Rhinoplasty in London

A well-performed rhinoplasty should be invisible as surgery. The goal is that people notice your face looks more balanced and harmonious, not that they can identify a specific change. Dr De Silva's approach is consistently guided by the principle that the nose should complement your face rather than draw attention to itself.

He uses advanced ultrasonic instruments and diamond burr technology to reshape bone and cartilage with exceptional precision and minimal trauma, reducing swelling and bruising significantly compared to traditional techniques. Every rhinoplasty is planned using Golden Ratio facial analysis; evaluating the nose in relation to your chin, forehead and facial proportions, to ensure the result enhances your individual features rather than imposing a generic aesthetic.

Choosing a rhinoplasty surgeon is one of the most important decisions in the process; the nose is the most technically demanding area of facial surgery, and differences of less than a millimetre are visible in the final result. The questions worth asking are: does the surgeon specialise exclusively in the face? Do their results consistently look natural across a range of patient types? Do they have dedicated experience in your specific concern?

Dr De Silva is a facial-only specialist who has dedicated over 20 years exclusively to facial surgery. He has published over 30 peer-reviewed journal articles and book chapters on rhinoplasty, and authored the Complete Guide to Rhinoplasty and Nose Reshaping. He teaches rhinoplasty technique to other surgeons internationally and sees patients from more than 70 countries. Over 1,000 five-star reviews reflect consistent, natural outcomes. A consultation is the right next step — it is an opportunity to assess his approach firsthand before making any commitment

Being nervous before your first surgical procedure is entirely normal, and Dr De Silva's team is experienced in supporting patients through this. At consultation, Dr De Silva takes considerable time to explain every aspect of the procedure, answer all your questions, and ensure you have a clear, honest picture of what to expect - before, during and after surgery.

Dr De Silva performs rhinoplasty under his patented Rapid Recovery Twilight Sedation (RRTS) protocol rather than general anaesthetic, which many first-time patients find significantly more reassuring. You remain comfortable and unaware throughout the procedure, wake much faster, and experience far less nausea and grogginess than with general anaesthesia. Most patients find the experience considerably more straightforward than they anticipated. His team provides support throughout recovery, and Dr De Silva offers lifelong follow-up care to all his patients.

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Scar placement depends on the technique used. In closed rhinoplasty, all incisions are made inside the nose, leaving no external scarring whatsoever. In open rhinoplasty, a small incision is made across the narrow strip of tissue between the nostrils, which heals to a fine, inconspicuous line that is difficult to detect even at close range.

Dr De Silva uses micro-incisions and tissue adhesive to support optimal healing and minimise any visible marks. The choice between open and closed technique is determined by your specific anatomy and what the surgery needs to achieve. For patients where scar minimisation is a priority, Dr De Silva will discuss which approach is most appropriate at consultation.

Open and closed rhinoplasty are the two main surgical approaches used to reshape the nose. In open rhinoplasty, a small incision is made across the columella, the strip of skin between the nostrils, providing direct access to the nasal framework for precise correction of complex structures. This method allows greater visibility and control but may result in slightly more swelling and a longer recovery period, with most patients returning to normal activities within two weeks.

In closed rhinoplasty, all incisions are made inside the nostrils, leaving no visible scar. Because the internal tissues experience less disruption, patients typically experience less swelling and a faster recovery, often resuming social or work commitments within 7–10 days.

No, and for most patients, a specialist dedicated facility offers a significantly better experience than a general hospital setting. Dr De Silva performs all rhinoplasty procedures at his custom-built, CQC-regulated surgical centre at 23 Harley Street, designed specifically and exclusively for facial surgery.

As an outpatient procedure, rhinoplasty does not require an overnight stay. The facility is equipped to the highest clinical standards, fully accredited by the Care Quality Commission, and staffed by specialists in facial surgery and anaesthesia. All medical staff are certified in cardiac life support. Most patients are able to leave the clinic within one to two hours of surgery completing.

Yes, rhinoplasty and functional nasal surgery are frequently combined, and improving breathing is a central goal for many patients alongside cosmetic refinement. A deviated nasal septum, enlarged turbinates, or structural weakness of the nasal airway can all cause breathing difficulties, and these can be addressed as part of the same procedure.

Dr De Silva evaluates both the cosmetic and functional aspects of the nose at every consultation, assessing the internal nasal structures alongside the external appearance. In some cases, addressing the internal anatomy actually improves the cosmetic outcome as well - restoring structural support that has been lost. An in-person assessment is always required to evaluate breathing concerns, as this cannot be determined from photographs alone.

Yes, non-surgical rhinoplasty uses dermal filler to subtly reshape the nose without surgery. It can smooth a small hump, correct minor irregularities, lift a mildly drooping tip, or add definition to the bridge. Results are temporary, typically lasting around 12 months, and are best suited to patients with mild concerns or those not yet ready for surgery.

It is important to have non-surgical rhinoplasty performed only by an experienced, medically qualified clinician. The nose has a complex network of blood vessels, and injection technique in this area requires specialist anatomical knowledge to be performed safely. Dr De Silva offers non-surgical rhinoplasty and brings his full understanding of nasal anatomy to this procedure, ensuring it is performed with precision and a clear plan for the result.

Yes. A dorsal hump, the bump on the bridge of the nose, can be precisely reduced with rhinoplasty. The hump usually consists of bone and cartilage, which Dr De Silva reshapes using specialised techniques such as diamond burrs, ultrasonic instruments, and micro-tools for greater accuracy and minimal swelling.

The process involves both technical precision and artistry: once the hump is refined, the nasal bridge is contoured to create a smooth, natural profile that complements the rest of the face.

A natural, beautiful nose is one that complements the face; in proportion, harmonious with surrounding features, and without any sign of surgical alteration. It should support breathing function, suit the individual's facial structure, gender and heritage, and blend seamlessly into the overall facial balance.

Dr De Silva approaches every rhinoplasty using Golden Ratio facial analysis; a mathematical framework for evaluating facial proportion. By mapping the nose in relation to the chin, forehead, eyes and facial width, he identifies the precise refinements that will create harmony rather than simply change a feature. For women, this may involve a gentle slope along the bridge; for men, a straighter line that retains definition. For patients of different ethnic backgrounds, adjustments are made with careful attention to preserving the features that make each face individual. The goal is always a result that looks like the best version of your own nose.

No, not every rhinoplasty requires the nasal bones to be repositioned. This step, known as an osteotomy, is performed when the bridge needs to be narrowed or a hump correction requires the bones to be brought together. Approximately two-thirds of rhinoplasty patients require this; the remaining third do not.

When osteotomies are needed, Dr De Silva performs them internally, without any external incisions using precise controlled techniques to achieve a smooth, symmetrical result. Avoiding osteotomy where possible means less bruising, less swelling and a faster recovery. Whether your procedure requires this step will be discussed clearly at consultation, along with what it involves and what to expect during recovery.

Yes, rhinoplasty can be performed at any time of year, and summer is a popular time for patients who can use annual leave for recovery. A few additional precautions are needed during warmer months.

Direct sun exposure should be avoided for at least six months following rhinoplasty, as healing skin on the nose is more sensitive to UV damage and can darken with sun exposure. Swimming should be avoided for a minimum of six weeks. Wearing a wide-brimmed hat and applying broad-spectrum SPF 30 or higher whenever outdoors is strongly recommended throughout the recovery period. You will also need to avoid wearing glasses on the bridge of your nose for six weeks. Dr De Silva provides personalised aftercare guidance tailored to your specific recovery timeline and the season.

It is best to allow a minimum of six months between rhinoplasty and an important event such as a wedding. While most visible bruising and swelling resolve within two to three weeks, subtle swelling, particularly around the nasal tip can persist for several months, especially after revision or more complex surgery.

For straightforward cases involving only a small correction, recovery may be faster. However, because the final result of rhinoplasty is not fully visible until 12 to 18 months post-surgery, photographs from an event at six months will show a result that is very close to, but not quite, the final outcome. Dr De Silva uses refined techniques and anti-inflammatory treatments to minimise swelling and downtime, but timing should always be planned conservatively around important personal events.

Rhinoplasty can be performed once facial growth is complete, so generally from around age 17 onwards, though this varies between individuals. Most patients seek surgery in their twenties and thirties, though suitable candidates can range from late teens through to older adults.

Younger patients often pursue rhinoplasty after years of self-consciousness about their appearance or significant breathing difficulties, while older patients may seek correction for age related changes such as a drooping nasal tip or structural irregularity that has developed over time. Dr De Silva assesses each patient individually, considering physical development, emotional readiness, and the specific goals and expectations for surgery and only proceeds when it is genuinely in the patient's best interest.

Most patients are able to drive within three to five days of rhinoplasty, once they feel fully alert and confident in their ability to react quickly. On the day of surgery and the day following, driving is not appropriate due to the effects of sedation.

Dr De Silva uses twilight sedation rather than general anaesthetic for rhinoplasty, which means patients wake significantly faster and experience less grogginess than with general anaesthesia. However, you should not drive until you feel entirely clear-headed and comfortable and until you are no longer taking any prescription pain relief that may affect alertness. If you are in any doubt, err on the side of caution and arrange alternative transport for a further day or two.

Flying should be avoided for a minimum of one week following rhinoplasty. Most patients have a nasal splint and, in some cases, stitches that are removed at approximately one week post-surgery, so flying before this point is not recommended.

For short-haul flights, most patients can travel from approximately three weeks after surgery. For long-haul international travel, Dr De Silva recommends waiting six weeks to ensure the nose has stabilised sufficiently and that adequate follow-up care has been completed. Overseas patients should factor this into their planning; Dr De Silva's team can help coordinate the timing of your visit and follow-up appointments to accommodate your travel arrangements.

Glasses must not rest on the bridge of the nose for six weeks following rhinoplasty, as the weight can affect healing and potentially alter the shape of the nasal bridge during the early recovery period. For the first week, the nasal splint provides some protection, but glasses should not be worn on top of it.

From approximately one to six weeks post-surgery, Dr De Silva can advise on temporary support options if you need to wear glasses, typically involving taping the frames to the forehead to take the weight off the nose entirely. Contact lenses are fine to use as soon as you feel comfortable, provided there is no irritation. Sunglasses follow the same six-week restriction as regular glasses.

Hay fever is a common condition in which the lining at the back of your nose has a tendency to become inflamed and thickened by an allergy to pollen. Characteristically, this can result in symptoms of stuffiness, sneezing, and nasal discharge.

Rhinoplasty will result in swelling immediately after the surgery, which can result in symptoms of congestion. Rhinoplasty will not change or be affected by hay fever. It will change the shape of your nose; however, it will not affect the lining of the nose, and the tendency for hay fever will remain after surgery and require the same treatment, including antihistamines.

Direct sun exposure should be avoided for at least six months following rhinoplasty. The healing skin on the nose is more sensitive to UV damage during recovery and can develop hyperpigmentation with sun exposure, which is difficult to reverse.

Whenever outdoors, Dr De Silva recommends wearing a wide-brimmed hat and applying a broad-spectrum sunscreen of SPF 30 or higher to the nose. While it is generally safe to travel or holiday from approximately one week after surgery, protecting the nose from the sun is essential throughout the recovery period. Numbness in the skin during early healing can also reduce your awareness of sunburn, making consistent sun protection particularly important.

Nicotine causes blood vessels in the skin to narrow, a process called vasoconstriction, which reduces blood flow essential for healing. Good circulation is vital for your nose to recover quickly and naturally after rhinoplasty surgery.

Using nicotine products can delay healing and increase the risk of complications. For the best results, Dr De Silva strongly recommends avoiding all nicotine products for at least 6 weeks before and after surgery.

Most patients find rhinoplasty considerably less painful than expected. Discomfort and any pain typically settle within 24 to 48 hours after surgery, and over-the-counter paracetamol is usually sufficient for management. Dr De Silva's use of twilight sedation rather than general anaesthetic contributes to a more comfortable post-operative experience overall.

For patients who have had nasal bone narrowing (osteotomies), some mild sensitivity or intermittent discomfort over the nasal bridge can persist for several weeks. Swelling of the nasal lining can also cause a sense of congestion and, in some cases, mild headaches-  particularly in patients with a tendency toward hay fever or sinusitis. These symptoms are manageable with anti-inflammatory medications and resolve as healing progresses. If you experience severe or worsening pain at any point, contact Dr De Silva's team promptly.

It’s very unlikely. Most patients notice no change in their voice after rhinoplasty. Minor, temporary differences can occur due to post-operative swelling or congestion, which settle within weeks.

In rare cases, subtle changes may be heard in languages with naturally nasal tones, but these are uncommon. Patients with breathing issues often find their voice improves as nasal airflow becomes clearer.

Because Dr De Silva performs rhinoplasty under twilight sedation, the vocal cords are not affected by a breathing tube, further reducing any risk. He has treated many professionals who rely on their voices, ensuring results that preserve both function and tone.

Immediately after surgery, the nose feels blocked due to internal swelling of the nasal lining, and your sense of smell may be temporarily altered. Dr De Silva does not use nasal packs after rhinoplasty -a significant comfort advantage over many other practices,  but some congestion is normal as the inner lining settles in the first week.

Any change to the sense of smell during the recovery period is due to swelling rather than structural change, and returns to normal over the first four to six weeks as healing progresses. A permanent change to the sense of smell is very rare and is not an expected outcome of rhinoplasty performed by an experienced specialist.