Rhinoplasty in London
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What Is Rhinoplasty?
Rhinoplasty, commonly known as a "nose job," is a highly specialised cosmetic procedure that reshapes the nose to enhance facial harmony and balance. Dr Julian De Silva, a leading expert in facial aesthetics, tailors each Rhinoplasty in London to the individual, focusing on natural refinement to achieve the most harmonious results. Whether it's addressing a high dorsal hump, lack of tip definition, or a wide or large nose, Dr De Silva's precision ensures the nose blends seamlessly with the rest of the face.
The nose, being at the centre of the face, plays a crucial role in facial symmetry. A nose that feels out of proportion can make individuals self-conscious, affecting their confidence and overall self-esteem. Subtle changes, even those as small as half a millimetre, can have a noticeable impact on appearance. Dr De Silva’s goal is to help patients look the best version of themselves, improving not only their appearance but also their confidence.
Beyond cosmetic improvements, rhinoplasty can also address functional issues, such as breathing difficulties. Dr De Silva combines artistic vision with surgical skill to deliver results that enhance both form and function, ensuring a balanced and natural outcome. His innovative techniques, combined with his commitment to precision, have helped thousands of patients regain confidence and achieve facial balance.
Conditions Addressed by Rhinoplasty
Dr De Silva MBBS, MD is one of the best London facial cosmetic and plastic surgeons, he is an expert on the latest advances in facial cosmetic surgery and does not perform any body plastic surgery. Please note all information contained in these videos represents an overview and simplification of techniques and procedures, and at no time do they attempt to include all aspects necessary to complete surgical procedures.
Reducing a Nasal Hump:
A nasal hump or bump defines the size and shape of the nose and may be elevated as a hump, or depressed as a consequence of the collapse of the nose through trauma or over-surgical resection.
The nasal hump of the nose is reduced in size by reduction of both the cartilage (lower two-thirds) and bones of the nose (upper one-third). In addition, other measures are required to maintain the natural pyramidal shape of the nose and prevent the nose from becoming too wide, this is why the bones are usually narrowed with osteotomies.
For some patients the bridge is also supported with the use of cartilage grafts as these support the nose long-term and maintain functional breathing, however, care is required to avoid widening the nose. Other additional measures may also be required for patients with thin skin or thicker ethnic skin.
Large or Bulbous Tip:
A more refined, elegant nasal tip is a common request from nose job patients. There are a few common factors that can create tip bulbosity. The shape of the nasal tip is made by the cartilage in the lower third of the nose. The cause of an enlarged or bulbous tip may be a result of enlarged cartilages, wide or convex shape or asymmetry. In addition, the thickness of the patient's skin can also determine the width of the nasal tip. Patients with ethnic skin tend to have thicker skin that enlarges the size of the nasal tip.
Dr De Silva creates a more refined nasal tip by shaping and sculpting the lower lateral cartilages that are often too wide and asymmetrical. In addition, putting in special stitches (termed dome binding sutures) will also help shape the tip further by creating additional definition.
These dome-binding sutures can be used to reshape and define the nasal tip. In patients with thicker skin, additional techniques may also be required including thinning the skin at the nasal tip and placing a cartilage graft underneath the cartilages called a lower lateral crural strut graft. The lower lateral cartilages are shaped.
Drooping Nasal Tip:
A droopy nasal tip is defined as a tip that is low, commonly a patient with a low tip will have an appearance that the nose is too long, and often dips down further on smiling. Often when the patient looks in the mirror they will barely see their nostrils as the low tip hides them. The tip may naturally be droopy, can be inherited from parents and can also drop further with ageing or due to trauma.
Rhinoplasty can be used to reposition the tip in a more natural position by lifting the nasal tip. The pair of cartilages that make up the tip of the nose are shaped and sculpted, these are termed the lower lateral cartilages that are often too wide and asymmetrical. In addition, putting in dome binding sutures will also help shape the tip further by creating additional definition.
Care is required with this procedure as the tip should not be over lifted as this can result in a piggy-shaped nose in women, and a more feminine appearance in men. Artistry is required to ensure the tip is lifted to a natural position. The natural position will depend on male or female sex, facial proportions, the height of the patient as well as ethnicity.
Large Over Projected Nose:
A long projected nose is described as a nose that comes out from the face too far, this is called over-projection.
Tip projection refers to how far forward the nose travels from the face and rhinoplasty can be used to treat a long nose by repositioning or trimming the tip cartilage.
Reducing the size of an over-projected nose requires shaving down the underlying bone and cartilage and repositioning the nasal tip further back towards the face.
Dr De Silva feels it is important to consider the nose with the other facial characteristics, if you have a small chin it may create an illusion of a large nose when actually your chin is too small. For some patients combining a reduction in nose size with chin implant surgery will give the best possible result.
Crooked Nose:
A crooked nose or an asymmetrical nose is one that turns either to the right or left sides.
Broadly speaking the nose can be separated into three parts: the top third, middle third and lower third. To straighten a nose requires evaluating and treating each of these three-thirds to improve the appearance of the nose.
It is very difficult in rhinoplasty to completely straighten a crooked nose. The deviated cartilage and bone have a certain level of memory such that the nose wants to drift back towards its original shape, graft tissue can be used to help straighten the nose. Too much graft material in the nose can have a tendency to widen the nose so a balance is required to avoid over widening the nose while improving its symmetry.
Wide Nose:
A narrower nose generally has a more elegant appearance in both women and men and across different ethnicities and cultures.
Narrowing the nose can generally refer to three main areas: narrowing the bridge of the nose, narrowing the tip of the nose and narrowing the nostrils.
Narrowing the bridge of the nose, termed osteotomies also known as breaking the nose. Narrowing the base of the nose, termed osteotomy, is required in most rhinoplasty surgeries to give the nose an improved shape and a narrower nasal bridge.
Dr De Silva utilises electrocautery to minimise bleeding and to make a pocket incision for the osteotome instrument to be used. The nasal bones that make up approximately the upper third of the nose are individually broken with special instruments that result in a controlled and planned break. The nasal bones are then brought together and pressure is applied to minimise bleeding. Osteotomies can be performed through the skin or hidden within the inside of the nose, Dr De Silva prefers to use hidden incisions where possible as this avoids unnecessary scarring of the skin. This requires both precision and delicacy to hide the incisions on the inside of the nostril and maintain adequate functional breathing through the nose.
Deviated Septum:
Breathing through the nose is an important function of the nose and a nose job often narrows the airway passages that can reduce breathing. To improve the airways and maintain breathing, Dr De Silva frequently uses graft tissue to support the structure of the nose long-term.
Septoplasty is a common procedure that is combined with nose surgery. The septum is a cartilage plate that lies in the very centre of the nose (see the figure below), the septum is a wall of tissue that separates the right and left nostrils and airway. A deviated septum is common without symptoms, however, if severe it may cause a crooked nose and difficulty in functional breathing, it is an important consideration in surgery to ensure that the breathing is not affected by the procedure.
In addition, the septal cartilage may be used for graft material which Dr De Silva uses for supporting the nose and enhancing the fine definition of the nasal tip. The septal deviation should be corrected during cosmetic nose surgery to give a good long-lasting and effective result. Dr De Silva performs septoplasty in 30% of cosmetic rhinoplasties.
Be Inspired by Our Rhinoplasty Patient Results
Dr De Silva’s unparalleled surgical skill and artistic eye contribute to his natural Rhinoplasty results. Browse our Before and After gallery of our real-life patients and be inspired by their transformations.
View rhinoplasty Gallery
Types of Rhinoplasty Surgery Performed by Dr De Silva
Rhinoplasty covers a wide range of different types of nasal reshaping surgeries. Depending on your symptoms and concerns, Dr De Silva will choose the best approach for you to ensure you get the results you desire. His Harley Street nose job surgery procedures include:
Is Dr De Silva Your London Rhinoplasty Surgeon?
Dr. De Silva is a renowned facial plastic surgeon who specialises exclusively in rhinoplasty and facial surgeries. He has received world-class training in London, New York, and Los Angeles, gaining expertise in precision micro-surgery techniques that minimise scarring and accelerate recovery. He is also a member of the American Society of Oculoplastic & Reconstructive Surgeons (ASOPRS) and the European Association of Facial Plastic Surgeons (EAFPS).
His focus on functional and aesthetic outcomes, achieved through minimally invasive and endoscopic techniques, ensures that patients benefit from the most advanced and effective procedures. With over a decade of surgical experience, he remains dedicated to providing the highest standards of care and natural results for every patient.
- Board Certified by the American Board of Facial Cosmetic Surgery (ABFCS)
- Over 1000 Successful Surgeries in his CQC-accredited Harley Street Clinic
- Awarded a gold medal for research at the Imperial College London
Read What Dr De Silva’s Patients Say After Their Rhinoplasty in London
I would like to share my experience of my face and neck lift with Dr De Silva. First and foremost I will tell you truthfully, that with all I now know for my experience, I would go through it all again tomorrow if I had too. It was so different from what you hear, and all the botched jobs you see. I picked Dr De Silva after much research, and the fact that he only specialises on the face, I made my appointment. From my first consultation till my 1yr check up, I can only but give him and his team 100% Dr De Silva has an extremely calming way with him. He puts you at your ease and explains EVERYTHING in minuet detail. He leaves nothing out, everything he said happened in that way. From having pre op’s till the day of surgery nurses Ellie and Josie were fantastic, so helpful and friendly. I was told by Dr De Silva that It would not be painful, just a bit uncomfortable, that was true. I had no pain at all at anytime from start till now, Swollen and bruised yes, the bruising had all gone in 2 weeks. Swelling took a little longer. I was also told it would be quite numb for some time. It was, but it didn’t bother me, and now I have very little numbness left. It can take up to 9 months I think. I didn’t want to look different, I didn’t want to change anything, all I wanted was to look rested and fresher, a better version of myself. I am soooo happy with my lovely tight neck and no more loose skin and hanging jowls. It has made the biggest difference to my confidence. No one has asked have I had work done, they just say “ you are looking great”. If you are thinking of a face lift or any facial work done, I can 100% guarantee you will not find a better surgeon… anywhere. My extreme gratitude to Dr De Silva, Dr Andre (anaesthetist). Nurse’s Ellie & Josie and to Sarah who sorted all the paperwork etc.
What to Expect from Your Harley Street Rhinoplasty Surgery
Known as one of the best options for rhinoplasty in the UK, Dr De Silva makes sure that all patients are fully aware of and comfortable with the proposed plan for their nose surgery before the big day. Not sure what to expect? While all plans are personalised, they tend to follow this style.
During your initial consultation with Dr De Silva, a detailed discussion about your medical history, including any previous surgeries or nasal issues will take place. He will also talk to you about your expectations for rhinoplasty, explaining what the surgery can and can’t achieve. A brief physical examination of your face and nose will be conducted, and photographs will be taken and used to show potential outcomes through computer software, helping you visualise your goals. Once everything is agreed upon, the surgery can be scheduled, and you’ll be advised to arrange for someone to assist with transport and recovery.
At least two weeks before your scheduled surgery, Dr De Silva will request that you stop smoking and reduce any medications that could cause a side effect during surgery. You will also need to arrange for someone to care for you during the initial stages of recovery and arrange transport to and from the clinic.
Rhinoplasty is a highly customised procedure tailored to each patient's unique anatomy and goals. Performed under sedation anaesthesia, the surgery may last varying lengths of time depending on its complexity. It can be done either inside the nose or through a small incision at the base, between the nostrils. The surgery involves reshaping the nasal bones and cartilage and adjusting them as needed to achieve the desired result. If necessary, deviated septum surgery will also be performed to improve breathing. After the procedure, the incisions are stitched, and you will be monitored in a recovery room before being discharged the same day.
A video call will be scheduled for the day after your surgery so that Dr De Silva can monitor the initial stages of your recovery. Around 4-5 days later, a follow-up consultation will take place in person at the Harley Street clinic to remove any stitches and monitor your healing progress.
Most patients feel socially ready to return to work or social activities within 10 to 14 days after rhinoplasty, once swelling and bruising have significantly improved. Makeup can help conceal any residual bruising, allowing for a smoother transition back to daily life.
Open and closed rhinoplasty are two surgical approaches used to reshape the nose. In open rhinoplasty, a small incision is made across the columella (the tissue between the nostrils), allowing full access to the nasal structure for more complex modifications. Closed rhinoplasty, on the other hand, involves incisions inside the nostrils, leaving no visible scars and typically resulting in a shorter recovery time. Dr De Silva carefully selects the best approach based on each patient’s needs and desired outcome.
Ideal Candidates for Rhinoplasty Surgery With Dr De Silva
The ideal candidate for rhinoplasty is in good overall health, has realistic expectations, and seeks to improve the shape, size, or function of their nose. Candidates may have concerns such as a nasal hump, asymmetry, breathing difficulties, or previous nasal trauma. Dr De Silva assesses each patient individually to ensure the procedure aligns with their goals while maintaining facial harmony and natural-looking results.
Recovery After Rhinoplasty With Dr De Silva
Recovery from your nose job with Dr Julian De Silva is designed to be as smooth and efficient as possible. With his specialised “twilight anaesthesia,” patients do not require an overnight stay and are typically able to go home within one hour of the procedure. Dr. De Silva and his team provide clear recovery guidelines and are available to address any concerns or questions during the healing process.
In the first few days following surgery, it’s important to keep your head elevated when sleeping, avoid blowing your nose, and refrain from heavy lifting or exercise to support optimal healing. You may experience some swelling, which can affect your breathing, and you can use an ice pack for short intervals to help alleviate discomfort.
Timeline of Recovery:
- First Week: Most patients see about 80% of swelling resolve. After the cast is removed, you'll notice changes in your nose shape, though some swelling will still be present. You may experience some discomfort or blockage in your nose, which will improve after the first week.
- 2–4 Weeks: Bruising typically resolves within 1–2 weeks, although some mild bruising around the eyes may persist for up to six weeks. Your sense of smell and nasal breathing should begin to normalise.
- 3–6 Months: By three months, most of the swelling should be gone. However, it may take up to a year for the final shape of your nose to fully settle.
- 6–12 Months: Any scarring beneath the nose remains discreet and fades over time, with the final appearance of the scar reaching its endpoint after 6–12 months.
Most patients return to social and professional activities after 1–2 weeks, depending on their individual recovery. While there may be some numbness or altered sensation in the nose, this improves within the first 6 weeks. For faster healing, Dr De Silva advises using saline sprays and ointments for nasal dryness and applying make-up to conceal any scarring after one week.
Dr De Silva's careful attention to detail ensures that your recovery is smooth and your final results are as natural and refined as possible.
Rhinoplasty Risks & How
Dr De Silva Minimises Them
Rhinoplasty carries risks such as swelling, numbness, pain, infection, scarring, and, in rare cases, nasal septal perforation. Dr De Silva minimises these risks with advanced micro-surgical techniques, reducing trauma and promoting faster healing. He operates in a fully accredited facility, ensuring the highest safety standards. Comprehensive pre-surgical assessments and personalised aftercare further enhance recovery, leading to natural-looking, long-lasting results.
Patient Experiences
All these patients underwent Rhinoplasty with Dr De Silva. We encourage patients to watch one or two videos of patient experiences to have a good understanding of healing and the recovery period. Dr. De Silva and his team will provide support and reassurance during your recovery, we believe that being a well-informed patient is helpful to most patients undergoing Rhinoplasty.
Combine Your Rhinoplasty With Additional Enhancements
In some cases, Dr De Silva may suggest a combination of surgical procedures to achieve your desired look. Rhinoplasty is often combined with the following cosmetic facial enhancements to achieve improved symmetry, a balanced facial profile and a more youthful appearance.
Chin Augmentation
A common finding with rhinoplasty is a small chin. A small chin can give the illusion of a large nose, by augmenting the chin at the same time during nose surgery can improve facial proportions and final results.
Brow Lift
Achieve a more youthful appearance and correct fine lines and wrinkles around the forehead and eye area by gently lifting your brow.
Ear Surgery
Correct protruding or sticky-out ears and balance your facial profile by combining your nose job with an otoplasty surgery.
Interested in Rhinoplasty in London? Get In Touch
Trust your face to one of the best surgeons for rhinoplasty in England. If you are thinking about enhancing your facial features with nose surgery, Dr De Silva’s comprehensive knowledge and extensive expertise make him your top choice.
Rhinoplasty Frequently Asked Questions
Since plastic surgeons set consult costs, they vary greatly. Consultations cost around £80 to £300. Most London clinic surgeons who charge for consultations will deduct the price from your treatment. You shouldn’t feel pushed to choose a surgeon merely to avoid losing this money. Remember, £250 is a little thing to pay if a doctor can provide the results you seek.