Reconstructive rhinoplasty · UK
Reconstructive septorhinoplasty - rebuilding the framework after collapse.
A reconstructive operation for saddle-nose deformity, collapsed dorsum, revision rhinoplasty, cocaine-induced septal loss and post-traumatic devastation - using autologous cartilage (septum, ear, rib) or, in selected cases, alloplastic implants to rebuild the nasal framework.
Why patients choose us
- 01
Revision-only rhinoplasty surgeons
A named facial plastic surgeon whose list is revision and reconstructive work - not primary aesthetic rhinoplasty with occasional revisions.
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Autologous cartilage as the default
Your own rib and ear as first choice. Implants only where the aesthetic case makes sense and the risks are fully discussed.
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Disease and lifestyle honesty
Cocaine abstinence, autoimmune disease control, chest wall fitness - all mapped before consent, not after.
Indicative pricing
What private Septorhinoplasty with Graft or Implant costs in the UK.
Ranges across our reconstructive rhinoplasty network. This is not a cosmetic operation; complexity and graft choice drive the top of the range.
In short
Reconstructive septorhinoplasty with rib graft: £12,000–£18,000, home in 1–2 nights.
| Procedure | Indicative range | Typical duration | Stay / turnaround |
|---|---|---|---|
| Reconstructive consultation with photography | £300–£550 | 60 min | Same visit |
| CT sinuses + CT rib mapping | £500–£850 | 20 min | Report in 5 days |
| Revision septorhinoplasty (ear cartilage) | £11,000–£16,000 | 3–4 hours | 1 night |
| Reconstructive septorhinoplasty (rib graft) | £12,000–£18,000 | 3.5–5 hours | 1–2 nights |
| Saddle-nose reconstruction (rib + DCF) | £14,000–£22,000 | 4–5 hours | 1–2 nights |
| Alloplastic implant rhinoplasty (silicone or ePTFE) | £9,500–£14,000 | 2–3 hours | Day-case or 1 night |
| Second-stage revision | £8,500–£14,000 | 2–3 hours | Day-case or 1 night |
Prices vary by hospital, by consultant, and by the complexity of your case. We come back with a firm quote within one working day.
The problem
When the framework is gone, only reconstruction restores the nose.
Reconstructive rhinoplasty is a different operation from a primary septorhinoplasty. The stakes are higher, the anatomy is scarred, and the timeline is longer. It deserves a different surgeon and a different conversation.
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Autologous cartilage is the gold standard
Rib and ear cartilage integrates, resists infection and remodels over decades. Implants have a place, but the default is your own tissue.
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Cocaine and GPA change the plan
Ongoing cocaine use or active granulomatosis with polyangiitis makes reconstruction fail. We document abstinence and disease control before consent.
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A two-year endpoint, honestly
Structural reconstruction takes 18–24 months to settle. We plan the reviews, and the possible revision, from the start.
The journey
From enquiry to recovery - what happens, in order.
One team from first message through follow-up.
Phase 1 · Before
Assessment, imaging and planning
Phase 2 · On the day
Procedure and recovery
Phase 3 · After
Results, follow-up and review
- 01
Before
You tell us the whole story
A confidential form covering prior surgery, disease history, medications, cocaine history if relevant, and current concerns.
- 02
Before
We come back with a plan
Within one to two working days: which surgeon, which graft, whether preconditions (abstinence, disease control) need addressing first, and an indicative price.
- 03
Before
Reconstructive consultation and imaging
Full facial analysis, endoscopy, CT sinuses and CT rib. Autoimmune and infection screen where indicated.
- 04
Before
Preconditions and multidisciplinary review
Documented cocaine abstinence, rheumatology clearance for GPA, or wound optimisation for post-traumatic cases.
- 05
On the day
Admission and surgery
Same-day admission, GA, 3–5 hours in theatre. Graft harvest and inset, dorsal reconstruction, airway grafts, splint and tapes.
- 06
On the day
Overnight stay
One or two nights for chest wall analgesia and safe recovery.
- 07
After
Reviews out to two years
1 week, 6 weeks, 3, 6, 12 and 24 months. Any planned revision window sits at 12–18 months.
Typical end-to-end: 8–12 weeks from consultation to surgery. Aesthetic endpoint: 18–24 months.
When it helps
When Septorhinoplasty with Graft or Implant is the right step.
The situations where reconstruction with grafts or implants is the right route, and the flags that mean postponement.
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Saddle-nose deformity
A collapsed dorsum from cocaine, autoimmune disease, trauma or over-resection at prior surgery - rebuilt with rib or ear cartilage.
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Revision rhinoplasty
Persistent airway or aesthetic failure after primary rhinoplasty - usually needs structural grafting and often rib.
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Cocaine-induced framework collapse
After documented abstinence of six months or more - reconstruction with autologous cartilage is the reliable route.
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Granulomatosis with polyangiitis
Under joint rheumatology care with disease inactive on treatment. Reconstruction planned with the ANCA vasculitis team.
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Post-traumatic devastation
Comminuted nasal, ethmoid and septal fracture with framework loss - reconstruction after early management of soft tissues.
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Congenital framework deficiency
Bilateral cleft-lip nasal deformity, hemifacial microsomia or vascular malformations - reconstructive expertise in a facial plastic centre.
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Ethnic augmentation with implants
Selected non-Caucasian aesthetics where alloplastic implants (silicone dorsal, expanded PTFE) are appropriate - done sparingly and with full consent about revision risk.
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Red flag: active cocaine use or uncontrolled autoimmune disease
Reconstruction fails without abstinence and disease control. Not a scheduling problem - a prerequisite.
Graft material options
Every reconstructive case is a graft choice - where the material comes from and where it goes.
What each option involves, and when we recommend it.
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Septal cartilage grafts
Where residual septum is available, small grafts are the first choice. Not often possible in reconstructive cases - the septum is usually the problem.
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Conchal (ear) cartilage
Harvested through a retroauricular incision. Curved and thin - best for alar battens, tip grafts and small dorsal augmentation. Minimal donor site morbidity.
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Costal (rib) cartilage
The workhorse of reconstruction. Straight, strong, plentiful. Harvested through a 3–5 cm chest incision. Chest wall pain for 2–4 weeks; small pneumothorax risk under 1 percent.
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Rib cartilage with PDS foil
A biodegradable polydioxanone plate wraps or supports carved rib grafts to reduce warping in the first year - dissolves at 12 months.
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Diced cartilage in fascia (DCF)
Diced cartilage wrapped in temporalis fascia - a smooth, malleable dorsal augmentation. A widely used technique for saddle-nose reconstruction.
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Alloplastic implants - silicone
Off-the-shelf silicone dorsal implants - commonly used in East Asian aesthetics, less commonly in reconstructive UK practice. Higher long-term extrusion risk than autologous cartilage.
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Alloplastic implants - expanded PTFE / Gore-Tex
A porous polymer that allows tissue in-growth. Softer than silicone, lower extrusion risk but higher infection risk. Used selectively.
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Cadaveric (irradiated homograft) rib
When patient-derived rib is not available or refused. Higher resorption rates than fresh autologous cartilage but avoids a donor site.
Our vetted UK network
A small panel of specialists, we picked them.
Consultants across London and the major UK cities. Introductions are made privately, once we understand your case.
Selection criteria
How we choose every specialist in our network.
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Revision and reconstructive rhinoplasty surgeons only - not primary-only lists
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Access to costal cartilage harvest with a chest-experienced partner or plastic-surgery co-surgeon
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Joint pathways with rheumatology for GPA and other ANCA-vasculitis patients
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Independent counselling for cocaine-related reconstruction with documented abstinence
Safety and recovery
What to expect afterwards - honestly.
Reconstructive septorhinoplasty is not a primary case with more grafts. It is a different operation, with a different consent conversation and a longer endpoint. We say so before booking.
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GA and multi-site surgery
General anaesthetic, 3–5 hours in theatre for a reconstruction. Two sites (nose plus rib or ear) mean a slightly longer recovery than a primary case.
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Chest wall pain after rib harvest
Pain and stiffness at the donor site for 2–4 weeks. A small scar. Pneumothorax risk under 1 percent - recognised and repaired at the time.
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Graft warping and displacement
A small proportion of rib grafts warp in the first year. Modern technique (balanced cross-section carving, PDS foil support) reduces the risk.
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Graft resorption
Rib and ear cartilage resorb minimally. Cadaveric rib resorbs more. Implants do not resorb but can extrude - a specific risk of alloplastic material.
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Implant infection and extrusion
Silicone: extrusion around 3–5 percent long-term. ePTFE: infection risk higher than silicone but lower extrusion. Autologous cartilage does not have these risks.
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Airway issues
Reconstructive airway work protects the airway with spreader grafts, alar battens and lateral crural grafts - the goal is the airway not being worse than before.
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Longer aesthetic endpoint
Swelling in reconstructive cases takes 18–24 months to settle. The final result cannot be judged before then.
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Revision rate is higher than primary
Revision after a reconstructive case runs 15–25 percent - the honest number. Most are small refinements rather than repeat structural work.
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Red flags after surgery
Chest pain with breathlessness (pneumothorax), spreading redness, extrusion of an implant, unexpected asymmetry - same-day surgical team or A&E.
Reading your report
Your reconstructive note in four parts. Read the last one first.
Reconstructive notes carry more information than a primary rhinoplasty note - every graft site, orientation and fixation is recorded for the surgeon who might revise you in the future.
A quiet reminder
Medical language is precise and can read coldly - we translate it for you.
If you would like us to talk you through the report before your review, just ask.
- 01 Header
Indication, prior surgery and disease context
Why the reconstruction was done, what previous operations exist, and any autoimmune or substance-use context that must remain stable for the graft to survive.
- 02 Technique
Graft harvest and inset
Which donor site (septal remnant, ear, rib, cadaveric), how the graft was carved, and where each piece was inset - spreader, dorsal onlay, columellar strut, alar batten, shield.
- 03 Findings
Framework, scar and implant details
Cartilage quality, scar pattern from prior operations, and - for implant cases - the type and dimensions of the implant.
- 04 Plan
Two-year aftercare
Read this first: splint off at 7 days, chest wall care, and the review schedule out to 24 months. Any planned revision window and the disease-control conditions for it.
Recognised by major UK insurers
Reconstructive septorhinoplasty for saddle-nose, autoimmune collapse and post-traumatic devastation is often covered by UK insurers under reconstructive benefits. Cocaine-related reconstruction is typically patient-funded and requires documented abstinence. We confirm cover in writing before booking.
Frequently asked
Everything we get asked about Septorhinoplasty with Graft or Implant.
Quick answers on graft choice, revision, cocaine and autoimmune context.
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Rib, ear or implant - which is right for me?
Autologous cartilage is the default in UK reconstructive practice: rib for structural work (dorsum, columellar strut, spreaders), ear for smaller pieces (battens, tip grafts). Implants (silicone, expanded PTFE) are reserved for selected aesthetic cases and always carry the specific risks of infection and extrusion. Your surgeon will map the plan to your anatomy and prior history.
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What if I have used cocaine?
Cocaine-induced framework collapse is a well-recognised indication, but reconstruction fails without abstinence. UK reconstructive practice requires documented abstinence for at least six months, ideally 12, with hair-test corroboration in some units. Ongoing use is a contraindication - postponement, not refusal.
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What if I have granulomatosis with polyangiitis (GPA)?
Reconstruction is offered once disease is inactive on maintenance treatment for at least 12 months, jointly with the rheumatology team. Autologous rib cartilage is the standard graft. Long-term surveillance for disease reactivation continues alongside the rhinoplasty follow-up.
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Is a rib graft painful?
The donor-site pain is the honest part of the operation. Chest wall pain and stiffness for 2–4 weeks are the norm. Long-acting local anaesthetic at the harvest site, and a proper analgesia plan, make it very manageable. A small scar, usually hidden by clothing.
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How much does reconstructive septorhinoplasty cost in the UK?
Roughly £11,000–£16,000 for a revision case with ear cartilage, £12,000–£18,000 with rib cartilage, and £14,000–£22,000 for large saddle-nose reconstruction or GPA-related work. Autoimmune, saddle-nose and post-traumatic cases are often covered by insurance; cocaine-related work is typically patient-funded.
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How does this differ from a primary septorhinoplasty?
A primary case reshapes an intact framework. A reconstructive case rebuilds it. The tissues are scarred, the anatomy less predictable, the operating time longer, the graft harvest a separate site, the endpoint 18–24 months rather than 12, and the revision rate higher. Different surgeon, different consent, different fee.
Related treatments
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