ear cartilage taken from the back of the ear. Revision rhinoplasty is highly complex surgery. Centre for Surgery regularly perform revision rhinoplasty for patients who often had their first rhinoplasty operation in Eastern Europe.

Open revision rhinoplasty using ultrasonic technique. Correction of inverted-V deformity, dorsal hump reduction, tip-defining sutures and insertion of columellar strut. After photos are 5 weeks later. The mild degree of swelling will be expected to settle over the next 3 months.

Case 2:

This patient had his initial rhinoplasty procedure performed in Brazil. The dorsal hump was incompletely removed and the tip was not adequately addressed leading to a droopy tip. Revision rhinoplasty performed by Dr Gilleard demonstrates correction of both aspects as shown in the on-table before and after photos below. Note the minimal bruising due to the very delicate techniques employed by the surgeon even with a revision rhinoplasty where extensive bruising is often the norm.

2 weeks later:

The key to rhinoplasty is in getting it right first time. In a small number of cases, Dr Gilleard does perform secondary ‘tweakments’ to achieve the ideal result as everyone heals differently and healing is impossible to predict with perfect accuracy every time. Sadly the adage, ‘buy cheap, pay twice’ very much applies to rhinoplasty surgery where expertise and experience really matter. Poor planning leads to poor execution. Dr Gilleard makes use of Crisalix 3D imaging to map as accurately as possible all aspects of your nose to optimise outcomes as much as possible.

Rhinoplasty is often performed with a number of different anaesthetic techniques.

• General anaesthesia
• Conscious sedation
• Local anaesthesia

General anaesthesia is exclusively used for rhinoplasty surgery at Centre for Surgery.

More specifically, we use TIVA anaesthesia with a flexible laryngeal mask (+ throat pack) and controlled ventilation which we believe to be the gold standard technique for rhinoplasty surgery.

Some surgeons may prefer using local anaesthetic often combined with some form of sedation. We believe shortcuts should not be taken with anaesthesia especially with a highly intricate procedure like rhinoplasty. We only use the proper equipment with fully qualified specialist anaesthetists to monitor you at all times during your procedure.

You will have a breathing tube to secure the airway and with a throat pack inserted which helps to soak up an blood or debris which often seeps down through the nose during the procedure. The anaesthetist will use a ‘controlled hypotension’ technique to minimise the amount of bleeding during the procedure using precise controlled ventilation and TIVA. Patients report very little in the way of dizziness, drowsiness or grogginess after our anaesthesia method with a very satisfaction rate. Our post-operative nausea and vomiting rate is currently nil – we have never had a single patient who has felt sick after their procedure.

You will initially be reviewed by a fully qualified consultant plastic surgeon experienced in rhinoplasty surgery. Our lead surgeons are specialist rhinoplasty surgeons and hold NHS consultant appointments in central London and where they regularly perform complex reconstructive surgery. Your surgeon will use Crisalix 3D imaging to map your nose in incredible detail. This way you have the opportunity to discuss directly with the surgeon who will perform your operation (if you go ahead) your ideas, concerns and expectations about the rhinoplasty procedure. The surgeon may also inform you of the risks which may occur if you choose to travel abroad for your rhinoplasty.

As part of the consultation, the surgeon will:

• Take a full history and examine you;
• Explain what the rhinoplasty surgery involves; and
• Perform 3D Crisalix imaging
• Will offer his/her professional opinion of what can/cannot be done to achieve the ideal aesthetic outcome

All rhinoplasty procedures at Centre for Surgery are carried under a type of general anaesthetic called TIVA. TIVA stands for total intravenous anaesthesia and is the most advanced form of anaesthesia available. In our experience, patients experience fewer side effects with the TIVA technique than under traditional general anaesthesia. It also means that patients usually wake up quickly and are not required to stay overnight. They can recover in the comfort of their own home, which we believe leads to faster recovery and better outcomes. 

Rhinoplasty surgery can be performed in a number of different ways: the base of the nose can be narrowed, humps on the bridge can be removed, correcting flared nostrils or even refining the tip of the nose. 

The rhinoplasty procedure will in all cases be either open or closed. The surgeon will decide in consultation with you which is the best procedure for your case.

The open rhinoplasty approach is favoured for optimal binocular visualisation and precise diagnosis and correction of all nasal deformities.

Closed rhinoplasty vs open rhinoplasty: 

Closed rhinoplasty – cuts will be concealed inside the nose

Open rhinoplasty – a small incision is performed on the area at the inferior aspect of the nose between the nostrils. This area is called the columella 

In practice, only a very few patients will be appropriate for a closed approach as the limited exposure in a closed rhinoplasty only allows the dorsal hump to be addressed in most cases. An open rhinoplasty allows full exposure of the bony and cartilaginous framework to allow an accurate correction of the areas of concern.

After you are asleep, the bones of the nose and the cartilaginous areas will be exposed. This allows the rhinoplasty surgeon to use specialised instruments to shape the nose. Some procedures may require the use of cartilage taken from other areas of the body such as the back of the ear or even from a very small area of the ribcage. This is required for the extra support to maintain the structure of the nose. Airflow issues are corrected by ensuring the septum of the nose is straightened up. Very fine sutures will be used to close any incisions that were made. A special packing material will be placed to minimise the risk of bleeding, and a splint is worn for one week to facilitate proper healing.

Rhinoplasty continues to be among the most challenging procedures for plastic surgeons to develop consistency in. At Centre for Surgery, our careful preoperative nasofacial analysis and detailed functional assessment enables the surgeon to approach each nasal component systematically.

VIEW MORE RHINOPLASTY BEFORE AND AFTER IMAGES HERE

On table before and afters which show that bruising and swelling differ between individuals quite significantly. The patient on the left had rhinoplasty using traditional methods. The patient in the middle photo had the ultrasonic method and the minimal degree of bruising and swelling is clearly demonstrated. All 3 patients were very pleased with their results at 6 weeks.

VIEW MORE RHINOPLASTY BEFORE AND AFTER IMAGES HERE

Case 1:

Open ultrasonic rhinoplasty with dorsal hump reduction and tip-plasty. After photo is 2 days later hence the bruising on the nasal dorsum which settled completely..

Case 2:

Classic ‘Greek-type’ nose with comprehensive correction with precision bony contouring and tip re-shaping.

Case 3:

Open correction with dorsal hump reduction and extensive tip-plasty work with correction of hanging columella.

Case 4:

Open revision reconstructive procedure. First procedure performed by a different surgeon in Eastern Europe. Before photo shows classic inverted-V deformity from over-zealous dorsal hump reduction.

Case 5:

20 year old male – Complex open procedure with extensive dorsal hump reduction.

Case 6:

62 year old male – 1 week post-op rhinoplasty

Read more about Male rhinoplasty here.

After your rhinoplasty procedure, there will be bruising and swelling. In particular, the lower eyelids may look particularly bruised. This is normal and will subside with time.

What to eat to speed up recovery after surgery

To minimise the impact of the bruising and swelling, you should lie with head up in bed on a few pillows. We also highly recommend our patients to apply cold packs for the first 48 hours following the surgery to reduce bruising and swelling.

You will be discharged the same day and you can rest in the comfort of your own home providing you have a responsible adult with you for at least 24 hours. Our medical team will phone you the next morning and you will see the surgeon one week later for removal of the splint. There will then be subsequent follow-up appointments to monitor your healing and progress.

Reducing the risk of surgical site infection

Top strategies to reduce the risk of venous thromboembolism

Top tips for recovery

• Avoid bending and heavy lifting
• Avoid bumping the nose
• Avoid gym activities for two weeks
• Avoid showering – take a bath instead
• Avoid blowing your nose
• Avoid hard-to-chew foods for the first week or two
• Avoid glasses for six weeks after surgery
• Avoid excessive smiling or laughing
• Avoid smoking
• Avoid high sun exposure in the first several months following the surgery as the skin on the nose will be prone to sunburn
• Sleep promotes healing so take naps when you need to

VIEW MORE RHINOPLASTY BEFORE AND AFTER IMAGES HERE

Everything you need to know about Rhinoplasty

What is the recovery like from rhinoplasty?

Everything you need to know about ethnic rhinoplasty

Male rhinoplasty

VIEW MORE RHINOPLASTY BEFORE AND AFTER IMAGES HERE

There are a number of factors which will determine the overall cost of your rhinoplasty procedure and the final quotation will be given after your face to face consultation with your specialist plastic surgeon.