Breast

Preserve the Nature, Preserve the function

Published by Mr Paul Wilson
03 February 2020

This weekend I have attended the international preservation rhinoplasty course in Nice 2020 ‘Preserve the Nature, Preserve the function’

Today, the world of rhinoplasty is in effervescence and full of excitement.

Many significant innovations are now occurring in Rhinoplasty, such as biomechanical anatomy concepts, new instruments and techniques. Preservation Rhinoplasty is a philosophy of remodelling the existing nasal anatomy, using very few tissue resection and very few grafts, this leading to a natural appearance of the nose, which most most patients are seeking. Dorsum preservation and tip modifying sutures to minimise the need for immediate mid-vault reconstruction and allow minor revisions rather than rib grafts, giving greater predictability with less risk.

The aim of this 3-day meeting is to show the most recent advances introduced by the rhinoplasty masters.

About The Author

Mr Paul Wilson

Mr Paul Wilson BDS, MB ChB, FDS RCS, FRCS(Ed), FRCS(Plast) is a Consultant Plastic, Reconstructive and Aesthetic Surgeon with more than 35 years of surgical experience. He specialises in rhinoplasty, facial rejuvenation, breast and body surgery, and complex revision procedures. Mr Wilson is listed on the GMC Specialist Register in the UK and Republic of Ireland, is a member of leading professional organisations including BAAPS, BAPRAS and ISAPS, and is Founder and Lead Surgeon of Paul Wilson Aesthetics, as well as Owner and Director of Northwood Hospital in Bristol.

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Open Preservation Rhinoplasty | Before & After

This patient presented for a consultation with both functional and aesthetic concerns.

She had experienced several previous nasal injuries, including a horse-riding accident, a netball incident, and a facial injury. Although she had undergone a septoplasty in 2022, she was still experiencing intermittent breathing difficulties, shifting between the right and left sides.

Aesthetically, her primary concerns were a dorsal hump and the droopiness of her nasal tip.

On assessment, her nose was reasonably straight, with a dorsal hump created by a combination of prominent nasal bones and increased septal height. There was also slight nostril asymmetry and some external valve collapse on the right side, meaning the outer wall of the nostril could collapse slightly during sharp, deep breathing.

A CT scan revealed a relatively straight septum, with only a small posterior deviation, clear sinuses, and normal-sized turbinates.

An open preservation rhinoplasty was performed.

The plan was to refine the dorsal hump, create a gentle curve to the nose, improve the tip position, and achieve as much symmetry as possible while respecting the patient`s existing anatomy.

Rhinoplasty planning is never about chasing perfection. The aim is to make a considered improvement that looks balanced, functions well, and remains in keeping with the rest of the face.

The result shown here is part of that process, with healing continuing over time.

Patient images shown with consent.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

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Open Preservation Rhinoplasty | Before & After

This patient presented for a consultation with both functional and aesthetic concerns.

She had experienced several previous nasal injuries, including a horse-riding accident, a netball incident, and a facial injury. Although she had undergone a septoplasty in 2022, she was still experiencing intermittent breathing difficulties, shifting between the right and left sides.

Aesthetically, her primary concerns were a dorsal hump and the droopiness of her nasal tip.

On assessment, her nose was reasonably straight, with a dorsal hump created by a combination of prominent nasal bones and increased septal height. There was also slight nostril asymmetry and some external valve collapse on the right side, meaning the outer wall of the nostril could collapse slightly during sharp, deep breathing.

A CT scan revealed a relatively straight septum, with only a small posterior deviation, clear sinuses, and normal-sized turbinates.

An open preservation rhinoplasty was performed.

The plan was to refine the dorsal hump, create a gentle curve to the nose, improve the tip position, and achieve as much symmetry as possible while respecting the patient's existing anatomy.

Rhinoplasty planning is never about chasing perfection. The aim is to make a considered improvement that looks balanced, functions well, and remains in keeping with the rest of the face.

The result shown here is part of that process, with healing continuing over time.

Patient images shown with consent.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

A rhinoplasty consultation is not just about examining the nose.

It is about understanding the patient, their anatomy, their breathing, and their reasons for considering surgery.

In this video, Mr Wilson explains what happens during a rhinoplasty consultation at Paul Wilson Aesthetics.

Patients are seen personally by Mr Wilson at Northwood Hospital in Bristol. The consultation includes a full medical history, a discussion about aesthetic concerns, breathing and functional symptoms, previous injuries or surgery, and the support available at home after the procedure.

The nose is then carefully assessed, as rhinoplasty always addresses both form and function.

Two-dimensional photographs are taken for medical records, and 3D Vectra imaging may also be used to aid in planning the procedure. This allows Mr Wilson and the patient to visually discuss possible changes and ensure expectations are aligned before surgery.

The aim is not to promise a precise, screen-generated result.

It is to understand what the patient hopes to achieve, what is surgically attainable, and how to meticulously plan the operation.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

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Open post by paulwilsonaesthetics with ID 18092058527366255

A rhinoplasty consultation is not just about examining the nose.

It is about understanding the patient, their anatomy, their breathing, and their reasons for considering surgery.

In this video, Mr Wilson explains what happens during a rhinoplasty consultation at Paul Wilson Aesthetics.

Patients are seen personally by Mr Wilson at Northwood Hospital in Bristol. The consultation includes a full medical history, a discussion about aesthetic concerns, breathing and functional symptoms, previous injuries or surgery, and the support available at home after the procedure.

The nose is then carefully assessed, as rhinoplasty always addresses both form and function.

Two-dimensional photographs are taken for medical records, and 3D Vectra imaging may also be used to aid in planning the procedure. This allows Mr Wilson and the patient to visually discuss possible changes and ensure expectations are aligned before surgery.

The aim is not to promise a precise, screen-generated result.

It is to understand what the patient hopes to achieve, what is surgically attainable, and how to meticulously plan the operation.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

Open Septorhinoplasty | Before & After

This patient had previously undergone rhinoplasty and otoplasty at the age of 23, which included the reduction of a dorsal hump.

Over time, he began to notice increasing droopiness of the nasal tip. He had also broken his nose as a child during gymnastics, although his breathing was otherwise good.

On assessment, he presented with a long, straight nose and a dependent, droopy, and slightly asymmetric tip. There was a mild deviation of the nose to the left, but no remaining bony hump. The septum appeared straight.

One of the key findings was the acute angle between the base of the nose and the upper lip. Simply lifting the tip helped to improve the appearance of the nose and also made it appear straighter.

In this case, an open septorhinoplasty was performed under general anaesthetic.

Revision rhinoplasty requires careful planning, particularly when the nose has been previously operated on. The existing structure, scar tissue, tip support, and previous surgical changes all need to be considered before any further refinement is made.

The aim was to improve tip position and support, address the asymmetry, and create a more balanced nasal profile while working with the patient`s existing anatomy.

The result shown here is part of that process, with healing continuing over time.

Patient images shown with consent.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

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A bump on the bridge of the nose can change the entire facial profile.

For many patients, a dorsal hump is the feature they notice most in side-profile photos or from certain angles. It may be part of the natural nasal structure, or it may appear more pronounced after trauma or injury.

However, a dorsal hump is never treated as just a "bump".

The bridge, tip, septum, nasal bones, and facial proportions all need to be assessed together before any surgical plan is made.

At Paul Wilson Aesthetics, rhinoplasty planning focuses on refining the nasal profile in a way that remains balanced with the individual face.

Depending on the anatomy, this may involve preservation rhinoplasty or structural rhinoplasty.

The aim is not a perfect nose.

It is a considered, proportionate result that suits the patient.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #dorsalhump #rhinoplastybristol #preservationrhinoplasty #northwoodhospital

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When rhinoplasty does not go as expected, subsequent operations are rarely simple.

Revision rhinoplasty often involves navigating scar tissue, altered anatomy, reduced cartilage support, and the outcomes of previous surgery.

In this reel, Mr Wilson explains why patients seek him out for revision rhinoplasty and why this type of surgery demands meticulous planning, extensive experience, and candid discussions.

Additional support may sometimes be required, utilising cartilage from the ear or rib, fascia, or fat grafting.

This also underscores the importance of aftercare. Should concerns arise post-surgery, patients need assurance that they will receive proper review, support, and care.

Revision rhinoplasty is not merely about re-shaping the nose.

It involves comprehending previous interventions, assessing current possibilities, and meticulously planning the subsequent stage.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #revisionrhinoplasty #rhinoplastysurgery #bristolplasticsurgeon #northwoodhospital

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When rhinoplasty does not go as expected, subsequent operations are rarely simple.

Revision rhinoplasty often involves navigating scar tissue, altered anatomy, reduced cartilage support, and the outcomes of previous surgery.

In this reel, Mr Wilson explains why patients seek him out for revision rhinoplasty and why this type of surgery demands meticulous planning, extensive experience, and candid discussions.

Additional support may sometimes be required, utilising cartilage from the ear or rib, fascia, or fat grafting.

This also underscores the importance of aftercare. Should concerns arise post-surgery, patients need assurance that they will receive proper review, support, and care.

Revision rhinoplasty is not merely about re-shaping the nose.

It involves comprehending previous interventions, assessing current possibilities, and meticulously planning the subsequent stage.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #revisionrhinoplasty #rhinoplastysurgery #bristolplasticsurgeon #northwoodhospital

A blocked nose is not always "just congestion".

A deviated septum can make one side of the nose feel constantly blocked, affect airflow, and make breathing feel uneven.

The septum is the internal wall of bone and cartilage that separates the two nasal passages. When it sits off-centre, one side may become narrower, which can make breathing more difficult.

It is not always visible from the outside.

This is why assessment matters. The nose needs to be examined for both structure and function, especially when symptoms are linked with previous injury, nasal asymmetry, or ongoing obstruction.

Treatment may involve septoplasty to improve airflow, or septorhinoplasty when breathing concerns and external nasal shape need to be addressed together.

The aim is to understand what is causing the obstruction and choose the most suitable approach for the individual patient.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

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Open post by paulwilsonaesthetics with ID 17978141679019165

A blocked nose is not always "just congestion".

A deviated septum can make one side of the nose feel constantly blocked, affect airflow, and make breathing feel uneven.

The septum is the internal wall of bone and cartilage that separates the two nasal passages. When it sits off-centre, one side may become narrower, which can make breathing more difficult.

It is not always visible from the outside.

This is why assessment matters. The nose needs to be examined for both structure and function, especially when symptoms are linked with previous injury, nasal asymmetry, or ongoing obstruction.

Treatment may involve septoplasty to improve airflow, or septorhinoplasty when breathing concerns and external nasal shape need to be addressed together.

The aim is to understand what is causing the obstruction and choose the most suitable approach for the individual patient.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

Dorsal Preservation Rhinoplasty | Before & After

This young patient desired refinement of her nasal profile and tip, aiming for a result that remained balanced with her facial features.

Her primary concerns included a prominent dorsum and a bulbous nasal tip.

In this case, an open tip rhinoplasty was performed, utilising piezo-electric surgery for surface reduction of the dorsum. A septal projection graft was also employed to support and define the nasal tip.

Piezo-electric surgery facilitates highly precise work on the nasal bones. This is particularly beneficial when reshaping the bridge of the nose, as it permits controlled refinement while preserving crucial surrounding structures.

The tip also necessitated meticulous planning. A bulbous tip is not merely reduced; it requires reshaping and support to ensure the final result remains stable as the nose heals.

This is where dorsal preservation rhinoplasty and tip definition must work in conjunction. The objective is not to create an entirely different nose, but to refine the existing structure in a manner that complements the individual`s face.

The result displayed here represents an stage of that process, with healing progressing over time.

Patient images shown with consent.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #dorsalpreservationrhinoplasty #rhinoplastybristol #piezoelectricsurgery #northwoodhospital

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Rhinoplasty is not a single technique.

It is a series of decisions.

In this reel, Mr Wilson explains the difference between structural rhinoplasty and preservation rhinoplasty, and why preservation techniques have become such a valuable option in suitable primary cases.

The principle is simple: where possible, preserve the natural bridge of the nose rather than dismantling and rebuilding it.

For the right patient, this can allow refinement of the nasal profile while maintaining more of the existing nasal structure.

However, suitability is crucial.

If the nose is very crooked, has been previously broken, or the patient is concerned about the frontal view, a structural or hybrid approach may be more appropriate.

That is why consultation and assessment are so important.

The technique should fit the patient, not the other way around.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

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A second rhinoplasty is not simply a repeat of the first.

Revision rhinoplasty often means working with a nose that has already healed, scarred, and changed after previous surgery.
Sometimes the concern is visible; sometimes it is functional; often, it is both.

The nose may need more support, better definition, improved symmetry, or correction of breathing issues.

In some cases, grafting may be required to rebuild or strengthen areas that no longer have adequate support.
This is why secondary rhinoplasty needs time, experience, and a very clear plan.

The goal is not to chase perfection.
It is to make the next operation as careful, realistic, and considered as possible.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #revisionrhinoplasty #secondaryrhinoplasty #rhinoplastysurgery #northwoodhospital

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Open post by paulwilsonaesthetics with ID 18077740157672564

A second rhinoplasty is not simply a repeat of the first.

Revision rhinoplasty often means working with a nose that has already healed, scarred, and changed after previous surgery.
Sometimes the concern is visible; sometimes it is functional; often, it is both.

The nose may need more support, better definition, improved symmetry, or correction of breathing issues.

In some cases, grafting may be required to rebuild or strengthen areas that no longer have adequate support.
This is why secondary rhinoplasty needs time, experience, and a very clear plan.

The goal is not to chase perfection.
It is to make the next operation as careful, realistic, and considered as possible.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #revisionrhinoplasty #secondaryrhinoplasty #rhinoplastysurgery #northwoodhospital

Preservation Rhinoplasty with Septoplasty | Before & After

This patient presented with a previously fractured septum, leading to breathing difficulties, a dorsal hump, and a bulbous nasal tip.

In such cases, rhinoplasty extends beyond merely altering the external appearance of the nose; the internal structure is equally crucial.

The procedure performed was a preservation rhinoplasty with septoplasty. The objective was to enhance the shape of the nose while simultaneously addressing the septum, which had been impacting her breathing.

A preservation approach involves meticulously working with the existing nasal structure rather than simply excising tissue. The bridge, tip, septum, and overall support of the nose all require integrated consideration.

What has been particularly gratifying in this case is the post-operative feedback from the patient. She expressed continued satisfaction with her result, consistently recommends Mr Wilson, and feels the surgery made a significant difference to her. She also noted that while she occasionally experiences some breathing difficulty, she was informed that her nose had been considerably improved from its initial state.

Such feedback is always valued, as rhinoplasty is a protracted process. The outcome encompasses not only the day of surgery but also the planning, healing, trust, and long-term results.

Patient images and feedback shared with consent.

🏥 Paul Wilson Aesthetics
📍 Northwood Hospital, Bristol, UK

📞 0117 332 1585 | 07480 125 890
📧 info@paulwilsonaesthetics.co.uk

#paulwilsonaesthetics #preservationrhinoplasty #septoplasty #rhinoplastybristol #northwoodhospital

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$Preservation Rhinoplasty with Septoplasty | Before & After This patient presented with a previously fractured septum, leading to breathing difficulties, a dorsal hump, and a bulbous nasal tip. In such cases, rhinoplasty extends beyond merely altering the external appearance of the nose; the internal structure is equally crucial. The procedure performed was a preservation rhinoplasty with septoplasty. The objective was to enhance the shape of the nose while simultaneously addressing the septum, which had been impacting her breathing. A preservation approach involves meticulously working with the existing nasal structure rather than simply excising tissue. The bridge, tip, septum, and overall support of the nose all require integrated consideration. What has been particularly gratifying in this case is the post-operative feedback from the patient. She expressed continued satisfaction with her result, consistently recommends Mr Wilson, and feels the surgery made a significant difference to her. She also noted that while she occasionally experiences some breathing difficulty, she was informed that her nose had been considerably improved from its initial state. Such feedback is always valued, as rhinoplasty is a protracted process. The outcome encompasses not only the day of surgery but also the planning, healing, trust, and long-term results. Patient images and feedback shared with consent. 🏥 Paul Wilson Aesthetics 📍 Northwood Hospital, Bristol, UK 📞 0117 332 1585 | 07480 125 890 📧 info@paulwilsonaesthetics.co.uk #paulwilsonaesthetics #preservationrhinoplasty #septoplasty #rhinoplastybristol #northwoodhospital$

Mommy Makeover | Mastopexy + Full Abdominoplasty
After two pregnancies, this patient was left with skin laxity and a change in shape to both her breasts and tummy — despite returning to a stable, healthy weight. She was happy with her breast volume but troubled by the drooping and excess skin, and by the loose skin and stretch marks across her abdomen.
We planned a combined approach:
🔹 Mastopexy (breast uplift) — excess skin removed and the nipple repositioned higher to lift and reshape the breast, while keeping her own natural volume, exactly as she wanted. This uses an “anchor” pattern scar.
🔹 Full abdominoplasty (tummy tuck) — removal of the loose skin and stretch marks below the belly button, with repair of the separated tummy muscles (diastasis recti) that so commonly follow pregnancy.
Because she’s naturally slim and athletic, no liposuction was needed — tightening the muscle separation and removing the skin overhang simply revealed the toned, defined abdomen that was already there. She’s especially delighted with her new core definition. 💪
Every patient and every result is individual. Surgery carries risks, and a full consultation is essential to understand whether a procedure is right for you.
📍 Surgery by Paul Wilson @ Northwood Hospital, Bristol Consultations via the link in bio.
#MommyMakeover #Abdominoplasty #TummyTuck #Mastopexy #BreastUplift PlasticSurgery CosmeticSurgery BristolSurgeon PaulWilsonAesthetics NorthwoodHospital PostPregnancyBody DiastasisRecti

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Mommy Makeover | Mastopexy + Full Abdominoplasty
After two pregnancies, this patient was left with skin laxity and a change in shape to both her breasts and tummy — despite returning to a stable, healthy weight. She was happy with her breast volume but troubled by the drooping and excess skin, and by the loose skin and stretch marks across her abdomen.
We planned a combined approach:
🔹 Mastopexy (breast uplift) — excess skin removed and the nipple repositioned higher to lift and reshape the breast, while keeping her own natural volume, exactly as she wanted. This uses an “anchor” pattern scar.
🔹 Full abdominoplasty (tummy tuck) — removal of the loose skin and stretch marks below the belly button, with repair of the separated tummy muscles (diastasis recti) that so commonly follow pregnancy.
Because she’s naturally slim and athletic, no liposuction was needed — tightening the muscle separation and removing the skin overhang simply revealed the toned, defined abdomen that was already there. She’s especially delighted with her new core definition. 💪
Every patient and every result is individual. Surgery carries risks, and a full consultation is essential to understand whether a procedure is right for you.
📍 Surgery by Paul Wilson @ Northwood Hospital, Bristol Consultations via the link in bio.
#MommyMakeover #Abdominoplasty #TummyTuck #Mastopexy #BreastUplift PlasticSurgery CosmeticSurgery BristolSurgeon PaulWilsonAesthetics NorthwoodHospital PostPregnancyBody DiastasisRecti

Breast Augmentation

A natural increase in volume — restoring shape after hypomastia
Hypomastia is the medical term for naturally underdeveloped breast tissue. It’s a recognised developmental variation, not a flaw — but for many women it affects how comfortable and confident they feel in their own body.
This patient, a mum of two with a completed family, had thought about augmentation for several years. Her request was simple and one I hear often: a natural, modest increase in volume and improved shape — not a dramatic change. On examination she had reduced upper-pole fullness in both breasts with good underlying symmetry.
Rather than reaching for a number, we planned this properly. Measurements, 2D and 3D imaging morphed to her chosen implant, external sizers tried on in clinic, and a home rice test to let her feel the volume for herself. Her choice: a 275cc round, moderate-profile Mentor micro-textured implant, placed subfascially through an inframammary incision — a plan designed to add soft upper-pole fullness in proportion to her petite frame.
You can see in the lateral and oblique views how the goal was balance, not bulk.
The psychological side matters just as much. In appropriately assessed patients, augmentation for hypomastia is consistently associated with improvements in body image, self-confidence and quality of life — and that outcome means as much to me as the surgical one.

Shared with this patient’s full consent.
Results vary from person to person. This is educational and not a recommendation to undergo surgery — any decision should follow a personal consultation.

📍 Address: 1400 Parkway North, Stoke Gifford, Bristol BS34 8YU (Northwood Hospital)
📞 Phone: +44 7480 125890
🌐 Website: paulwilsonaesthetics.co.uk
🕐 Hours: Monday–Friday, 9:00 AM – 5:00 PM

#BreastAugmentationUK #Hypomastia #NaturalResults #PlasticSurgeon #BeforeAndAfter

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