Consultant Cosmetic Rhinoplasty & Sinus Surgeon In Fareham & Winchester, Hamps
Rhinoplasty Techniques | Mr Tim Biggs Hampshire
Not all rhinoplasty is the same. The techniques used, and the combination in which they are applied, determine the quality, longevity, and naturalness of the result. This page summarises the surgical approaches I use at Adnova Clinic in Fareham, and why I choose them.
I am one of only a small number of surgeons in Hampshire using both Piezo ultrasonic instrumentation and dorsal preservation rhinoplasty as standard techniques. Most rhinoplasty surgeons in the UK use traditional osteotome and chisel methods, and a structural rather than preservation approach to the dorsum. The combination of Piezo and preservation, where appropriate, produces more precise bone work, less trauma, faster recovery, and more natural long-term results.
The right technique for each patient is determined at consultation, based on their nasal anatomy, skin thickness, functional needs, and aesthetic goals. I use a tailored combination of the methods described below, and I explain my planned approach in detail before any patient commits to surgery.
Septoplasty = This is a procedure to straighten the middle partition of the nose. It is undertaken through a small cut on the inside of the nostril. It is a procedure to improve nasal breathing. It will not alter the outside shape of the nose.
Functional Septorhinoplasty = This is a procedure to improve breathing function. The bones and cartilages are supported. It is not a cosmetic procedure. It can be undertaken through an open or closed approach (see below). It will result in a minor change to the outside shape of the nose.
Cosmetic Septorhinoplasty/Rhinoplasty = This is a procedure aimed at improving the look (and/or function) of the nose. It is undertaken through an open approach, using the techniques below.
There are very few Hampshire Rhinoplasty Surgeons that use Piezo. Piezo, also known as ultrasonic Rhinoplasty, involves the use of piezoelectric instruments to perform precise bone cutting (osteotomy), removal (ostectomy) and reshaping (osteoplasty). The main advantage of piezo is its ability to selectively cut bone, while preserving soft tissue structures, compared to traditional hammer and chisel techniques. This can lead to faster recovery times, less post-operative discomfort, and better outcomes.
I use Piezo instrumentation for all cases requiring osteotomy — the controlled bone cuts needed to narrow the nasal bones or correct a deviated bony pyramid. Piezo is also an essential component of dorsal preservation rhinoplasty, where the precision of ultrasonic cutting allows the dorsum to be lowered as a single unit rather than by removing and reassembling individual structures. For patients, the practical benefits are reduced bruising around the eyes, less post-operative swelling, and a more comfortable recovery compared to traditional techniques.
I am the only Hampshire Rhinoplasty Surgeon currently using preservation techniques. Preservation Rhinoplasty, is a surgical method that maintains the natural support structures of the nose, preserving as much as possible, to maintain or restore the nasal shape, structure, and function.
Preservation Rhinoplasty has gained popularity in recent years as it offers several potential benefits, including reduced risk of complications, faster recovery times, and more natural-looking results. However, not all patients may be suitable candidates for preservation Rhinoplasty, and the appropriateness of this approach, depends on factors such as your nasal anatomy, aesthetic goals, and functional concerns. It's essential that if you are considering Rhinoplasty, you consult to determine the most appropriate surgical approach for your specific needs. I perform a tailored surgical approach for each patient and their anatomy, using a combination of structural and preservation techniques. Combining Piezo is an essential part of preservation rhinoplasty, and why not all surgeons use this technique.
I transitioned my practice to dorsal preservation as the default approach for primary rhinoplasty cases following specialist training and a detailed review of the outcome literature. My published 2026 series of 72 consecutive dorsal preservation cases documents this transition. The technique avoids disruption of the keystone area — the junction between the upper lateral cartilages and the nasal bones — which is the zone most likely to produce an irregular or pinched dorsal appearance when disturbed. Not every patient is a candidate: dorsal preservation works best in patients with a smooth, reducible hump and adequate septal support. Where anatomy dictates a structural approach, I use that instead.
Functional Rhinoplasty is a surgical procedure designed to improve nasal breathing by correcting the underlying structural problems that cause nasal obstruction, with a small non-cosmetic change to the outside shape of the nose.
Where the airway is compromised by a deviated nasal septum, collapsed nasal valves, or a combination of structural abnormalities, the nasal framework needs to be rebuilt and supported from within rather than simply reshaped on the outside.
Mr Biggs uses cartilage grafts, taken from the patient's own septum, ear, or rib, to restore the internal architecture of the nose, open the nasal valve, and provide long-term structural stability. The result is a durable and meaningful improvement in airflow that nasal sprays, antihistamines, and other medical treatments are unable to deliver.
Because functional rhinoplasty addresses the root cause of the obstruction rather than managing the symptoms, the benefits are lasting. The external appearance of the nose is preserved throughout, making this procedure suitable for patients whose sole concern is breathing rather than cosmetic change.
The open approach allows much better access to the nasal tip, allowing me to perform tip modification (tip plasty) with greater refinement. The majority of my Rhinoplasty surgeries involve tip modification/tip plasty. If you need a tip plasty, the approach or surgery you require is a Rhinoplasty.
Open Rhinoplasty is a surgical procedure performed to alter the shape, size, or structure/function of the nose. It is called "open" because during the surgery, I make an incision on the strip of skin between the nostrils (the columella), in addition to incisions inside the nostrils. This allows me better access and visibility to the underlying nasal structures, such as bone and cartilage. The advantage of open Rhinoplasty is that it offers the a clearest view of the nasal anatomy, allowing precise adjustments. The scar heals well and becomes barely noticeable over time. I perform open Rhinoplasty in the vast majority of cases, and especially cosmetic surgeries.
Closed Rhinoplasty is performed through tunnels, without making any cuts on the outside of the nose. This approach is normally reserved for patients with traumatic/bent nasal bones, but an otherwise normal looking nose, without any nasal tip problems.
The decision between open and closed rhinoplasty is made at consultation based on what needs to be corrected. For most cosmetic rhinoplasty, including tip refinement, dorsal reduction, and complex structural work, I use the open approach. The columellar scar heals reliably and is not visible from the front. Closed rhinoplasty is reserved for specific cases where the tip does not need modification and the correction required is confined to the bony pyramid.
Structural Rhinoplasty is a surgical technique focused on addressing the underlying structure of the nose, including the bone and cartilage framework. This approach is often employed to correct functional issues with the nose, such as breathing difficulties due to a deviated septum, as well as aesthetic concerns related to the shape and symmetry of the nose.
In structural Rhinoplasty, the nasal bones and cartilage are manipulated from on-top (the dorsum) to achieve the desired outcome. This can involve techniques such as osteotomy (controlled bone cuts), septoplasty (straightening of the nasal septum), and grafting (using tissue from another part of the body or materials to support or augment the nasal structure).
The goal of structural Rhinoplasty is to create a nose that not only looks aesthetically pleasing but also functions properly. This approach requires meticulous planning and precise surgical techniques to achieve optimal results while maintaining or improving nasal function. I perform a tailored surgical approach for each patient and their anatomy, using a combination of structural and preservation techniques.
Secondary Rhinoplasty, sometimes called revision Rhinoplasty, is performed to correct or revise the results of a previous Rhinoplasty surgery. It is typically undertaken when the initial Rhinoplasty did not achieve the desired outcome or resulted in complications that require correction, or following a septoplasty procedure that has left a change to the function or aesthetics of the nose. It can be performed after filler rhinoplasty too.
Secondary Rhinoplasty is generally more challenging than primary Rhinoplasty due to alterations made during the initial surgery and changes in the nasal anatomy caused by scar tissue. It requires a thorough evaluation of nasal structure, previous surgical techniques used, and desired outcomes. During revision Rhinoplasty, its often neccessary to create structural support, using additional tissue scaffolds, such as rib cartilage or facia lata (see below).
Approximately 30% of my rhinoplasty practice is revision work, which is higher than most primary rhinoplasty surgeons. Patients come from across the UK and internationally for revision surgery, often after procedures performed elsewhere. I assess each case individually, with particular attention to what cartilage and bone remain, what the internal airway looks like, and whether donor material will be needed. I discuss all of this in detail at the preoperative consultation, including realistic expectations for what revision surgery can and cannot achieve.
During secondary (revision) Rhinoplasty it is often neccessary to add structural strength to resupport the nose, following cartilage removal during the first procedure. It is difficult to predict what cartilage was removed during the initial surgery and what structural support might be left to work with.
It is common for me to use donated rib cartilage and facia lata (tissue over the thigh muscle) to resupport and restore the support structures of the nose. This tissue provides a cartilage and tissue structure and is fully tested and treated to make sure it is safe to use. I have used these tissues in many patients with good success. These types of surgeries are more time consuming than primary Rhinoplasty and therefore require a higher charge/cost as a result, due to the requirements for tissue implants and increased theatre operating time. Using donor cartilage and tissue saves the pain and potential complications of harvesting these tissues from your own body. I use these grafts every week, so I am experienced with their use.
What rhinoplasty techniques does Mr Tim Biggs use?
Mr Tim Biggs uses Piezo ultrasonic rhinoplasty, dorsal preservation rhinoplasty, open rhinoplasty, closed rhinoplasty, tip-plasty, structural rhinoplasty, functional septorhinoplasty, revision rhinoplasty, and donor rib and fascia lata reconstruction. He is one of only a small number of surgeons in Hampshire using both Piezo and dorsal preservation as standard techniques. The right approach for each patient is determined at consultation based on individual anatomy, skin thickness, functional needs, and aesthetic goals.
What is the difference between open and closed rhinoplasty?
Open rhinoplasty involves a small incision on the columella — the strip of skin between the nostrils — which allows full access to the nasal framework for precise adjustments to bone, cartilage, and tip structure. It is used for the majority of cosmetic cases. Closed rhinoplasty uses internal incisions only, with no external scar, and is reserved for cases where the tip does not require modification and correction is confined to the bony pyramid.
What is dorsal preservation rhinoplasty?
Dorsal preservation rhinoplasty reduces the nasal bridge as a single intact unit rather than removing and rebuilding individual cartilages and bones. It preserves the natural support structures of the nose, avoiding disruption of the keystone area, the junction between the upper lateral cartilages and nasal bones, which is the zone most likely to produce an irregular or pinched dorsal appearance when disturbed. The technique produces more natural, stable long-term results compared to traditional structural approaches. Mr Tim Biggs is one of the only surgeons in Hampshire using this technique and published a 72-case series documenting his transition to dorsal preservation in 2026.
What is Piezo rhinoplasty?
Piezo rhinoplasty uses ultrasonic piezoelectric instruments to perform bone cutting, reshaping, and removal with a precision that traditional hammer and chisel techniques cannot match. Piezo selectively cuts bone while preserving surrounding soft tissue, resulting in less bruising around the eyes, less post-operative swelling, and a more comfortable recovery. Mr Tim Biggs uses Piezo instrumentation for all cases requiring osteotomy, and it is an essential component of his dorsal preservation technique.
What is the difference between septoplasty, septorhinoplasty, and rhinoplasty?
Septoplasty is a purely internal procedure to straighten the nasal septum and improve breathing. It does not change the external appearance of the nose. Functional septorhinoplasty addresses internal breathing problems but also modifies the external nasal framework where necessary to restore airflow, for example where nasal valve collapse or a crooked nose is contributing to obstruction. Cosmetic rhinoplasty focuses on improving the shape, size, and proportion of the nose, with or without functional correction.
What is revision rhinoplasty and when is it needed?
Revision rhinoplasty, also called secondary rhinoplasty, corrects or improves the result of a previous nose operation. It is indicated where the initial procedure did not achieve the desired outcome, where complications have arisen, or where a previous septoplasty has altered the external shape of the nose. Revision rhinoplasty is more technically demanding than primary surgery due to scar tissue, altered anatomy, and reduced cartilage availability. Mr Tim Biggs frequently uses donor rib cartilage and fascia lata to restore structural support in revision cases. Approximately 30% of his rhinoplasty practice is revision work.
What is donor rib rhinoplasty?
Donor rib rhinoplasty uses processed, sterilised rib cartilage from a tissue bank to provide structural scaffolding in complex revision cases. It avoids the pain and recovery associated with harvesting cartilage from your own rib. The tissue is fully tested and safe to use. Fascia lata, a thin tissue layer from the thigh, is sometimes used alongside donor rib to wrap grafts and improve the final contour. Mr Tim Biggs uses donor rib and fascia lata regularly in revision and complex reconstruction cases.
How do I know which rhinoplasty technique is right for me?
The appropriate technique is determined at consultation after a full clinical assessment of your nasal anatomy, skin thickness, and goals. There is no single correct approach, most rhinoplasty cases involve a tailored combination of methods. At Adnova Clinic in Fareham, consultations include clinical examination, facial analysis, photographic assessment, and Crisalix 3D simulation to help plan the right approach for your nose specifically.
Book a Rhinoplasty Consultation in Hampshire
If you would like to discuss which rhinoplasty technique is most appropriate for your nose and your goals, I see patients at Adnova Clinic in Fareham for cosmetic and functional rhinoplasty on a self-pay basis. All consultations are with me personally and include clinical examination, facial analysis, and Crisalix 3D simulation.
Adnova Clinic, Fareham — Secretary: Natasha Read | timbiggssec@adnovaclinic.com | 01489 663273
