Thinking about reshaping your nose? Whether it’s for cosmetic reasons or to fix breathing issues, it’s completely normal to wonder about the best route to take. One of the most common questions Dr. Julian De Silva gets asked this question, “Surgical vs. non-surgical rhinoplasty: which is better?” Both options can improve the look of your nose, but they work very differently and offer different kinds of results. Let’s break it down so you can make a confident, well-informed decision. What Is Non-Surgical Rhinoplasty? Also known as a liquid nose job, non-surgical rhinoplasty involves using dermal fillers (usually made of hyaluronic acid) to change the shape of your nose. There’s no cutting, no general anaesthetic, and you can be in and out of the clinic in under 30 minutes. This treatment is ideal for people who want to: Smooth out small bumps on the bridge of their nose Lift a droopy tip slightly create more balance or symmetry from a side profile However, it’s important to understand that non-surgical rhinoplasty works by adding volume. So, it can only enhance certain features—it can't make your nose smaller or remove tissue. If your nose already feels too large, adding filler may actually make it look even bigger. What Is Surgical Rhinoplasty? Surgical rhinoplasty, on the other hand, involves reshaping the bone and cartilage of the nose under general anaesthesia. This can include removing bumps, refining the tip, straightening the bridge, and reducing overall size. It also allows for internal corrections to improve breathing, such as fixing a deviated septum. This option is better suited for people who: Want permanent results Need structural changes or reduction Struggle with breathing due to nasal obstruction Have thick skin, asymmetry, or previous injuries Unlike fillers, surgery can subtract tissue, which means it offers far more flexibility in terms of reshaping and reducing the nose. Non-Surgical vs. Surgical Nose Jobs: Key Differences If you’re trying to decide between rhinoplasty vs. non-surgical rhinoplasty, the main difference comes down to what each method can actually achieve. Non-surgical rhinoplasty is great for subtle surface changes. It’s less invasive, requires no recovery time, and results are visible immediately. However, these results are temporary and need to be repeated every six to 12 months. Surgical rhinoplasty offers long-term results and can dramatically change the structure of your nose. But it comes with a longer recovery period, typically one to two weeks of downtime and several months for full healing. So, if you’re hoping to slim your nose, fix a crooked bridge, or breathe better, surgery is usually the only option that can deliver those results. Who’s a Good Candidate for Each? Dr. De Silva suggests that non-surgical rhinoplasty works best for people who already have a reasonably shaped nose and want a small touch-up, like smoothing a minor bump or slightly lifting the nasal tip. It’s also a good way to “trial” how your nose might look after surgical rhinoplasty, without committing to surgery straight away. Surgical rhinoplasty is better for people looking for long-term or functional results. It’s the best choice if you want to make your nose smaller, narrow the nostrils, or correct deformities caused by injury or genetics. Also, if you have thick skin or certain ethnic nose shapes, surgical ethnic rhinoplasty gives more control and precision than fillers can offer. Dr. De Silva is careful to preserve each patient’s ethnic features while enhancing their natural beauty, so the outcome still feels like you. Risks and Safety Considerations As with any procedure, both types of rhinoplasty come with risks. With non-surgical rhinoplasty, the main risk is accidentally injecting filler into a blood vessel. This can reduce blood flow and, in rare cases, lead to skin damage or even blindness. While the chance of this happening is less than 1%, it’s serious, which is why it’s so important to go to an experienced medical professional. Dr. De Silva uses techniques that reduce risk, like injecting slowly, using small amounts of filler, and sometimes choosing a blunt-tipped cannula instead of a needle. He also keeps an enzyme called hyaluronidase on hand, which can dissolve the filler immediately in case of emergency. Not every clinic offers this. Surgical rhinoplasty carries its own risks, like infection, scarring, or not being happy with the final result. But when performed by a skilled facial specialist, complications are rare. What About Functionality? If your concerns are more than cosmetic—say, you’ve had an injury, struggle to breathe, or have a deviated septum—non-surgical rhinoplasty won’t help. It simply can't fix internal nasal structures. In these cases, surgery is necessary. A proper exam, which includes looking inside your nose with a small camera, will help identify if your breathing issues are due to a blocked airway or structural defect. Dr. De Silva often combines cosmetic and functional surgery to improve both the appearance and performance of your nose. Recovery Time and Results One of the biggest benefits of non-surgical rhinoplasty is that there’s basically no downtime. You might have a bit of swelling or bruising, but most people return to work or normal activities the same day. Results are visible instantly, although they’ll fade after about a year. Surgical rhinoplasty requires a bit more patience. You’ll likely need a week off work, and while most swelling subsides within the first month, the final shape of your nose may take up to a year to fully settle. That said, the result is long-lasting, often permanent, and you don’t need to keep coming back for top-ups. Cost Considerations Non-surgical rhinoplasty is more affordable in the short term, but keep in mind that it’s not permanent. If you continue getting fillers every year, the costs can quickly add up. Surgical rhinoplasty involves a bigger upfront investment, but the results last for many years or for life. It may be more cost-effective in the long run, especially if you want a significant change. Which Should You Choose? If you’re still debating between rhinoplasty vs. liquid rhinoplasty, it helps to think about your priorities. Want a quick fix for a minor concern, with no downtime and reversible results? Non-surgical might be your best bet. Need a permanent change, want to reduce size, or fix functional issues? Surgical rhinoplasty is the way to go. Dr. De Silva advises everyone to book a consultation before making a decision. During that time, your nose shape, skin thickness, facial balance, and even your breathing will be carefully assessed. From there, you’ll get personalised advice on which treatment is right for you. Conclusion Choosing between surgical and non-surgical rhinoplasty is a personal decision, and the best option depends on your goals, anatomy, and expectations. Dr. Julian De Silva is a world-renowned facial cosmetic surgeon with years of experience helping patients achieve natural-looking results they love. Book a rhinoplasty consultation today and find out which approach suits you best, because your nose should look and feel just right for you.

As we age, the skin around our eyes starts to change. You might notice puffiness, sagging skin, or dark circles that make you look tired even when you’re not. If that sounds familiar, you’re probably wondering what your options are. Should you go for something non-invasive like fillers or laser treatments? Or is surgery the better long-term solution? Let’s break down the key differences between non-surgical vs surgical blepharoplasty, based on expert advice from Dr Julian De Silva, a facial cosmetic surgeon who specialises in eye surgery options. Why Do Our Eyes Age Like This? The skin around the eyes is thinner than the rest of the face, which means it shows signs of ageing earlier. You might see loose skin on the upper eyelids, puffiness caused by fat pushing forward, or shadows under your eyes (often called tear troughs). Creams may promise results, but they rarely make a big difference. That’s because most of the changes are happening under the surface, where creams can’t reach. Non-Surgical Eye Treatments: When They Work Best Non-surgical treatments can work well for people with mild signs of ageing—usually in their 30s or early 40s. Here are a few options: Tear Trough Fillers Fillers made with hyaluronic acid can help fill in shallow depressions under the eyes. This softens shadows and gives a more refreshed look. These are ideal if you’re younger and only have mild hollowing. However, the tear trough area is delicate. It’s riskier than other parts of the face because of the blood supply around the eyes. If filler accidentally enters a blood vessel, it can cause serious complications, even blindness. This is why it’s critical to go to a qualified medical professional who uses dissolvable fillers and knows how to inject safely. Botox Botox works well for crow’s feet—those little wrinkles on the outer corners of the eyes that show up when you smile. It temporarily relaxes the muscles, smoothing out the skin. Botox is effective across age groups and doesn’t require downtime. Laser Resurfacing and Plexr If you’ve got fine lines or some loose skin, treatments like CO2 laser resurfacing or Plexr can help. They stimulate collagen and improve skin texture. But the effects are mild and come with a recovery time. The skin will be red or pink for a few days. When Non-Surgical Treatments Aren’t Enough Non-surgical options have limits. They don’t remove fat or tighten large amounts of loose skin. If you’ve got heavy eyelids, puffiness, or deeper hollows under the eyes, it might be time to consider surgery. Surgical Eye Treatments: What Is Blepharoplasty? Blepharoplasty is the surgical term for eyelid surgery. It can be performed on the upper eyelids, lower eyelids, or both (called quad blepharoplasty). This option allows for more dramatic and longer-lasting results. Upper Blepharoplasty Upper blepharoplasty removes excess skin and fat from the upper eyelids. It’s great if you have droopy lids or puffiness. The result is a fresher, more awake look. Lower Blepharoplasty Lower eyelid surgery reduces puffiness and smooths the area under the eyes. One common approach is transconjunctival blepharoplasty, where the fat is removed through the inside of the eyelid. This technique helps avoid changing the natural shape of the eye. If there’s also a hollow or depression under the eye, fat transfer may be used. A small amount of fat is taken from another part of your body (usually the belly), processed, and placed under the eyes to smooth the area. What About Wrinkles and Texture? While blepharoplasty handles structure, it doesn’t target surface wrinkles caused by sun damage. That’s where laser treatments or regenerative medicine like platelet-rich plasma (PRP) come in. These can be done as part of your surgical plan to improve skin quality. Recovery Time: Non-Surgical vs Surgical Eye Surgery Non-surgical treatments like fillers or Botox take about 30 minutes. There's little to no downtime, and the results can last up to a year. However, if the wrong filler is used or placed poorly, it can cause puffiness that needs to be corrected, often with surgery. Choosing eye surgery like blepharoplasty is a bigger commitment. Surgery takes about 1–2.5 hours, and recovery involves swelling and bruising for up to two weeks. Full healing can take six weeks or more, but the results often last 8 to 10 years or even longer. Weighing the Risks Every treatment has risks. For non-surgical eye treatments, the most serious risk is vision loss from filler being accidentally injected into a blood vessel. This is rare but very serious and irreversible if not treated immediately. Surgical blepharoplasty also comes with risks, like infection, scarring, or changes in eyelid shape. But when done by an experienced surgeon, these risks are low. Which Option Is Right for You? Here’s a quick way to look at non-surgical vs surgical eye surgery: Non-surgical: Great for younger patients with mild ageing, shallow tear troughs, or light wrinkles. You’ll see faster results with minimal downtime. Surgical: Better for moderate to severe puffiness, significant loose skin, or deep hollows. The results are more noticeable and last much longer. There’s no one-size-fits-all solution. The best approach depends on your specific anatomy, age, and what kind of results you’re looking for. Always consult with a qualified medical professional—ideally someone who offers both options—so you can make a decision based on what’s safest and most effective for you. Conclusion Do you want help choosing eye surgery or deciding between non-surgical and surgical blepharoplasty in London? Dr. Julian De Silva’s clinic in Central London, Harley Street, W1, is one of the best. Book a blepharoplasty consultation here to discuss your options and get a personalised treatment plan.