NEW: nose clip for every patient

Dr. Uppal has performed over a thousand nose operations. He is a member of the council of the British Society of Rhinoplasty Surgeons. He is one of the leading rhinoplasty surgeons in the UK and has helped to establish teaching courses for plastic surgeons who wish to learn nose surgery.

The goal of nose reshaping or rhinoplasty is to improve the nose aesthetically (without creating a “surgical” look) in order to create harmony with other facial features. It can make a significant contribution to increasing one’s confidence. Patients wanting to know the price of a nose job in London should appreciate that you get what you pay for. The price for a nose job is from £5800 for Open Rhinoplasty and from £7850 for Closed Rhinoplasty. If you are looking for one of the best rhinoplasty surgeons in London, you may choose Mr Uppal for his proven skills and experience.

Rhinoplasty is usually performed with general anaesthesia but is also possible under local anaesthetic with sedation. Most patients go home the same day.

Closed nose surgery without scars on the nose?

Most plastic surgeons who do not specialise in nose surgery make a cut under the nose on the skin to perform the surgery. This is called an OPEN rhinoplasty. The Open approach to rhinoplasty is easier to perform than CLOSED rhinoplasty which Mr Uppal specialises in. Closed rhinoplasty causes no scars on the face at all but requires great skill and experience. Mr Uppal has used this type of keyhole surgery for the last 15 years using cuts inside the nose so it’s all hidden. No one will know you have had surgery as there is no scar. The recovery is also much quicker and patients can return to work within 1- 2 weeks depending on the swelling and bruising.

Although closed rhinoplasty is more difficult for the surgeon, Mr Uppal uses his skills to get you the best results using his techniques and many years of experience. Closed rhinoplasty causes less swelling of the nose and face as well as fewer long-term problems with the nose.

However, when thinking about rhinoplasty, the site of the incision is less important than the actual surgery that’s done. An example would be say a mechanic fixing an engine problem – it’s not how he looks inside your car that matters, but actually what he does when he gets there. A mechanic may open the whole engine of your car (open rhinoplasty) or fix what’s needed without opening up the whole engine unnecessarily. It’s best left to the specialist surgeon such as Mr Uppal to decide what’s best in your case.

Closed rhinoplasty incisions are made inside the nose in this way where they are invisible. In some rhinoplasty cases however, Mr Uppal does indeed use the ‘open’ approach with an incision made in the area of skin separating the nostrils. Mr Uppal will let you know what’s best for you to get the best results. Please do not get fixated on the incision. Rhinoplasty surgeons all over the world get good nose re-shaping results with either technique.

Before having nose surgery, you need to think deeply about your body image and your emotions. Please see the Psychology link for more advice.

See NoseSurgeryLondon.com

Closed Rhinoplasty

Nose surgery without breaking bones

Mr Uppal can achieve good results without breaking the bones of your nose. This reduces swelling and bruising, meaning that you can return to work much earlier.
To reduce a large bump on the nose, sometimes however certain amounts of bone and cartilage are removed or rearranged to provide a newly shaped nose. If the patient has a deviated septum (cartilage and/or bone causing obstruction inside the nose), septal surgery, called septoplasty, is also performed. The incision is placed entirely inside the nose. The septoplasty removes portions of cartilage and/or bone that are causing the obstruction. The incisions are closed with fine sutures, followed by placement of a splint to the outside of the nose. The splint helps retain the new shape while the nose heals.

There are no packs or bandages put inside the nose.

The nose has very complex anatomy and rhinoplasty requires a surgeon with many years of experience such as Mr Uppal.

Mr Uppal often performs complex rhinoplasty for patients who have had nose surgery in the past but are still unhappy with their nose. He is an expert in the use of cartilage grafts to correct subtle abnormalities of the nose, especially the end of the nose. To learn more about cartilage grafts click here.

Usually no packing is placed inside the nose during surgery but in some cases if used it is removed the next morning following surgery. The nasal splint is usually removed seven days after surgery. At that time, tape is applied to the nose for another seven days and then removed. The majority of the bruising and swelling usually resolve two weeks after surgery. Cold compresses are used to help reduce the bruising and discomfort.

Although discomfort is minimal, pain medication is available if required. Vigorous activity is avoided for four weeks following surgery. Sun exposure and risk of injury must be avoided. If you wear glasses, tape is used to avoid putting stress on the nose.

All surgery has risks as well as benefits and this will be discussed in your consultation. Mr Uppal and his team will show you rhinoplasty before and after photos at your consultation. You can also see nose job or rhinoplasty before and after photos by clicking here. Remember that photos of other patients may have no bearing on the results of surgery to your particular nose as everyone is different.

Can I get the skin of my nose improved?

Yes we can an offer you a ‘peel’ of your nose skin which will improve large pores and black heads. It re-conditions the nose skin and makes it less shiny. It takes 20 minutes to perform and is like sun burn. The nose may blister or go red for a week before fresh new skin develops which is smooth and clean. This is usually done 4 weeks before rhinoplasty and costs £495.

Who is a good candidate for Rhinoplasty or nose surgery?

Anyone who is concerned about their nose should research on the Internet and see a specialist nose surgeon such as Mr Uppal. Rhinoplasty is one of the most complicated operations in plastic surgery as it requires great experience and specialist training which Mr Uppal has had. He has worked around the world where he has presented his own work on rhinoplasty and taken part in discussions on nose jobs and rhinoplasty.

Mr Uppal will give you an honest and independent opinion on whether nose surgery will improve the look of your nose or the breathing through the nose. Mr Uppal is skilled in performing precise adjustments to the end of the nose to get the shape that you want. He uses his proven techniques to adjust the small nose tip cartilages shown in the diagram.

I am Asian – is it harder to make my nose smaller?

Yes. Asian skin and Middle Eastern skin is thick and oily at the end of the nose. There may be lots of black heads too. The thick skin masks improvements that are made to reduce the nose structure. Thick skin also produces more scar tissue. The nose may start out small after surgery but grow over months. There are treatments for this and ways to prevent this. Mr Uppal is the best rhinoplasty surgeon in Asian noses so please ask him for details.

How much does rhinoplasty or a nose job cost?

A full rhinoplasty or nose job price starts from £6500. Cheaper surgery is available abroad and by less experienced surgeons. Don’t go for the cheapest surgery. If you can’t afford nose surgery then it’s better to wait till you can and get a good result first time rather than needing revision.

The old phrase “Buy Cheap, Pay Twice” really applies to rhinoplasty surgery.

The cost of a non-surgical rhinoplasty starts at £1545. This involves an injection of filler or fat taken from your body to improve the shape of your nose. It takes half an hour to perform in the clinic and patients can go back to work the next day. Not all patients can have this type of Rhinoplasty so check with Mr Uppal if this is possible for you. It can be used to make changes to a hump on the nose or to change the end of the nose. Non surgical rhinoplasty can also improve the nose if it is different from one side to the other (asymmetry).

Nose surgery or rhinoplasty starts at £6512 for a mini-rhinoplasty under local anaesthetic. This is for patients who do not want any surgery to the bone part of the nose and can be a quick and effective way of improving the shape of the nose without a full rhinoplasty.

A full rhinoplasty or nose job price starts from £6400 to £9000 depending on complexity. This includes the fee for the surgeon, the anaesthetist, hospital costs, operation theatre costs and 2 follow up consultations with Mr Uppal. This surgery allows changes to be made to any part of the nose if needed including the bone of the nose, nose cartilages and/or the soft parts of the nose. Unlike surgery abroad, the care package includes lifetime review at any time.

A septo-rhinoplasty or revision rhinoplasty or nose job can start from £7455 as this is much more complex and takes longer. This can improve breathing through the nose. It can also correct problems with the nose after rhinoplasty surgery in the past. Remember rhinoplasty is about improving the shape and function of the nose and perfection is not possible. Mr Uppal is one of the world’s leading rhinoplasty and nose surgeons and may be one of the best nose surgeons in London but even he cannot guarantee an unrealistic expectation of outcome.

Can I have a nose job if I’m 16 years old?

No.  Rhinoplasty is only possible after the age of 18.

The legal age of an adult is 18 but there is some protection under the law for young people under 18 years of age seeking some treatment who are deemed to be Gillick Competent (Gillick v Norfolk 1986 House of Lords). This means if the doctors and nurses feel that the 16 or 17 year old patient is mature enough to understand the risks and benefits of surgery, then this can be discussed in clinic. Surgery is only possible once 18 years old however. Supportive parents also help and Mr Uppal will involve the family in the process of considering nose surgery. Mr Uppal feels that a nose that is a real issue for young people can lead to bullying and an abnormal psychosocial development, even leading to social handicap. Just as prominent teeth or big ears are corrected at a young age, correcting a large nose can make a significant contribution towards the future social confidence of the young person. Clinical studies have shown that success in social, study and work relationships can thus be improved.

How long after rhinoplasty surgery can I fly?

You can fly 1 week after nose surgery once the splint has been removed by Mr Uppal and his rhinoplasty team.

Nose surgery abroad is cheaper but is it a good idea?

It is possible to get a cheaper nose job in Poland or other European countries. However these European clinics are driven by profit and the surgeons they hire are cheaper than fully qualified and trained surgeons. Mr Uppal undertakes many revisions on patients who have had poor results abroad. The language barrier also means you don’t fully appreciate what the surgeon is trying to tell you about rhinoplasty and equally they often don’t understand you. They are usually not fully insured if something goes wrong. And you cannot pop in to see the surgeon afterwards if you have a problem. Mr Uppal and his team are fully insured for all cosmetic surgery including rhinoplasty and are governed by UK laws.

I’ve seen a few clinics and surgeons giving free consultations – is that ok?

“There’s no such thing as a free lunch.”

Clinics with good marketing try to get you to book surgery and draw patients in with free consultations. They will not give you an independent and honest assessment of your needs. Their main aim is to get you to pay a deposit for surgery.
Deciding to have nose surgery is a big decision and you need a responsible surgeon with integrity such as Mr Uppal who will not put any pressure on you to have surgery unlike those offering ‘free’ consultations.

What are the risks involved in a nose job?

All operations carry risk but as long as they are done safely by a surgeon with experience and skill such as Mr Uppal, you are unlikely to experience any problems. The main risks are bruising and swelling which everyone gets to some extent and lasts about 1-2 weeks. Most people return to work after 1 week of a nose job. There is some swelling that can last 3-6 months. Less common risks include tiny abnormal bumps that can be felt by touching the nose. These can develop because the skin, cartilage and bone of the nose are living tissue and grow with time. These subtle bumps are normally not visible and settle after some months as the scars inside the nose start to mature and soften. Another risk is asymmetry, meaning that the left and right sides of the nose are not a mirror image of each other. Nobody has a mirror image of their nose. In fact, computer studies that create this mirror image result in a very unnatural and deformed looking nose. The shape of the nose can change in the long term. The other risk is that you may not be entirely happy with the appearance of the nose. Part of how we see ourselves is in the mind, as much as it is in the physical body. How we feel depends on our self esteem and psychological state. This is especially true of rhinoplasty patients who sometimes have high expectations that cannot be achieved by surgery – even by Mr Uppal who is a world expert. We cannot make you look like your favourite movie star or a model. Other risks include temporary numbness, infection, bleeding, scars inside the nose, scars on the outside and breathing problems.
Any complications of surgery will be corrected by Mr Uppal and the team without any surgical fees. Personal wishes to change the shape of the nose further are welcome but need the approval of Mr Uppal and full payment. Revision surgery is not normally considered for at least 6 months after the first surgery.

What does the nose clip do for my nose?

An important issue after nose surgery is the swelling of the nose that occurs afterwards. Most of the swelling is reduced about 3 months after surgery. However many patients find there is still a little swelling of the nose which keeps changing up to 1 year after surgery. Mr Uppal has many years of experience in treating this swelling to get the best shape possible for your nose. To help reduce nose swelling, Mr Uppal recommends that you wear the nose clip that we will provide for you free of charge upon request. We recommend that you wear this at night for 6 weeks after surgery. Mr Uppal will advise you on what is best for you and how to use the nose clip. Please ask our office for details.

Can frown lines be reduced during nose surgery?

Yes. Mr Uppal has developed a technique to reduce the effect of the tiny muscles at the top of the nose that create a frown. Most patients use non-surgical injections in this area to remove a frown that can make one look angry or tired. Ask Mr Uppal about this so that he can reduce your frown at the same time as your nose surgery.

When I smile my nose gets wider and bends over – can I fix this?

Yes. Please ask Mr Uppal for his techniques to reduce the flaring of the nostrils that occurs when you smile. There are lots of muscles around the nose that change it’s shape when we smile or talk. To get a really good result from surgery, Mr Uppal can improve these changes to the nose that happen when you smile. Patients are then much happier to smile in photos after this procedure.

I have a fear of general anaesthetic. 

Don’t worry as we can use twilight special sedation. This is designed by our Anaethetic team for people with a fear of General Anesthasia if needed.

What can I expect after surgery?

Nose swelling is a feature that happens to all patients having nose surgery. This is normal and always improves. This can obscure the final result and so patience is needed. There is no way to accelerate the reduction in swelling but we do advise you to use cool packs and moisturising cream. In time, the swelling will resolve for sure. However, it can be a stressful and emotional time while we wait for the swelling and bruising to resolve. Please use moisturising cream and gentle finger pressure to reduce swelling that is uneven on the nose.

Body Image – “I want to feel better about myself”

We take great care in looking after your mental health and ensuring that you do not feel down about plastic surgery. All reputable surgeons will recommend that you see a counselor or therapist if you want to discuss your body image or for any issues. Please click here for more info from the Mental Health Foundation.

“I don’t want my nose to look fake”

This is the most common statement that Mr Uppal hears from his patients. We ensure that your nose will not look fake; nor operated. We believe that nobody should notice your nose after surgery. That’s why Mr Uppal places great emphasis on avoiding the “ski-jump” look or the “Los Angeles” look which results in a triangular nose. Mr Uppal will tailor make your nose surgery to suit your face. Mr Uppal also specialises in corrective surgery if you are not happy with nose surgery in the past. See example below of too much taken away from nose – this makes the end of the nose look longer or like “Pinocchio”.

If we analyse the before and after picture below we can see the signs of a typical “Los Angeles” rhinoplasty. In real life this nose will look fake and obvious.  The angle with the lip is over 110 degrees making the end of the nose look upturned. The ski slope is a real giveaway of a “nose job”. Mr Uppal will give you a natural look as close as possible to your wishes. And there will be no tell-tale scar in the middle of your nose because Mr Uppal uses the closed rhinoplasty technique rather than the easier “open” technique. The closed approach also prevents the end of the nose dropping after many years.
 

After surgery

Please get in touch with us or send us more photos for Mr Uppal to take a look at. You are always welcome to come to see Mr Uppal at anytime or arrange a phone call if this is more convenient.

Common Questions:

1. My nose is Numb in some parts?

Answer: The Feeling around the nose returns over 2-5 weeks.

2. An area under my nose and top lip is swollen and doesnt move properly?

Answer: Normal mouth movement returns in 2-5 weeks if affected.

3. I have bruising under my eyes and nose. When does this go?

Answer: Bruising improves over 2-5 weeks.

4. When can I start my normal vitamins and lifestyle?

Answer: You can return to your normal lifestyle including exercise after 1 week. And start vitamins or supplements.

5. When do my nose stitches dissolve?

Answer: Nose Stitches dissolve in 7-10 days. Although you may not see them as they are often covered in crust inside the nose. Please use Vaseline and cotton buds to gently clean inside nose after 1 week.

6. I have swelling at the end of my nose that makes it look round and swollen. What can I do?

This is due to swelling that can happen after nose surgery. Over time this swelling will get better and the shape that we want will come through. Patience is required however. You can massage the end of the nose to reduce swelling and apply tape at night to compress this swollen part, as shown in the diagram below.  This Microporous tape is available at most chemists. Do call our office anytime for advice or to arrange an appointment to see Mr Uppal.

Nose Re-shaping
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