Surgical or Non-Surgical Approach

Which one is for you?

The truth is that you may be best off with one option or a combination of both. It is impossible to generalise, so if someone you know has, for example, had a non-surgical treatment such as botox for wrinkles, it does not automatically mean that the same will apply to you. A few key principles apply which may help in the decision-making process:

1. Non-Surgical Approach

These options include botox injections, chemical peels and fillers. These are extremely popular procedures, not least because they are relatively inexpensive, low risk and deliver predictable results time after time. They do not require anaesthetics in the vast majority of cases, and the aesthetic improvements usually occur rapidly. They appeal to people with relatively minor cosmetic imperfections of the facial skin. One disadvantage is that the effects are usually not as permanent as a surgical solution. However, they can be repeated many times, and on each subsequent occasion, the amount and/or dose given can be carefully adjusted to fine-tune the overall aesthetic appearance.

2. Surgical Approach

These options are usually considered by patients with more significant cosmetic problems. By definition they require an operation of one sort or another, which itself means that either a local or general anaesthetic needs to be administered.

Careful consideration needs to be given to the possible side effects, risks and complications of the procedure as these factors are crucial in any decision as to whether to proceed with surgery. The bottom line is that you need to feel comfortable that the likely benefits to be gained by the operation outweigh the small but definite chance of developing a problem following the surgery. Your surgeon wil be able to help guide you through this process so that you arrive at the correct decision.

Cosmetic procedures

Whether you already have a clear idea as to your aesthetic objectives or not, our aims are to provide a range of high quality facial aesthetic treatments and procedures tailored carefully to complement your facial features as closely as possible. Paul Chatrath currently practices as an ENT/facial plastic surgeon within the NHS and private sectors and has developed a particular interest in this specialty. This reflects in the quality and consistency of advice and treatment you will receive, offered in an environment exercising the highest level of professional integrity, impartiality and discretion.

Cosmetic facial operations:

  • Rhinoplasty: Otherwise known as a ‘nose job’, a rhinoplasty aims to change the external shape of the nose in order to improve its appearance. The nature of the surgery can be precisely tailored according to the deformity or problem which exists, and may include reduction of a dorsal hump, straightening of the nasal bones, refinement of the tip of the nose (‘tip-plasty’, which itself may involve reshaping, narrowing, and/or increasing or decreasing the length/projection) or widening the middle of the nose. It is occasionally combined with a septoplasty (called septorhinoplasty) if there is a deviated nasal septum and this is causing a blocked nose.
  • Pinnaplasty: A pinnaplasty, or ‘ear pinning’, is a procedure which is required for people with ears that protrude out from the side of the head to a greater degree than is normally the case. It is commonly performed in children who may experience teasing at school, but also in adults. It can be performed via a traditional approach involving an incision behind the ear and sutures to straighten the cartilage, or via a minimally invasive technique which does not require an incision and in appropriate cases can create similarly impressive results with far fewer complications. Ear Lobe Surgery: In people with unusually large ear lobes, an operation can be performed to reduce the size of the ear lobes to bring them more into proportion with the dimensions of the rest of the ear. The procedure requires an incision in the ear lobe itself which can occasionally be, but is rarely, visible.
  • Scar Revision: Patients with scars on the face can experience significant psychological distress as any visible deformity on the face is readily identified by other people, often to a disproportionate extent. Thankfully there are several different techniques available to minimise the appearance of unsightly scars. Whilst none of these procedures can promise to make the scar disappear completely, they can, either singly or in combination, result in significant improvements to the visibility of the scar to an extent that makes it less noticeable.
  • Excision of Facial Skin Lesions: This involves removal of lumps or bumps on the face such as moles, blemishes, scars or other lesions, the appearance of which the patient does not like. There are also some lesions which occur as a result of sun damage/exposure in which removal is recommended by clinicians in order to exclude the remote possibility of a cancerous growth, although this is thankfully quite rare. In most cases, removal of the lump is carried out with a local anaesthetic. In addition, because surgical scars in the face generally heal extremely well, it is likely that you will not be able to notice the eventual scar. Even if it is faintly visible, it should be far less noticeable than the original lump.

Non-surgical facial aesthetic treatments:

  • Botox: This is a treatment which has been used for a variety of medical and cosmetic reasons. In the face, it is used to improve the aesthetic appearance of wrinkles. Botox is based on a highly potent neurotoxin called botulinum toxin which numbs the nerve endings and prevents the contraction of muscles in the vicinity of the wrinkle, thereby reducing its appearance. It is extremely safe if administered by an appropriately qualified and trained practitioner. The main drawback is that the effect of the botox chemical wears off after approximately 4 months.
  • Chemical peels: This is an example of a non surgical treatment which aims to smoothen the complexion of the whole face. It is particularly good for reducing the appearance of very fine wrinkles, areas of thickened skin and acne spots/scars. Chemical peels come in different strengths – as a general rule, the stronger the peel, the more dramatic the results but the higher the risk of complications such as facial scarring and hyper-pigmentation. Also the ‘downtime’ is increased which means you cannot return to work straight away. The gentler peels have few if any side effects, although the results after one peel are less dramatic, which means that for best results, it is advised that a course of between 4-6 such peels are undertaken, often together with a gradual pre- and post-peel programme of graded creams and facial washes to prepare the skin optimally thereby ensuring that the end result is the same as for a stronger peel. The other advantage of this gentler type of peel is that you can return to work the same day.
  • Fillers: These are used to fill in areas of deep scarring or atrophy of the skin or tissues beneath the skin. The most common type of filler used today is RestylaneTM, which contains hyaluronic acid. This is a compound which is naturally occurring in the tissues beneath the skin. It can be administered in the outpatient clinic, often without any anaesthetic at all although occasionally a local anaesthetic may be required. The results are almost immediately apparent, and last anything from 3 to 18 months depending on the type of filler used, with the longer results being achieved if an interim top up application of a lower amount is given.