Choosing your rhinoplasty surgeon

Choosing the right surgeon is the most critical decision you make when deciding to undergo a rhinoplasty procedure. Although rhinoplasty is the earliest performed plastic surgery procedure – ancient Indian surgeon Sushruta, known as the Father of Surgery, is known to have performed rhinoplasties as early as around 600 BC – it is a highly challenging operation. Many plastic and ENT surgeons choose not to offer this complex surgical procedure.

The purpose of a rhinoplasty

Rhinoplasty can be undertaken for reconstructive reasons, functional improvement, or aesthetic enhancement. Aesthetically, patients may wish to address features of the nose that have caused dissatisfaction or distress for many years. These can be issues with the nose bridge, nasal tip, size of the nostrils, or how the nose harmonises with the other facial features.

Functionally, rhinoplasty can address irregularities that impede air flow through the nasal passages, impacting breathing function. This can be caused by too narrow nasal passage or a deviated septum, whether genetically or as a result of trauma. Form and function are often intertwined, so both surgical approaches may be required.

Reconstructive rhinoplasty is required to rebuild deformities in the nose, which may result in tumour removal, infections, trauma or congenital issues. Reconstructive surgery is often needed if prior rhinoplasty surgeries have negatively affected function. Reconstructive revision rhinoplasty techniques typically require bone or cartilage grafts taken from other body areas such as the ear or rib.

Rhinoplasty surgeon choice

A plastic surgeon performs both reconstructive and aesthetic surgery and can operate on nearly any area of the body, including the face and neck, arms, breasts, back, abdomen, buttocks and thighs.

Otolaryngologists, also known as ENT surgeons, focus on diagnosing, evaluating, and managing diseases of the head and neck, principally the ears, nose, and throat. They undergo extensive training that allows them to perform complex functional or cosmetic surgical procedures that affect the structures of the head.

Annakan Navaratnam is a Consultant ENT Surgeon who is part of the Craniofacial team at UCLH, where he works with Ophthalmologists, Neurosurgeons and Maxillo-Facial and Plastic surgeons in the management of complex craniofacial presentations such as patients with cleft lip/palate and congenital syndromes.

“In my reconstructive and craniofacial surgery work,” Annakan explains, “I often must make extensive changes for patients that have congenital malformations or significant trauma. Understanding how to reconstruct a nose completely allows me to understand the subtle changes required to produce the aesthetic outcome my rhinoplasty patients expect.”

A question of facial balance

“The nose is never assessed in isolation, and often, a very underdeveloped chin can give you the appearance of a prominent nose and both aspects of the face will need to be addressed.”

“If the mid-face is underdeveloped that it can make nose appear flatter or broader. For my cleft patients I often must reconstruct the mid-face area. The nose needs to be built on a solid foundation.

“The nose is a complex anatomical 3D structure of bone and cartilage, so you’re not simply making something bigger or smaller in a 2D plane. Also, every action has a reaction. So, if you reduce the dorsal hump, you could compromise airflow. If you refine the nasal tip, you could make the nasal airways slightly narrower. It is essential to consider all these factors to find the correct balance.”

Factors to consider when choosing your rhinoplasty surgeon

Choosing your surgeon depends on several factors:

1. Your specific needs: Do you have significant functional issues that are causing breathing difficulties, or is your primary concern the external appearance of the nose?
2. Your surgeon’s expertise: Do they have the training to perform this often challenging and complex surgical procedure?
3. Experience: Does the surgeon perform a significant number of rhinoplasties and focus on this procedure?
4. Before and after photos: Does the surgeon have before and after images of past patients so you can ensure that their results reflect the outcome you wish to achieve?
5. Patient testimonials: Do they have past patient feedback that helps you understand how they achieve patient satisfaction?

To find out more about Mr Annakan Navaratnam, call +44 (0)203 627 2918 or email secretary@annakan.co.uk to arrange a consultation.