With over two decades of surgical and academic experience, Mr Ferguson is widely regarded as one of the UK’s foremost experts in both functional and cosmetic nasal surgery.
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Fully trained as an ENT / Rhinology surgeon, facial plastic surgeon, and anterior skull base specialist, Mark brings a hybrid skill set that few others can match.
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This integrated background means he understands not just how a nose looks, but how it works. In cosmetic cases especially, he believes aesthetics must never compromise breathing or long-term structural integrity.
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He performs hundreds of rhinoplasty and revision rhinoplasty procedures annually, refining both the art and science of nasal surgery.
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Mark holds a senior NHS role as Head of the ENT Department at Imperial College Healthcare NHS Trust.
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He is co-founder of the Imperial Facial Reconstruction Unit and leads in national ENT initiatives, including the “Getting It Right First Time” (GIRFT) programme for ENT in North West London.
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He is sought after as an expert witness to NICE (National Institute for Health & Care Excellence), and contributes in leadership roles in pan-London ENT groups and European facial plastic surgery associations
Some of the most common complaints that I can help to address are;
- Asymmetry – the nose may appear crooked or uneven.
- Too thin or too wide – the bridge or tip may have been over- or under-reduced.
- Residual bump – not enough of the dorsal hump was removed or scar tissue may create a bump where there wasn’t an issue before.
- Over-reduction – the nose may look scooped or collapsed (saddle nose deformity).
- Pinched tip – the tip appears too narrow or lacks support (alar collapse).
- Visible nostrils – excessive nostril show (alar-columellar disproportion).
- Short nose – the nose appears too upturned or over-rotated.
- Prominent nasal bones – the upper third of the nose may still look wide or irregular.
- Deviated septum – breathing problems that were not corrected, or were made worse.
- Snoring or nasal obstruction – often due to internal valve collapse or poor support.
FAQ’s on Revision Rhinoplasty
My approach to Revision Rhinoplasty
In my practice, I perform a large number of revision rhinoplasty procedures every year. Many of my patients come to me after a previous nose surgery that left them unhappy (whether due to cosmetic concerns or functional issues, or both).
I find revision or corrective rhinoplasty surgery particularly rewarding. I have helped many patients move on from a disappointing result to finally feeling confident in their appearance. Revision rhinoplasty is a highly specialised and complex procedure. It requires not only technical skill, but also a deep understanding of nasal structure, airflow and function.
Revision rhinoplasty is about restoring balance, function, and confidence. I’ll always be upfront about what’s achievable and what’s not advisable. If a request risks your long-term health or the stability of your nose, I won’t perform it. If I don’t feel I can make a huge difference to your nose’s appearance, I will advise you honestly.
In many revision cases, the nose has lost support or structure. That’s why material is often needed to rebuild or reinforce the nose. The most common source is cartilage from the ear, which is soft, curved, and ideal for reshaping the tip or sidewalls.
Every case is different, but I have very high levels of patient satisfaction for Revision Rhinoplasty.
Common complaints after Rhinoplasty
There are many reasons someone may be dissatisfied after a first nose job. Some of the most common complaints that I can help to address are:
- Asymmetry – the nose may appear crooked or uneven.
- Too thin or too wide – the bridge or tip may have been over- or under-reduced.
- Residual bump – not enough of the dorsal hump was removed or scar tissue may create a bump where there wasn’t an issue before.
- Over-reduction – the nose may look scooped or collapsed (saddle nose deformity).
- Pinched tip – the tip appears too narrow or lacks support (alar collapse).
- Visible nostrils – excessive nostril show (alar-columellar disproportion).
- Short nose – the nose appears too upturned or over-rotated.
- Prominent nasal bones – the upper third of the nose may still look wide or irregular.
- Deviated septum – breathing problems that were not corrected, or were made worse.
- Snoring or nasal obstruction – often due to internal valve collapse or poor support.
These issues can be distressing—especially when you’ve already gone through surgery once. My role is to listen carefully, assess thoroughly, and offer a clear, honest plan for what can be improved.
What Happens During Surgery
Revision rhinoplasty is performed under general anaesthetic and typically takes 3 to 4 hours, depending on complexity.
- I usually use an open approach, with a small incision across the columella, to allow full access to the internal structures.
- Scar tissue from the previous surgery is carefully released
- I then reshape or rebuild the nose using grafts—from the ear or donor tissue.
- If functional issues are present, I’ll address them at the same time. This might entail straightening the septum, reinforcing the nasal valves or correcting internal collapse.
Every step is done with precision and care, with the goal of restoring both form and function, while also creating a beautiful and natural looking nose.
Recovery and Results
Recovery from revision rhinoplasty is similar to primary surgery, but healing may take longer due to scar tissue and the complexity of the procedure.
- Week 1: Plaster is removed. Swelling and bruising are expected.
- Weeks 2–3: Internal nasal splints are removed (more common in revision surgery). Bruising fades. You can usually return to work after 10–14 days.
- Months 3–6: Swelling continues to settle, especially around the tip.
- 12–18 months: Final results become visible.
I’ll see you regularly during recovery to monitor healing and ensure everything is progressing as expected.
Case Studies
Patient A – Male
This patient came to me after a primary procedure (performed elsewhere) that left him with a visible dent – a midline deformity – and compromised nasal airflow. I performed an open approach revision septorhinoplasty to reconstruct the nasal framework: rebuilding the structure, restoring airflow and refining the nasal contour. The final result is a balanced, natural- looking nose that complements the patient’s facial features and restores perfect harmony to their profile.
Before - Front View
Before and After Side View
Patient B – Female Open Septorhinoplasty (revision)
The patient presented following two prior rhinoplasty procedures performed by other surgeons. She expressed significant dissatisfaction with the aesthetic outcome, specifically citing nasal bone malalignment and dorsal contour irregularities. Additionally, she reported persistent functional impairment, including severe nasal obstruction and difficulty breathing.
A second revision external (open) septorhinoplasty was performed. The procedure focused on 1) Realigning the nasal bones to correct asymmetry; 2) Refining dorsal irregularities to achieve a smoother nasal profile; 3) Addressing internal structural issues contributing to airway obstruction
Postoperatively, the patient demonstrated marked improvement in both nasal function and aesthetics. The nasal dorsum was successfully reshaped to match the patient’s desired profile. The revision achieved a softer nasal contour with enhanced structural integrity and her breathing function was restored.
Before and After Side View
Before and After - Front View
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