Consultations are held with our Medical Director, Mr Santdeep Paun in one of our two locations in Central London. At the initial consultation, we engage with our patients to gauge their concerns about their appearance and any associated functional problems they may have. A thorough examination and analysis is then performed. This may involve examination using specialist equipment including an endoscope to look into the nose. This may require a spray of local anaesthesia in the nose to make the procedure more comfortable. Normal still digital photographs are taken as well as highly specialist 3 dimensional images using a state of the art 3D camera. These can then be shown and discussed using sophisticated image morphing software which allows us to go through what can be achieved and ensuring our advice matches our patients desires. 

We allow enough time for thorough discussion and insist we see patients again for at least one further consultation. Our consultation is followed up with a letter detailing the important points discussed together with an individualised quote for any procedure discussed, including whether any functional parts may be covered through any medical insurance the patient may have. This way our patients can reflect on the advice that has been given over a period of time, contemplate any potential procedure and have time to think of any additional questions they may have. We never charge for such pre operative follow up consultations for cosmetic procedures.

Our fees reflect the highly specialised work we do and will depend on the procedure being performed, its complexity, whether it is a revision procedure and also our patients own individual requirements and wishes such as which hospital they desire and whether they need or wish to stay overnight. We will also discuss whether the procedure can be done as a local or general anaesthetic or even deep sedation. As one can imagine, each quote will be highly individualised to reflect this. Depending on the condition and how it occurred, parts or all of the surgical procedure may be covered by Medical insurers. We would be happy to discuss this with our patients and liaise as necessary with the insurer although ultimately it will be up to the patient to ensure such funding is covered. Medical insurance, does not, however cover any pure cosmetic surgery or aesthetic parts of the operation and fees would be payable by the patient. 

Where there is an overlap and part of the procedure is covered, we will ensure the patient is given a written quote in advance of any amount payable by them. Typically these will incorporate additional hospital, anaesthetic and surgical fees. Our quotes do not include costs of medications as these will vary from patient to patient and even when patients are insured, these are not typically covered. We are fully accredited and recognised by all major UK insurers and have worked with overseas insurers on some occasions in the past, although this is done on a case by case basis. We generally bill within most insurers guidelines although insurance companies vary in their maximum fees allowable, so it is important for our patients to check about their individual level of cover for any procedure.

We are often asked to provide second opinions by both patients and other surgeons. Our approach is always impartial and in the patient’s best interest. In some cases, this may mean advising against surgery if the risks outweigh the benefits. However, we do not provide opinions or reports on previous surgeons’ work unless requested through legal channels.

While the principles of primary rhinoplasty apply, revision surgery requires specialised expertise. It is often performed to correct deformities from previous surgery or trauma. Given the complexity of revision cases, it is crucial to choose a surgeon skilled in both aesthetic and functional nasal reconstruction. Minor irregularities from initial surgery may be easily corrected, whereas more complex cases might require reconstructive techniques, including cartilage grafting. In rare instances, further surgery may not be advisable, making expert assessment essential. Realistic expectations are key to a successful outcome. Mr Paun specialises in revision rhinoplasty and is a recognised referral expert for complex cases from ENT and plastic surgery colleagues.