Indian Ethnic Rhinoplasty - Dr Julian De Silva (Hammersmith, London) London, GB

This review is for my South Asian / Indian...

This review is for my South Asian / Indian Community. I was frustrated by the lack of detailed Indian recovery / review stories, so much of this website is geared towards caucasian girls with different skin types and of course different types of procedures... So I hope future non-white users of realself find this illuminating. Of course, Indian people have the most genetic diversity of all races, so even my post may not be relevant to everyone, nor would Dr JdS use the same techniques on another Indian person, but at least it gives another perspective.
For anyone out there with Asian heritage, please feel free to ask questions. I recommend printing out these posts, highlighting anything that you find interesting and bringing them with you to consultations to ask more relevant questions to your surgeons! I would finally just like to say that I have zero pain tolerance, so a lot of the experiences detailed here probably apply to me only.

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Feminisation of nose:
* Reduce slight hump on profile
* Reduce width of bridge
* Refine + reduce droopy tip

* Slightly 'thicker' south asian skin may limit how petite the tip can look
* Lifting the droopy tip may reveal more of the nostril, but should not at all look pig-like

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I have had consultations with 3 other surgeons, Dr Uppal, Dr Rowe-Jones and finally Dr de Silva. Of the three Dr de Silva, seemed the most genuinely interested in understanding my specific situation, giving me plenty of time to ask questions (and not rush or patronise me!). He provided me with a booklet with extensive pre-op suggestions and tips for healing which gave me something constructive to focus on in the run up to the surgery.

Interestingly, every surgeon told me that from my profile-view I had a 'tiny chin' and that this was causing any nose projection to look exaggerated. While I have never thought of this aspect and none of them pushed for me to have a chin implant, I decided not to go ahead with a chin implant, as that was not the priority. But I thought I would mention it here in case any others would like to find more 'facial balance' rather than just 'nasal balance'

At the time of surgery I was 27, I have been intensely thinking of surgery since I was 16, that’s 11 years. It’s only after working and saving up money for the consultations myself that I had the capacity to do something about this problem that has been a burden on every aspect of my life, confidence and even promotions at work. What’s worse is that my elder sister has a more normal looking nose, that fits in with the rest of the family, and I just pulled the short straw looking like the odd one out.

Currently I have seen Dr JdS twice, one at the consultation £225 in Harley Street, and a second time at the clinic in Hammersmith. I was given an information pack at the consultation along with a full cost breakdown (£8000) on the same day. At the clinic I has my height and weight recorded and paid £775 to secure the surgery. While the price is the highest of the three surgeons I met, I believe he was the most rounded and considerate.

At this stage, I am slightly nervous about 2 things: 1) The final result! The noses on caucasian girls look great, but there arent as many images for south asian girls that significantly feminise their look! 2) The sedation process, being vaguely awake while my face is being operated on is something Im not quite sure I understand. But if it helps to reduce discomfort immediately out of theatre, it should be fine.

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Blood Test

Getting my blood test done was a nightmare. This has nothing to do with Dr JdS team, but I wanted to mention it here as advice: Do not go to the NHS for blood test! I know it’s free but a simple thing like a blood test is too difficult for them and they don’t alert you if anything else goes wrong. Also with NHS you have to make a physical appointment with your GP to review the results and ask for a copy. The receptionist wasn’t able to download the results and send it to me directly for ‘patient confidentiality’ reasons, which is a waste of time. I was extra unlucky as my GP (at the time) Dr Cowling is incompetent IMO and she has a random work schedule so it was hard to get a hold of her. Despite getting my blood test done 3 weeks ahead of surgery, I found out 3 days before surgery that the lab messed up my blood and only 1 out of 3 tests actually came back with results… such. a. joke. The NHS is a farce! I was forced to go to a same day clinic by Tower Hill and paid £280 for the 3 tests, they emailed detailed results (with lots of other data) in a .pdf document back within a few hours, which I finally forwarded to Stephanie. It’s expensive, but its 2016, and that’s how blood tests should be done. Unfortunately as both bloods were taken out of my left arm, my veins bruised causing unnecessary uncomfort before I even got to my surgery! Overall it was a big mess, perhaps one of the most stressful points in my life because I had waited so long to save up for this operation and the NHS screwed up almost causing me to rearrange surgery, which would have also impacted my work!


As I mentioned in my first post, the good thing about Dr JdS’s Team is that they gave a full pack with lots of useful (non-monetary related) information. I was quite nervous about ingesting a lot of new medication that I never heard of before, but that is what good preparation looks like. In total I spent c£50 at Boots (UK pharmacy chain) collecting all these items. I also bought a c-shaped travel pillow to help secure and elevate my head at night so that I don’t slip down. I also got a massive waitrose (grocery store) shop delivery of vegetables and fruit that I would later use in the first few days to ensure I didn’t hit up the comfy food which is most likely counter-productive.


I was lucky to secure the first operation for the day, but it was deep-winter and cold outside and I was doing all that I could to avoid getting ill! When I got there Stephanie welcomed me and so did the assistant. I was asked to go to the ladies and then do another round of checks in the prep-room. I signed another set of papers, and one to record that I wasn’t pregnant. Stephanie asked me to remove my underwire bra and wear a blue gown, hair cap and blue socks.
I then met the anaesthetist who immediately seemed like a warm person. He asked that I wasn’t allergic to any ibuprofen type painkillers - as that was what he would be putting in first into my bloodstream. So by the time they started operating the pain meds would be working. Within 3mins of connecting me up I suddenly felt a hot flash and my heart rate jumped, I said I was starting to feel hyped-up and the anaesthetist said that was my body releasing adrenaline in reaction to the medication, he then mentioned some patients feel nauseous, after he said that I did start feeling light headed so he immediately reclined the chair back which made me feel better.
I then met Dr JdS who asked me if I had any more questions, to which I said all my questions were trivial at this point and that I would leave the fate of my face in his safe hands, he reassured me and said that everything is order and that he would just be doing a few more things to prepare before I go in. First he quickly drew three lines on my nose, not really sure how that helps nor did he explain. Then he told me he was going to squirt this numbing agent up my nose and that it would feel uncomfortable. It really did! I was grimacing at the sharp stinging for a few seconds, but then it became numb and the back of my throat felt funny. He said that some patients say that that was the most uncomfortable part of the whole experience, which I logically found hard to believe, but of course at that point I was hoping it were true!
I was then told by the anaesthetist to get up and walk to the operating theatre next door while he held the tubes that were connected to me. I lay down and Stephanie stuck what she called a ‘sticky pad’ on my lower right leg, I’m assuming it was a monitor of some kind. That was the last I remember pre-op in the theatre room.

Immediately Post-Op

My first sensation that returned was hearing. My eyes were still closed but I could first hear faint music then it eventually became louder and more recognisable as I became more awake, this took around 30mins. At this point I wasn’t aware of my body, nothing was in pain, but I felt so out of breath, like I just ran a marathon! I think my body was coming out of shock and obviously it was hard to breathe through the nose at that point.

I do not remember a single thing about anything during the operation, I was out like a light. Some people say they could feel a few elements during the operation itself… but I don’t even remember the anaesthetist telling me that he was putting in the sedative! I just remember waking up like I was up in the Himalayas ie very cold, breathing deeply, chapped lips, slightly drowsy. I’m going to call it the Himalayas-effect. I don’t think this was a result of the sedative approach or operation, perhaps just my reaction to the procedure.

As I was slowly waking up I over-heard the anaesthetist mention to Stephanie and the assistant that they should allow energy drinks up to two hours before the operation, because a 6 hour strict fast could be too hard for some people, to which Stephanie said that the preparation document needed to be updated. This didn’t concern me because it showed that the anaesthetist took his work and his patients’ recovery seriously to avoid any extreme version of the Himalayas-effect happening in other people.

The anaesthetist then came over and asked if I was OK, I murmured back, then he said that he was going to give me some water, at this point I realised I was really cold, I started shaking and I noticed I was more aware of my body. He slowly raised the bed and helped me take a few sips of water, he then removed the tubes that were connected to me. I slowly got up then dragged my feet to the room next door and sat on the chair. I realised my vision was still a bit blurry and that unless someone was directly in front of me I didn’t feel like straining my eyes to look at them.
I realised at this point I could now feel a very strong ache along the length of my nose, also the entire top row of teeth really hurt! I wasn’t expecting this, and not many people have written about this on realself! One-by-one the JdS team came to ask me questions but I don’t remember the details now. I just remember asking Dr JdS if the fact that he broke the top half of my nose caused my top jaw to hurt, but he said it was the result of the numbing agent. He said that I was the perfect patient during the operation and that I responded well to sedation.

Dr JdS seemed quite pleased in good spirits as he was talking to me, so this was my first sign that everything was in order. He then said that ‘sedation was the future’ and even in my drowsy state I agreed and could tell it was more appropriate for facial surgery at least. I said my thanks and then slowly got changed. Stephanie then gave me a fruit smoothie to slowly sip to help put something light in me after the operation which felt comforting.

For the first time I looked at myself in the mirror I could immediately see that the footprint of my nose on my face somehow seemed smaller, but this could be because of the residual swelling around the rest of my face making my nose look smaller in proportion. I couldn’t tell if the slight bump on my profile had gone because of the silicone splint but everything felt tight. I also noticed no bruising which was remarkable. The only thing I found strange was my eyes, which are normally quite big, shrunk to half their size because my under-eye / cheek area was puffy, so this must have also been the cause of blurry vision.

Car Journey

Now the car journey was regrettable, firstly it was lunch time so it was among the peak traffic times in London, next the uber driver didn’t know where he was going per usual, so that was causing me stress. During the car journey I noticed that I developed blue streaks from the top corners of either side of my nose diagonally down my cheeks. So unless you live 30mins away don’t do any extensive travelling! I was a bit upset about the bruising as they only go away after 14 days at best. Looking back I think it’s best to insist that you stay put for extra 30mins minimum at the clinic, even if people come in and out and try to rush you. It’s not worth getting bruising for travelling.

Rest of the day Post-Op

When I finally reached home, I noticed that the bleeding had got worse and I had to change the gauze material twice in the space of 15mins. It wasn’t a great feeling. But this was expected especially walking around normally after the operation.

I think my body was in a state of shock that day. My hand-to-eye coordination wasn’t 100%, like I was very slightly drunk, but that wore off quite quickly. I tried to get into bed and relax but it was in the middle of the day and I was hungry so my nap didn’t last very long. I had tomato soup and soft white bread for lunch along with my antibiotics. Despite not eating anything for breakfast until this point, my appetite was gone and I was finding it hard to eat anyway. I didn’t want to make any big chewing motions either in case that upset the sutures.

At 6.30pm I got a call from Dr JdS where he asked if my bleeding had calmed down, which it had done over the course of the day. Now that I was fully awake I had prepared some questions that I wrote down on paper to ask him like how best to calm down the bruising and when extensive bleeding would stop.

In the evening I had the leftover soup, I had enough energy to do the dishes and then tried to get to bed at a reasonable time for 10pm. I guess during the day post-op some people knock-out after surgery and some people are in a state of adrenaline / shock so the surgery doesn’t really register in a material way. I was part of the latter group.

Day 1 Post-op

I woke up at my usual body-clock work-time which is quite early at 6.30am without feeling much pain. I decided I might as well have some tea and take my first dose of anti-biotics. I then had a second cup of tea and took the first dose of anti-inflammatories and anti-reflux. I realised I was very warm and my blood pressure was pumping which I knew was going to cause me issues later in the day. I naturally wake up hot most days, it’s like my body is kick-starting me for the day ahead as I have a tough, high profile job that requires me to think immediately when I get to my desk. Luckily I tried to calm down and went back to sleep again until lunch time.

For lunch I made curried carrot soup which is warming and naturally flavourful / comforting. But I realised that the bleeding had increased because of getting up and making soup etc. I was half expecting this, but because the blood inside my nose was blocking my nasal channel, the seeping blood was tickly and annoying.

After lunch I got back into bed and applied some more ice-packs on my face, did a bit of browsing on my phone and tried to take a nap. I noticed even when I was sitting in bed I felt these sharp pangs of pain by the stitches like a tiny needle was pricking them, but that is the effect of the healing process, it didn’t merit taking pain killers it was just annoying and its worth mentioning that its nothing to get too concerned about.

Stephanie called during the middle of the day and asked how things were going, she said everything was alright and that my healing process seems normal. She reminded me to take it easy and drink lots of water. I recommend drinking water as it helped to keep my lips refreshed which were really dry and shrivelled up at this point. I looked like a chipmunk! The puffiness in my face got worse and the bruising spread out more despite applying ice packs. I had to take one co-codamol pill to subdue a little pain.

I noticed that the sides of my nose were a little yellow and that looking closely the point where the injection pierced the top of my nasal bridge, which had a small circular brown bruise too. I guess on the day of surgery, my body was like ‘what the fudge just happened?!?’ and it was only in day 1 that my body started recovering, hence the more material symptoms above.

Day 2 Post-op

I woke up with my tongue dry and rough like sandpaper, it was very uncomfortable, but drinking hot tea resolved that issue. There’s no way around that sensation apart from waking up in the middle of the night and sipping on water constantly, I guess breathing through my mouth for an extended period of time will naturally cause dryness.

The puffiness has not gone done, but luckily no real pain. I noticed that there was no major seeping of blood this morning, despite waking up hot, so I’m hoping the wounds are slowly starting to heal up. From what I’ve read day 2 is an important day for healing so I made an effort to do as little as possible. If I wasn’t lying in bed I was on the computer doing a bit of browsing to keep my mind occupied.

Day 3 + 4 Post-op

Much of the same of day 2, I would say my energy and appetite came back and as it was a Saturday my partner was also around and we made bigger meals. Again there would be a little bit of seepage whenever I got up and moved around but this is normal. By now my body clock has completely gone out of wack. I normally wake up early, but doing nothing mentally / physically stimulating during the day meant that I would go to bed later around midnight or later and this would mean I would wake up feeling groggy and irritable. Interesting fact, during my recovery I had a craving for fish like salmon seabass etc, I thought I’d mention to see if anyone else has any cravings… I guess it’s a good food option in any case as it provides healthy fats and nutrients perfect for healing skin.

The quality of my sleep was poor and the c-shaped pillow around my neck was becoming problematic to use. I did feel better cleaning my nose before bed to give me that extra clean feeling, but sleeping upright was possibly the most draining part of the entire process. Sleep is so important for the following day and healing. I wish there was an easier way to be comfortable while sleeping without reducing swelling. There was a time when I did slip down my pillow I could feel the pressure build up in my nose, so sleeping upright is the only option, but perhaps take relaxation / sleeping pills to speed up the recovery.

Day 5 Post-op

Stephanie called me late in the morning to ask how things were going, I told her the bleeding had stopped and that there was tenderness, but there was no severe pain. I told her about my concern for removing stitches and her response was ‘its fine it’s not painful, it’s just an awkward sensation as Dr JdS is close to your face’ She said the whole thing takes 20mins to complete and that if I was overly concerned to take some co-codamol 30mins before I was due to be seen. She did a good job of removing my concern at the time, given the experience on the day its just a shame it was a bit too sugar-coated for me. I just like to know facts and I hate the unknown so at this point I just wanted to make sure opening the wounds again would not be too detrimental.

Day 6 Post-op

At this point I found the days seemed to drag, especially as I hadn’t stepped foot outside my flat. I would just wake up groggy, eat, lay on my bed to read, do some house chores, then repeat. I had a lot of other stuff going on in my life, but I didn’t find the motivation to complete them. I guess this shows that having the rhinoplasty was always on my mind or a constant worry. I don’t think the cocktail of medication I was taking every day was something that I would continue past a week, because I could feel my stomach churning hard to process it all. I took photos of my nose this day to see if any of the steps I was taking improved the swelling immediately post-op. From what little of my actual nose I could see, it did reduce in swelling.

Cast Removal

I had my cast removal fairly late in the day at 6pm, and unfortunately it gave me the whole day to think about what was going to happen. I suggest you have your cast removal first thing in the morning. Because we live far from the clinic we took a cab all the way, but I took 2 co-codamol pills in anticipation of any ringing pain. I didn’t realise how drowsy they make you! I felt spaced out unable to concentrate or visually focus on anything, it also made me more prone to car-sickness sensations on the journey there and back. So I wouldn’t recommend taking these unless you have a low pain threshold like me.

This day involved a 3-part step, first the cast came off, stiches removed and then injections for swelling. Again as I mentioned before my pain tolerance is low, but because I went in not expecting much from my conversation with Stephanie and with all the reviews on this site, I had an uncomfortable time here: Tragically the cast removal felt very rough and I felt Dr JdS was using a bit too much force on my nose and I was worried that he would change the shape of it especially after the extensive work that was done! I understand the nose is hyper sensitive but he said that my cast was very tightly stuck on so he was using extra force which made me upset. As after all that I’ve been through I think using another loosening approach would have been infinitely better! Obviously the amount of physical and monetary investment I gave, I became protective of my nose. The stitch removal was in comparison only slightly better, but it was still a raw experience, it certainly was not ‘fine’ like Stephanie had said it would be! This is why I wish I was more prepared with the events of this day. I also had 2 injections on the bridge of my nose to reduce swelling, Im not sure what was inside the injection itself but it felt like a short stab with a bit of pressure and then it went away. Unfortunately the pain relief aspect from the co-codamol must have worn-off as it just made me drowsy, at one point I felt like my limbs were going white and I felt really faint, so Dr JdS lowered the chair and let me sit for a few seconds to calm down. It’s meant to be an exciting part of the process to finally see the first glimpse of what the result would look like, not something that adds more stress! So unless you are white, I feel this process could be improved, so please speak to your surgeon about this step!

I had the option of having whatever was inside suctioned out, but at this point I was done with any more pain so I just said I would clean it at home in my own time! I’m sure the suction cleansing would not hurt, but I was tired and hyper-sensitive of my nose and I didn’t want anything else touching it. For those of you who had minor work done, I would consider getting the suction treatment, it won’t impact healing or swelling, it’s just for comfort. But I was able to mostly breathe through my nose anyway I thought that I would not be missing out on much.

Finally Dr JdS mentioned that there may be 1 or 2 small stiches that usually dissolve inside the nose or they may fall out, and not to be alarmed by that. But just to clean the nose as I had been doing with q-tips until we met each other again in 6 weeks time. He also mentioned I continue sleeping with my head slightly elevated and to tape my nose at night to give it some support. He did a demo on my nose as to how to apply the tape and I found that after a week of wearing a tight heavy cast, the tape provided some support and comfort.

In terms of Dr JdS himself, he was able to keep everything under control, act calmly and responsively and be immensely helpful throughout each interaction and process. I applaud his skill as a surgeon and as someone who deals with a huge range of drastically different people. I asked him more questions about what happened during the actual operation itself and he said that he was sincere about what he did and completed everything to plan. He used some of my excess septum to prop-up the end of my nose and give it stability which I found interesting and cool. In terms of a client, I would probably be a fussy / more critical client, but it didn’t phase him. Dr JdS team were also a happy helpful bunch, so theres no complaint at all on that front. I was very happy with him and the whole team. Thanks for looking after me.

Immediate Reaction

Given the amount of work done on my nose, I am happy that above all, it still looks natural. The aim of the operation as stated is to remove the slight hump and address the heavy tip, both of which have been immediately met, even despite the swelling. I am thankful for Dr JdS to have artfully delivered on those 2 problem areas. My slight hump has been shaved and the tip looks more defined, they are ultimately subtle changes and I’m just very glad that my nose doesn’t look pinched or like Michael Jackson with a pig-like nose. My partner was relieved when the cast eventually came off as he was concerned that I would look very different but he said that it looks like I haven’t had major surgery at all. The minor bruising on my face is now faint and will vanish in a week and if I take things easy for a month, everything should heal as normal. Also the profile shape of my nose looks better in relation to the rest of my face, especially as I have a tiny chin. So there is a level of harmony with my face that was achieved.

Looking closer I can see that there is some slight irritation where the hump was shaved and it looks sore and inflamed but hopefully the swelling should bring it down. I still feel that the overall width of my bridge is on the larger side for the average nose, I know that some of this was due to the fact that shaving a hump may slightly blunt the bridge making it appear wider on the top surface, but I’m hoping that Dr JdS brought-in both sides of the nose to counteract that effect!

Also, I can’t really tell if the base of my bridge has been brought-in. During the consultations Dr JdS said that he would give a very slight curve to the nose to make it appear more feminine, but I can’t see this, yet. I feel in order to have a balanced nose and the best possible result, the bridge should be smaller and hence more feminine. So in summary, I am hoping after the swelling has gone down over the weeks, I will be able to see the improvements that his work brought to my nose. I would hope that the width of the bridge at both the top and bottom should eventually settle and narrow! As there’s no point doing open rhinoplasty if all I got was a slight hump reduction.

Overall, I am pleased that everything is in order, there were no major complications and that the first impression looks normal, apart from the width of my bridge. These are the signs of a professional surgeon that cares for the technical function of the nose. There is still a few things that need to improve and significant swelling needs to go down, which I am hoping will occur over the next few weeks, so I can’t make a call on the final result just yet. So the signs for the cosmetic skill of Dr JdS have yet to be revealed which I am praying they do appear! This is especially important as my case was ethnic rhinoplasty which is usually more complicated, so his skill was tested. I want to feel happy and ecstatic by the results.

Day 1 Post-cast

I still felt drowsy from the co-codamol pills I took the day before. I wanted to have a light breakfast in case I felt nauseous, but I did feel better after I had tea. I am not going to concentrate on the shape and look of my nose at this point in time as it’s too early to tell, and instead focus thought and energy on continued healing, being more mindful of how to take care of my face and being positive.

Unfortunately, I can still feel a mild echo of pain on the side of my nose where Dr JdS was pushing hard on my nose to remove the cast, which is upsetting as I know my nose is now trying to recover from that experience! I just wish he didn’t do that, it was so unnecessary! And now I am concerned that one side of my nose will be more indented than the other. I felt it’s unfair I had to go through that. Really not the kind of feeling you want to be having at this stage…

My partner told me to focus on more of the positives throughout the past week and I think it certainly helped on many levels. I would urge you to do the same as the worst is over and now the priority should be on healing and returning to normal life.

I think at this point my close friends or family may know the difference because of faint signs of under-eye bruising and the discolouration / condition of my skin around my nose. But I think with makeup and perhaps a hair-cut people may not be able to immediately tell what happened. I don’t think I will be wearing makeup for at least a week given the tenderness my nose has to any pressure, using makeup wipes or water would just be too much at this stage. I now have the brand of rhinoplasty on my columella, which is the chevron stitch line between my nostrils, its sore and noticeable now, but I’m hoping that also begins to fade soon. That mark will always remind me of Dr JdS’s work and how I went to great lengths to achieve harmony.

Day 2 Post-cast

I know that it is still way too early to tell what the results are going to be, but as I mentioned before I am getting nervous about the width of my nose. The swelling I would say is severe, and if it doesn’t go down I would say that nothing was really achieved in terms of the width of my nose, only the slight hump reduction. I am hoping I can eventually move on in life passed my nose. It is something I felt that has dragged me back for a long time and now that I have made great efforts to reduce it, I am hoping it will comply!

In a way I do feel like I accomplished something in this process, and Im glad I did act on my gut instinct to have this procedure, as its given me the capacity to embrace the face I was given. I had such hate for my face, but now I feel like celebrating its quirkiness and uniqueness, and if other people don’t find me pretty, that’s their problem and a reflection of them, not me. I do feel jealous at this point of other girls who don’t need to go through this much effort to feel normal in their own skin, who have had a life not bound by insecurities and so can focus on enjoying instead of worrying. Even as an academic, logical or practical person, I do feel I have missed out on enjoying more of life. Proving that I don’t have to feel mentally trapped by my appearance or how it used to drag me down, should soon be a relief.

Some bitchy girls I knew and twisted guys at university said that I had a big funny nose. It ultimately wasn’t huge, but it certainly was an imperfection about me that they would capitalise on to purposefully hurt me. So I guess over the years it took its toll and I’m glad that I can soon be free of those chains. While my nose still may be bigger than theirs, the main problem areas are now gone. There will be days where there will be more swelling and tenderness, recovery takes a while, and exercise may impact my nose shape, but over the weeks Im praying it should settle. Of course I suspect I will also get used to the new look and it will slowly be the ‘new normal’ so I wouldn’t be able to imagine my face without Dr JdS help. I think the crucial thing now is to make all the effort I went through worth it by building confidence, and being more present in this world.

4 Weeks Post Surgery

Apologies for the delay in getting back to questions I am back at work and my far-east / asian clients are hard work! Its now been a month since surgery. I will first talk about the function of my nose and secondly the look:

In terms of function, everything seems ok, I am breathing normally through it. I would just say that it is now harder to clean my nose than it was before the operation. Because of the swelling, any slight blockages cause my nose to make a 'dragging' sound as if I am breathing deeply - when I am not really. I am assuming some of the tissue is still inflammed which is why blockages appear to be stuck more deeply inside. When I was in London, I noticed the cold air hurt the tip of my nose a little, gave it an ache-type pain, this is probably because there is more grafting inside the tip now, whereas before it was just skin. Strangely, my top lip still gets unusually very dry and chapped, almost asif its not getting the right blood flow and the skin keeps on drying up / dying. I dont want to have thin shriveled lips as a side-effect of this surgery!

In terms of the look, so far I am not convinced to be perfectly honest. I feel at this stage 'ethnic' rhinoplasty is just an excuse to pay more. Ultimately everyones nose is different so Im not too sure why 'ethnic' people have to pay more to achieve similar goals... For example my south korean and some singaporean friends who have had rhinoplastys say their surgeons do 'white' rhinoplasty that costs more. At this point in time I am seriously doubting the amount I paid for open surgery unfortunately.

I came to London for surgery as I grew up here and I thought more Indian girls would have done operations here. But now I feel I should have gone to Dubai where middle eastern features are more closely aligned to Indian features in general. I also know in 5 years time the costs will be lower as more surgeons will be around and better techniques will be developed, so I feel a little short changed. At this point in time, the changes made so far could all have been achieved via closed surgery!

I look at my nose and compare it to some other girls, not celebrities, other indian girls, and they have dramatically smaller nasal footprints, size and projection. I feel all that Dr JdS has given me is to slightly shave my small hump. NO ONE at work has commented on my nose, ie NO ONE thinks anything has changed to my nose! That fact alone is shocking. Only my manager and my immediate family know I had an op. This means not only did people not notice the slight hump in the first place, the overall size / width and shape of my nose has not been changed AT ALL! Secretly, I was hoping someone would make a comment like 'is there something different about your face?' because that would mean there has been some change, but its still natural looking enough to confuse other people.

Logically, I dont understand how someone can open up your face for 3 hours and just shave off 3mm2 of excess bone from the bridge. I myself have a demanding job and I deliver my best to my clients, so in the same way, I had high expectations of Dr JdS. Its a shame I feel this way now, I wanted to feel like a had a refreshed look, not another tiny variation of the same. I recently had to get a visa photograph at a photobooth in a shopping centre and I have never felt like such a dunce in all my life - After spending hard earned money I realised my nose is now double the size it was in my passport!!! At this point in time I am thinking if Dr JdS did this on purpose so that I am forced to undergo revision? I specifically asked for a smaller / narrower nose, but the width has clearly not changed! All I wanted was a feminine nose and now I am back to square one.

In terms of preparation and communication before surgery I feel I was clear. I gave a photoshoped image of what I was aiming for and sent it to Dr JdS. But he said that 'people arent made of clay'. Agreed, but why isnt more meaningful change available to ethnic people? - Why do other people have a fully functioning nose that is literally half the size of mine? I just wanted to feel balanced and pretty with a feminine nose. Not asking to be super-model beautiful, just balanced and pretty. It appears I have been denied this despite my hard efforts.

Glass Half Full? - A Lesson in Psychology

So I went in to see Dr JdS 6 weeks after the surgery. I had so many questions, it was hard to figure out what to say and how to say it. I wanted my conversation to be structured and productive so I wrote down my questions beforehand and memorised them - from this fact alone you can tell how much I care about specifics and detail… It is important not to be so naïve when it comes to life-changing operations such as rhinoplasty…
We discussed process and healing and he said he was happy about the progress so far. He said he read my blog on realself and now is more aware of the cast removal process. He said he asks his clients before and after he removes the cast and if it hurts, as it did with me (see my posts above). I found this encouraging as it shows he takes patients review on board. I am glad to see my detailed account has been illuminating to other readers as well as Dr JdS himself!
I asked him “Do you think my nose looks like it has been improved? Ie If I had to start this whole process again from scratch, would you think I still qualify for rhinoplasty to feminise my nose?” - His reply was not great: ‘Look I am happy if you are happy’…. This is not what I wanted to hear. He knows I am all about measurable details, I wanted something more substantial in his reply. If subjective ‘happiness’ is a measure of how well you do your work, I’m afraid that is not enough for someone paying a lot of their own hard earned money and trusts you for your skill.
Finally he then injected me with steroid in an attempt to calm the swelling down. I asked him this time what was in the injection exactly, he gave a quick one sentence reply. I’m not sure if I can sense some secrecy in the contents of the injection? I know other users have had bad experiences on this site immediately following the injection… I think it would be more professional to show clients the exact liquids and dosages before injecting?
Exactly as he described to me before injecting - my nose indeed felt swollen and immediately looked pink. I did not mind this as I had been through the same process after the actual operation and the effects would last just over a day or so. Luckily it was going to be Easter soon, so I had a few days for the swelling to go down.
We had a long discussion about the differing results of patients, people, healing, ethnicity etc. Interestingly he said “some people view the world with the glass half empty, others view it with the glass half full – I feel you fall in the first category but you should know that your state of happiness does effect the healing process” This was not something I expected him to say. I found it a little patronising. I AM OFCOURSE HAPPY THAT YOU DID NOT BOTCH UP MY NOSE, thank you very much lol... As I have explained many times above – the function of my nose is in-tact. The aesthetic requirements have not been met.
He is also right to say that “perfection cannot be attained, only an improvement” - Yes I agree. I never aspired to have Adriana Grande’s button nose… I just wanted to make my nose smaller and straighter! Why am I having to explain this many times!?! As I mentioned above – my sister has a very petite nose, one that blends with harmony on her face. Yet mine STILL looks like it has been bolted-on from someone else as the footprint is still large. Hence, this is not a true ‘improvement’. I am frustrated that the images I had prepared for Dr JdS were not taken into account.
Ultimately I feel sorry to say this, but, I feel Dr JdS has had too many clients who are ‘happy-go-lucky’ about doing plastic surgery… Young girls who only need very slight tweaks here and there and come out content because the fix was small and easy. I am not medically trained. I do not have any idea about the complexities of noses. I am sure it must be crazy difficult beyond justification. But surely, just from a logical point of view, if you can’t see or feel and meaningful natural / professional looking change after a long procedure, what exactly did you pay for then?

3 Months On - Disappointed

Hi All, its been just over 3 months now since the operation. I have read many plastic surgery websites and I have compiled their suggestions: It is at this point that you should be able to see most (75-80%) of the final look. Any other improvements may be due to slight reduction of nose swelling over the course of the next 12 months.
I have to say, Dr JdS you have let me down. I really did believe in your approach and style, I did my research, I explained everything I could, I asked the right questions. But finally, after patiently waiting and hoping. I feel you pay more attention to your sedation technique rather than addressing the needs of ethnic patients. I know you may think you know whats best, and perhaps dont believe ethnic patients could carry off smaller noses, but tbh, you were asked to provide a service and to the best of your ability; you should have delivered on it.
I initially was excited about looking forward to meeting my new nose, my posts above of optimism was unfortunately very short lived. It was all wishful thinking. Its so sad to see my situation versus others on this site. I have come to realise you have eroded my belief in myself and my confidence is perhaps lower than it was before I started this process as I am £8k poorer. I feel betrayed.
I feel there are very many surgeons like you in the industry and UK. Surgeons who know the anatomy of a nose, but may not appreciate the subtitles of improving appearance with harmony, and that people have different preferences. Surgeons hide behind the 'natural' label to charge high prices for minimal work? I feel in my review above I have been fair in pointing out strengths and weaknesses throughout the process, but ultimately the product did not deliver.
Of course, you can choose to ignore this review but I feel people should know what they are in for. It is only fair to the consumer. Writing these open honest and detailed accounts does not help me. It only helps other people. Sadly this account wont fix the outcome of my nose. But having gone through this process. I am considering getting my money back. If you bought an apple for £1 and was given a half eaten one, would you be happy?

Trust Your Instincts!

From my post on the 12th of February titled 'Immediate Reaction' I said the following:

"So in summary, I am hoping after the swelling has gone down over the weeks, I will be able to see the improvements that his work brought to my nose. I would hope that the width of the bridge at both the top and bottom should eventually settle and narrow! As there’s no point doing open rhinoplasty if all I got was a slight hump reduction."

And based on my more recent posts, it appears that the following weeks DID NOT show a change in the top and bottom of my bridge. My gut reaction was right! All I got was a slight hump reduction. I initally wrote my concerns down so that I was able to go back to it and confirm whether or my concerns were out of place - but they sadly were not. My instincts were right.
As it was my first cosmetic procedure I was too distracted by all the swelling in my face to accept the fact earlier in my recovery that all I basically got was a minor hump reduction.
Dr JdS did you not read my file notes? Do you just blindly walk into your client operations! No one outside my immediate family know I even got a rhinoplasty!?!? You shaved off millimeters off the hump only, is that called 'balance' to you? Why did you do an open surgery in that case?
If you could not apply certain techniques as a surgeon, you should not coax patients in and do what you want to them in theatre! If you couldnt be bothered to attempt to slim the width of my nose I want my money back!
For all those with ethnic backgrounds out there who are considering Dr JdS, please read my detailed account above. This is not right or fair! There are other girls on this site with an ethnic background that have similar issues, I am not an unusual case it seems...
ALL I WANTED WAS A NORMAL NOSE! I did not ask you to emulate someone elses nose, I just wanted a slimmer, refined nose. Why was that so hard for you to understand? I feel so let down by the whole system. There is no protection for patients it seems. This industry is so hit and miss. Even someone as methodical as me has suffered the negative effects of dismissive surgeons who dont realise how much this means to clients.

Ethnic Rhinoplasty Needs 18m...?

It has been 7 months since my surgery. Every time I visit JdS he extends the timeline to see the final results. The elusive 'steroid injections' do not work. I feel they are just a placebo, especially as JdS himself said he doesnt want to use them too much (but he did not offer any further explanation as to why he wanted to limit the injections) I suppose he doesnt want to waste his resources on me as Im not worthy enough, also my nose is clearly a lost cause so whats the point, ey!?


I had an open-rhinoplasty procedure. This type of procedure is used for 2 reasons:

1) If you are just shaving the hump and not dramatically altering any other dimensions.

2) If you dont know what you are doing or have never dont ethnic rhinoplasty before.

There is literally NO DIFFERENCE to my front view which was ALWAYS F'ING LARGE!

This is so unfair and I am running out of patience.

Here is a warning to all the other South Asians out there:

London Facial Plastic Surgeon

At Consultation = Very calm and collected, took a look at my nose and suggested ways to improve my look for 'natural balance'. At Pre-op = Gave me time to think and ask more questions, always asked me if I had any more questions, was interested in my thoughts. Post op results = Not at all satisfactory! His techniques DID NOT deliver results for me.

2 out of 5 stars Overall rating
3 out of 5 stars Doctor's bedside manner
3 out of 5 stars Answered my questions
2 out of 5 stars After care follow-up
2 out of 5 stars Time spent with me
2 out of 5 stars Phone or email responsiveness
4 out of 5 stars Staff professionalism & courtesy
1 out of 5 stars Payment process
3 out of 5 stars Wait times
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