Concierge ENT rhinology · London
Private nasal polypectomy and FESS in London, by a consultant rhinologist.
Definitive treatment for symptomatic chronic rhinosinusitis with nasal polyps - but only after medical therapy and, where appropriate, biologics have had their turn. Delivered by a named rhinologist, in a proper theatre, with image-guided navigation where needed.
Why patients choose us
- 01
A consultant rhinologist, in theatre
Not a generalist and not a training list. A named ENT rhinologist, a proper theatre with image-guided navigation when needed, and controlled hypotensive anaesthesia to keep the field clean.
- 02
Medical therapy optimised first
For many people intranasal steroids, saline rinses, a short oral prednisolone course or a biologic (dupilumab, mepolizumab) do the job. We say so before you commit to surgery.
- 03
Independent, and free
We are paid by no clinic, so the recommendation is impartial and costs you nothing.
Indicative pricing
What private nasal polypectomy and FESS costs in London.
Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.
In short
Comprehensive FESS + polypectomy in our network: £5,000–£9,000, home same day or overnight.
| Procedure | Indicative range | Typical duration | Recovery |
|---|---|---|---|
| Isolated endoscopic polypectomy | £3,000–£6,000 | 60–90 min | Day-case |
| Polypectomy + FESS (comprehensive) | £5,000–£9,000 | 90–180 min | Day-case / overnight |
| Revision FESS + polypectomy | £6,000–£10,000 | 2–3 hours | Overnight |
| CT sinuses (Lund-Mackay planning) | £350–£600 | 15 min | Same-day report |
| Rhinologist consultation + endoscopy | £300–£500 | 45 min | Same visit |
| Biologic therapy assessment | £350–£600 | 45 min | Same visit |
Prices vary by clinic, by which rhinologist does the case, by whether image-guided navigation is used, and by whether the frontal recess and sphenoid are opened alongside polypectomy. We come back with a firm quote within one working day.
The problem
The right rhinologist, the right medical therapy, the right operation.
Nasal polyps are one of the areas of ENT where practice has moved fastest - with biologics rewriting what surgery has to do. We make sure medical therapy is fully optimised before booking a theatre.
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Have you finished medical therapy?
Intranasal steroid drops plus a short oral prednisolone course change what surgery even needs to do - we make sure it has been tried properly.
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Could a biologic replace surgery?
For severe eosinophilic CRSwNP, dupilumab or mepolizumab may be a better answer than another operation. We put both on the table.
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Want it done properly if we operate?
A named consultant rhinologist, image-guided navigation for revision cases, and a dedicated anaesthetist - not a general ENT list.
The journey
From enquiry to recovery - what happens, in order.
One rhinologist from first message through medical optimisation to endoscopic follow-up.
Phase 1 · Before your procedure
Concierge, off-stage for you
Phase 2 · On the day
A few hours at the clinic
Phase 3 · After
Concierge, back on
- 01
Before
You tell us what is going on
A short, confidential form. Nasal blockage, loss of smell, facial pressure, snoring, asthma or aspirin sensitivity - and what has already been tried.
- 02
Before
We come back with a recommendation
Within one working day: the right rhinologist, whether CT sinuses is needed, whether medical therapy still has room to run, and an indicative price for surgery if that is the step.
- 03
Before
We arrange the appointment
Usually within one to three weeks. Any blood-thinning medication is reviewed with the team and you are told exactly how to prepare, including the pre-op steroid course.
- 04
On the day
Arrival at the clinic
Arrival, consent and a chat with the rhinologist and anaesthetist. Almost always under GA with controlled hypotensive anaesthesia to reduce bleeding.
- 05
On the day
The procedure itself
60 to 180 minutes in a proper theatre. Endoscopic polypectomy with microdebrider, plus FESS if the sinuses are involved. Dissolvable packing where possible.
- 06
On the day
Home the same day or overnight
A short recovery on the ward. Day-case for isolated polypectomy; overnight is more usual for a full FESS. Someone will need to collect you.
- 07
After
Recovery and endoscopic review
Saline irrigation from day one to three. Back to office work in five to ten days. Endoscopic follow-up at 2, 6 and 12 weeks - and lifelong intranasal steroid to hold recurrence back.
Typical end-to-end: 2–4 weeks from enquiry to procedure. Endoscopic review out to 12 weeks.
When it helps
When polypectomy is the right step.
The presentations we see most, plus the red flag that means an urgent two-week-wait ENT referral, not a routine appointment.
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Chronic nasal blockage
A blocked nose that does not clear with sprays, worse over months to years, often bilateral.
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Loss of smell (anosmia)
Reduced or absent smell - often the most bothersome symptom. Complete anosmia is common with extensive polyps.
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Facial pressure and post-nasal drip
A dull ache across the cheeks or forehead, catarrh at the back of the throat, snoring and disturbed sleep.
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Asthma or AERD (Samter’s triad)
Adult-onset asthma, nasal polyps and aspirin sensitivity together - an eosinophilic pattern that responds well to biologics.
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Recurrent polyps after surgery
Symptoms creeping back despite intranasal steroids after previous FESS - biologic therapy or revision surgery may be the next step.
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Allergic fungal rhinosinusitis
Thick eosinophilic mucin, polyps and characteristic CT findings - needs surgery plus prolonged medical therapy.
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Cystic fibrosis or PCD
Polyps as part of underlying ciliary or CF disease - managed jointly with the respiratory team.
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Red flag: unilateral polyp or bleeding
A one-sided polyp, bleeding or a mass in a child needs urgent ENT assessment - a two-week-wait referral, not a routine appointment.
Treatment options
Surgery is not the only option.
What each option on the table actually involves - from steroid sprays and biologics through to a full-house FESS.
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Intranasal corticosteroid + rinses
Mometasone or fluticasone spray plus large-volume saline irrigation (NeilMed). First-line for every case - and continued for life afterwards.
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Oral prednisolone course
A short reducing course (30 mg for 5–7 days) that shrinks polyps and buys weeks to months of symptom relief. Not a long-term answer.
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Biologic therapy (dupilumab, mepolizumab)
NICE-approved for severe eosinophilic CRSwNP failing surgery or steroids. Transformative for recurrent disease - specialist prescribing only.
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Aspirin desensitisation
For AERD / Samter’s triad - a specialist respiratory programme that improves polyp control alongside standard therapy.
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Isolated endoscopic polypectomy
Microdebrider removal of visible polyps under GA. Quick, day-case, and useful when the sinuses themselves are relatively clear.
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FESS + polypectomy
Functional Endoscopic Sinus Surgery - maxillary antrostomy, ethmoidectomy, sphenoidotomy and frontal recess opened alongside polyp removal. The standard for extensive CRSwNP.
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Extended “full-house” FESS (reboot)
A more aggressive Bachert-style dissection for severe recurrent disease - designed to reduce recurrence and let topical steroids reach every sinus.
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Consultation only
An honest discussion of whether surgery is needed at all, and which option fits - no obligation.
Our vetted London network
A small panel of rhinologists, we picked them.
Consultant ENT rhinologists across central, north, west and south London. Not listed publicly - introductions are made privately, once we understand your case.
Selection criteria
How we choose every rhinologist in our network.
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Consultant ENT rhinologists with a dedicated CRSwNP practice, not general ENT lists
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Image-guided navigation available for revision and complex frontal or skull-base cases
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Controlled hypotensive anaesthesia by a rhinology-experienced anaesthetist
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Biologic-therapy pathways (dupilumab, mepolizumab, omalizumab) offered before revision surgery where appropriate
Safety and recovery
What to expect afterwards - honestly.
Symptomatic improvement at three to six months is 80–90%. Recurrence, though, is common - which is why lifelong intranasal steroid and endoscopic follow-up matter as much as the operation itself.
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Bleeding is the commonest issue
Some ooze for a few days is expected. Significant bleeding is uncommon and controlled with packing; embolisation is rarely needed.
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CSF leak (0.1–1%)
A breach of the anterior skull base is rare but recognised. When it happens it is usually spotted at the time and repaired endoscopically in the same operation.
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Orbital injury is rare
The paper-thin lamina papyracea sits next to the ethmoids. Bruising or a subconjunctival haemorrhage settles; diplopia and visual loss are very rare.
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Smell recovery is variable
Many people regain smell, some partially, some not at all. We are honest about this before surgery - anatomical clearance does not guarantee olfactory return.
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Saline rinses from day one
Large-volume saline irrigation starts on day one to three and continues for weeks. It is the single most important thing you do after surgery.
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No nose-blowing for one to two weeks
A gentle sniff is fine. Forceful nose-blowing risks bleeding, subcutaneous emphysema and disrupted healing.
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Recurrence is common
Thirty to fifty per cent of patients need revision surgery within five to ten years. Lifelong intranasal steroid and - for eosinophilic disease - biologic therapy hold this back.
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Adhesions and altered taste
Scarring between the septum and turbinate can need a quick release in clinic. Altered taste is common early on and usually settles.
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Red flags after surgery
Clear watery discharge from one nostril, a stiff neck with fever, visual change or heavy bleeding are all reasons to call the team or A&E the same day.
Reading your operation note
Your operation note in four parts. Read the last one first.
Whichever technique was used, the note the rhinologist sends you keeps to the same shape.
A quiet reminder
Surgical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the note before your review, just ask.
- 01 Header
Indication, Lund-Mackay and SNOT-22
Why the procedure was done - CRSwNP, AFRS, AERD - with your pre-op CT Lund-Mackay score and SNOT-22 symptom score for comparison later.
- 02 Technique
Sinuses opened and instruments used
Which sinuses were cleared (maxillary, ethmoid, sphenoid, frontal), whether a microdebrider or cold-steel was used, and whether image-guided navigation was on.
- 03 Findings
Polyp burden, mucin and histology
How much polyp tissue was removed, whether eosinophilic mucin or fungal debris was seen, and what the histology showed on the sent specimens.
- 04 Impression
Post-op regime, follow-up, biologic plan
Read this first: the saline and steroid regime, endoscopic follow-up dates, and whether a biologic is being started or considered.
Recognised by major UK insurers
Nasal polypectomy for symptomatic CRSwNP is usually a covered benefit on major UK insurance policies. Biologics like dupilumab are increasingly covered where NICE criteria are met. We confirm cover before booking.
Frequently asked
Everything we get asked about nasal polypectomy.
Quick answers on smell, cost, biologic therapy, and how much time off work you actually need.
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Do I have to have surgery for nasal polyps?
No - not straight away. Guidance from ENT-UK and EPOS 2020 puts intranasal steroids, saline rinses and a short course of oral prednisolone first. Surgery is for people whose symptoms persist despite proper medical therapy, or whose polyps are structurally obstructing.
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Will my sense of smell come back?
Often, but not always. Many people regain smell in the weeks after surgery, some only partially, and a minority stay anosmic despite good anatomical clearance. We are honest about this before you commit to an operation.
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What is FESS, and why is it done at the same time?
FESS stands for Functional Endoscopic Sinus Surgery - opening the maxillary, ethmoid, sphenoid and frontal sinuses so that topical steroids can actually reach them. For extensive CRSwNP, combined polypectomy plus FESS gives better results than polypectomy alone.
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How much does a private nasal polypectomy cost in London?
Roughly £3,000–£6,000 for an isolated endoscopic polypectomy, and £5,000–£9,000 for comprehensive FESS plus polypectomy. Revision surgery sits at £6,000–£10,000. We confirm a firm figure within one working day.
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What is biologic therapy, and could it work for me?
Biologics like dupilumab (NICE TA828) and mepolizumab (NICE TA1004) are monoclonal antibodies for severe eosinophilic CRSwNP that keeps coming back despite surgery and steroids. They can transform smell, blockage and quality of life - and they are the reason we now offer more people an alternative to repeated surgery.
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How long is recovery after nasal polypectomy?
Most people are back at a desk job in five to ten days. Strenuous exercise waits two to four weeks, and forceful nose-blowing is off the table for one to two weeks. Endoscopic follow-up happens at 2, 6 and 12 weeks.
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How likely are the polyps to come back?
Recurrence is common - thirty to fifty per cent of patients need revision surgery within five to ten years. Lifelong intranasal steroid, saline rinses and, where indicated, biologic therapy make a real difference to that number.
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I have asthma and aspirin sensitivity - does that change things?
Yes. That triad (AERD or Samter’s) points to eosinophilic disease that responds particularly well to biologic therapy and, in specialist centres, aspirin desensitisation alongside surgery. We match you to a rhinologist who works with respiratory colleagues.
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Is nasal polypectomy dangerous?
It is a safe operation in experienced hands. The recognised complications - significant bleeding, CSF leak (0.1–1%), orbital injury - are uncommon, and image-guided navigation reduces the risk further in revision or complex cases.
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When should I seek urgent help?
A one-sided polyp, nose bleeds, a mass in a child, or - after surgery - clear watery discharge from one nostril, a stiff neck with fever, visual change or heavy bleeding all need same-day medical assessment.
Related treatments
Looking for something else?
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Nasal blockage surgery
Septoplasty and turbinate reduction for a blocked nose.
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Nasal septum surgery
Septoplasty for a deviated septum causing obstruction.
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Celon ENT (minimally invasive)
Radiofrequency turbinate and soft-palate options.
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All tests and procedures
Every test and procedure we arrange.
Learn more