Alwyn D'Souza
Alwyn D'Souza

Consultant ENT / Cosmetic Plastic & Reconstructive Surgeon

London

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Treatments provided by Alwyn D'Souza

Alwyn D’Souza is a London, Harley Street based, board-certified, Facial Plastic Surgeon. He specialises in aesthetic facial plastic and reconstructive surgery, along with non-surgical facial aesthetics, skin cancer treatment for cancers affecting the face, head and neck, and treatment for head and neck cancers.

Treatments, operations and tests

Acne laser treatment (N-Lite)

Small glands just below the surface of the skin called sebaceous glands produce a natural oil called sebum. If too much sebum is produced it causes a build up of oil in the hair follicles which creates an ideal environment for bacteria to grow. This can occur all over the body including the face, neck, back and chest. The N-Lite non-surgical laser aims to treat the root cause by targeting the bacteria causing the skin infections. It can be used on all skin types and all affected areas.

Acne scar treatments

The Pixel Laser is a revolutionary minimally-invasive Laser Acne treatment. It uses the very latest fractional technology to get rid of scars and reduces the appearance of dark pigmentation. It is suitable for all skin types, including dark skin. The Pixel Laser can also reduce pore size and smooth out rough skin. Alternatively, Dermaroller Treatment is is medical roller with hundreds of micro-skin needles around it. As this roller is passed over the skin it causes hundreds of micro punctures in the skin surface. These in turn stimulate the skin and encourage the skin to regenerate itself naturally.

Adenoid removal (adult)

Adenoidectomy is the surgical removal of the adenoids. They may be removed for several reasons, including impaired breathing through the nose and chronic infections or earaches. The surgery is common. It is most often done on an outpatient basis under general anesthesia. Post-operative pain is generally minimal and prevented with an abundance of icy or cold foods. The procedure can sometimes be combined with a tonsillectomy if needed.Adenoidectomy is not often performed on children aged 1-6, as adenoids help the body's immune system. Adenoids become vestigial organs in adults.

Adenoid removal (child)

Adenoidectomy is the surgical removal of the adenoids. They may be removed for several reasons, including impaired breathing through the nose and chronic infections or earaches. The surgery is common. It is most often done on an outpatient basis under general anesthesia. Post-operative pain is generally minimal and prevented with an abundance of icy or cold foods. The procedure can sometimes be combined with a tonsillectomy if needed.Adenoidectomy is not often performed on children aged 1-6, as adenoids help the body's immune system. Adenoids become vestigial organs in adults.

Balloon Sinuplasty

Balloon Sinuplasty is now available to eligible patients as a procedure, which can also be performed in the GP's office, under local anesthesia. This modern procedure reduces the chance of any damage to the lining of the nose, thus making healing faster and more effective.

Botulinum toxin (Botox) - one area

Botox is a cosmetic anti-ageing procedure which involves injecting weakened strains of toxins into the tissue to impair the function of facial nerves. Botox injections are usually performed on the areas of the face that are prone to the effects of ageing, such as the outer portions of the eye, the chin, the mouth and the forehead. There is a loss of sensation and movement in the treated areas, which slows the formation of wrinkles, crow’s feet and deep furrows as a result of ageing.

Botulinum toxin (Botox) - three areas

Botox is a cosmetic anti-ageing procedure which involves injecting weakened strains of toxins into the tissue to impair the function of facial nerves. Botox injections are usually performed on the areas of the face that are prone to the effects of ageing, such as the outer portions of the eye, the chin, the mouth and the forehead. There is a loss of sensation and movement in the treated areas, which slows the formation of wrinkles, crow’s feet and deep furrows as a result of ageing.

Botulinum toxin (Botox) - two areas

Botox is a cosmetic anti-ageing procedure which involves injecting weakened strains of toxins into the tissue to impair the function of facial nerves. Botox injections are usually performed on the areas of the face that are prone to the effects of ageing, such as the outer portions of the eye, the chin, the mouth and the forehead. There is a loss of sensation and movement in the treated areas, which slows the formation of wrinkles, crow’s feet and deep furrows as a result of ageing.

Branchial Cyst

A branchial cyst is also called branchial cleft cyst in children. If there are signs of infection, your doctor will prescribe antibiotics. Sometimes it is necessary to drain fluid from the cyst to ease swelling. To prevent future infections, surgery to remove the cyst is usually recommended. It is also important to exclude a metastatic lymph node as these can present similarly, particularly in people of 40 years of age or older.

Brow lift

A forehead lift, also known as a browlift or browplasty, is a cosmetic surgery procedure used to elevate a drooping eyebrow that may obstruct vision and/or to remove the deep “worry” lines that run across the forehead. Patients commonly request rejuvenation surgery on the forehead because the area is large enough to comprise the major focal and expression point of the upper face, the eyes notwithstanding. Correction of a wrinkled forehead usually leads to a more youthful look. Patients requesting the procedure commonly range in age from 40 to 60.

Cholesteatoma

In some babies, right from birth, a fluid filled sac (‘cyst’) may be found in the ear or skull bone, this is known as cholesteatoma. It can occur because of infection of the ear (‘otits media’). They may be unable to hear, may be dizzy and a foul smelling discharge (‘suppurative’) may leak from the ear. Surgery is performed to remove this cyst.

Clearing of the sinuses

Sinusitis is an inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune issues. Newer classifications of sinusitis refer to it as rhinosinusitis, taking into account the thought that inflammation of the sinuses cannot occur without some inflammation of the nose as well (rhinitis). Acute sinusitis is usually precipitated by an earlier upper respiratory tract infection, generally of viral origin.

Dermal Fillers - full syringe

Restylane® is an injectable wrinkle filler which enhances your natural looks by restoring your skin's volume, creating softness and revitalizing your appearance. Restylane® is safe and natural, because it is made of non-animal stabilized hyaluronic acid, the same substance used in Juvederm. Hyaluronic acid exists in the human body and provides volume and fullness to the skin.

Dermal Fillers - half syringe

Restylane® is an injectable wrinkle filler which enhances your natural looks by restoring your skin s volume, creating softness and revitalizing your appearance. Restylane® is safe and natural, because it is made of non-animal stabilized hyaluronic acid, the same substanced used in Juvederm. Hyaluronic acid exists in the human body and provides volume and fullness to the skin. Radiesse®, Restylane®, and Juvederm® at Aesthetic Plastic Surgery are all priced at $500 per full syringe, and a .4cc syringe of Restylane® is $300.

Ear draining

Myringotomy is a surgical procedure in which a tiny incision is created in the eardrum, so as to relieve pressure caused by the excessive build-up of fluid, or to drain pus. Myringotomy is often performed as a treatment for otitis media. If a patient requires myringotomy for drainage or ventilation of the middle ear, this generally implies that the Eustachian tube is either partially or completely obstructed and is not able to perform this function in its usual physiologic fashion. Before the invention of antibiotics, myringotomy was the main treatment of severe acute otitis media.

Ear pinning

Pinnaplasty / otoplasty / ear cosmetic surgery can be carried out under general anaesthetic (usually recommended for children) or local anaesthetic. The incisions are generally placed behind the ear, occasionally in front. The cartilage of the ear is remodelled and, on occasions, some of the cartilage may be removed. The sutures (stitches) are absorbable and do not require removal. After ear plastic surgery (otoplasty / pinnaplasty), the ears may be covered with a large head dressing which should be worn for one week. After this it is advisable to wear a tennis head band for six weeks although, due to pressures of school or work, it may only be possible to wear the head band at night.

Ear surgery (middle ear)

A stapedectomy is a surgical procedure of the middle ear performed to improve hearing. In both of these situations, it is possible to improve hearing by removing the stapes bone and replacing it with a micro prosthesis - a stapedectomy, or creating a small hole in the fixed stapes footplace and inserting a tiny, piston-like prosthesis - a stapedotomy. The results of this surgery are generally most reliable in patients whose stapes has lost mobility because of otosclerosis.

Ear syringing

Ear syringing, as the name implies, involves the use of a syringe to remove wax from the ears that seem to be blocked. In more details, this works by injecting water that is at body temperature into the ear canal through the nozzle of the syringe. With the very gentle force from the syringe, the water gets into the very deepest part of the ear canal and as this happens it forms a kind of miniature whirlpool of fluid which then helps to dislodge the wax. Apart from just dislodging the wax, the water eventually carries the wax out.

Ear wax removal (microsuction)

In the majority of cases, earwax falls out on its own without the need to remove it. However, if earwax is totally blocking your ear, or if any of the following symptoms are present, it may need to be removed: * hearing loss, * earache, * tinnitus (noises in your ear that come from an internal source), * vertigo (the feeling that you are moving while you are still), or * a cough. Treatment to remove an earwax plug usually starts with eardrops to soften the plug. If eardrops do not work, a process known as irrigation may be needed.

Eye bag removal

Blepharoplasty is surgical modification of the eyelid. Excess tissue such as skin and fat are removed or repositioned, and surrounding muscles and tendons may be reinforced. It can be both a functional and cosmetic surgery. Blepharoplasty is usually performed through external incisions made along the natural skin lines of the eyelids, such as the creases of the upper lids and below the lashes of the lower lids. Incisions may be made from the inside surface of the lower eyelid (transconjunctival blepharoplasty); this allows removal of lower eyelid fat without an externally-visible scar, but does not allow excess skin to be removed

Eyelid reduction - Lower eyelids (Blepharoplasty)

Skin slackens with age, resulting in wrinkles and folds of loose skin, often such folds can collect around the eyes. An eyelid reduction removes the surplus skin and produces a younger, more alert and healthy appearance.

Eyelid reduction - Upper and Lower eyelids (Blepharoplasty)

Skin slackens with age, resulting in wrinkles and folds of loose skin, often such folds can collect around the eyes. An eyelid reduction removes the surplus skin and produces a younger, more alert and healthy appearance.

Eyelid reduction - Upper eyelids (Blepharoplasty)

Skin slackens with age, resulting in wrinkles and folds of loose skin, often such folds can collect around the eyes. An eyelid reduction removes the surplus skin and produces a younger, more alert and healthy appearance.

Facelift

The facelift is an extremely popular tried and tested procedure which 'winds the clock back' by reversing the effects of gravity - refreshing the face, improving the contour of the neck, removing the heavy, tired look and revitalising the face. In both men and women the incision used in face lift surgery is the same; starting high in the temple area (hidden by the hair at this point) the incision travels down in front of the ear, round the earlobe and up behind the ear before curving gently back into the hair at the neck; occasionally it is necessary to add an incision under the chin. Using these incisions the skin and deep tissues are remodelled and re-draped and the incisions are then closed. The surgeon usually then applies a head bandage in order to pressurise (gently) the incisions during the post operative night.

Fat transfer

Fat Transfer is a method used to restore volume and shape to areas such as the face, breasts, buttocks and hands. Fat is taken from your body fat via VASER Liposuction or Micro Lipo and the purified fat is then transferred/injected into the areas of the body where volume has been lost. The procedure can be performed under local anaesthetic and is thought to be more beneficial than synthetic dermal fillers.

Insertion of grommets

Insertion of grommets is a common operation carried out on children. It is performed to improve hearing or to reduce the frequency of ear infections, to solve the problem of "glue ear". A grommet is a small tube that is inserted into a hole that is made in the eardrum to allow air to pass into the middle ear. A small cut is made in the eardrum, the fluid is drained out and a tube or grommet is inserted. The operation is usually done as a day case under a general anaesthetic.

Labyrinthitis

Labyrinthitis is an inner ear infection. It causes a delicate structure deep inside your ear called the labyrinth to become inflamed which can cause dizziness, affect your hearing and balance. As most cases improve with rest and hydration, treatments include medications such as corticosteroids,antiemetics or even antibiotics. In chronic labyrinthitis more involved treatments such as Vestibular rehabilitation therapy (VRT) may be recommended.

Laryngoscopy

Laryngoscopy is an examination that allows a doctor to look at the back of your throat, your voice box (larynx) and vocal cords with a scope called laryngoscope. There are two types of laryngoscopy, and each uses different equipment. Indirect laryngoscopy is performed in a doctor’s surgery using a small hand mirror which is held at the back of the throat. Your doctor shines a light in your mouth and wears a mirror on his or her head to reflect the light to the back of your throat. L aryngoscopy (flexible or rigid) lets a doctor see deeper into the throat. The scope is either flexible or rigid. Flexible scopes show the throat better and are more comfortable for the patient.

Lip reduction

Cheiloplasty or lip reduction is the technical term for surgery of the lip. It includes lip reduction, the process of surgically reducing the size of the lip or lips in order to reduce the appearance of abnormally large or protruding lips and the process of forming an artificial tip or part of the lips by using a piece of healthy tissue from some neighboring part. The procedure can also be performed to enhance the upper and lower lip for those who wish to make their lips permanently larger.

Liposuction

The most stubborn areas of unwanted fat usually include the chin, arms, hips, tummy, thighs and buttocks. Liposuction can permanently solve this annoying problem simply by removing the offending fatty deposits. It’s important to say that liposuction is designed to sculpt the body, not help you lose weight and unfortunately it does not get rid of cellulite either. Small areas of liposuction can be carried out under local anaesthesia. For bigger areas the procedure is performed under a general anaesthetic.

Mole removal

Moles, or nevi, are frequently removed for a variety of reasons. They can be removed by two surgical methods: Excision (cutting), with or without stitches Excision with cauterization (a tool is used to burn away the mole) Although laser excision has been tried for moles, it is not usually the method of choice for most deep moles because the laser light doesn't penetrate deeply enough. Typically, the doctor or dermatologist (a skin specialist) may choose excision with or without stitches, depending on the depth of the mole and the type of cosmetic outcome desired.

Nasal polyp removal

Polypectomy is the surgical removal of polyps (abnormal inflammatory tissue growths) that are located in the nasal passages. If polyps recur, it may be necessary to remove polyps from the deeper ethmoid, sphenoid, and maxillary sinus linings to provide longer-lasting relief. The polyps originate near the ethmoid sinuses (located at the top of the nose on both sides of the nasal cavity) and grow into the open areas of the nasal cavity. Large polyps can obstruct the airway and block drainage from the sinuses. Sinus infections can result from fluid accumulating in the blocked sinuses..

Neck cyst removal

Branchial Cleft Cysts are congenital cysts, that arise in the lateral aspect of the neck when the second branchial cleft fails to close during embryonic development. These arches and clefts contribute to the formation of various structures of the head and neck. Branchial cleft cysts are the most common of congenital neck masses. They are bilateral in about 2-3% of the cases. Usually, they do not appear at birth, but become noticeable much later in life. If they get infected, they may form a deep neck abscess or a draining fistula. The treatment of branchial cleft cysts is surgical excision.

Non-surgical facelift with dermal fillers

As people age they lose elasticity in the skin and gravity draws the skin downwards, which results in an ageing appearance. Whilst it affects people in different ways, it affects women more so as their skin is much thinner. In the 8 Point Lift procedure dermal fillers are used to restore volume to the mid face. The technique combats the soft tissue loss associated with the ageing process and offers a more complete solution compared to individual dermal filler treatments. No anaesthetic is required.

Nose enlargement

Small noses due to your family heredity… misshapen noses… mal-proportioned noses…overly wide or asymmetric nose shapes can be built-up and modified during your cosmetic nose surgery operation. Grafted tissues as well as modified implants can provide a new structure or framework and modified dimensions for your nose. Result? Your appearance is instantly improved, and you feel better about yourself.

Nose reshaping

The nose reshaping operation is carried out under general anaesthesia by a rhinoplasty surgeon and is carried out inside the nostrils so that there are no external scars; unless you decide to have the size or the nostrils reduced, in which case small scars around the sides of the nostrils, placed in the natural crease lines between nose and cheek, will be present. Rhinoplasty is one of the most sought after cosmetic procedures amongst men and women and the vast majority of patients undergoing rhinoplasty surgery gain a feeling of increased self confidence with improvement in their body image.

Nose surgery (for blocked nose)

Septoplasty is a corrective surgical procedure done to straighten the nasal septum, the partition between the two nasal cavities. Ideally, the septum should run down the center of the nose. When it deviates into one of the cavities, it narrows that cavity and impedes airflow. Often the inferior turbinate on the opposite side enlarges, which is termed compensatory hypertrophy. Nasal obstructions caused by serious deviations frequently lead to chronic sinus problems. Turbinate reduction may also be advised to further enlarge the nasal cavities.

Nose swelling removal

The turbinates are 3 ridges within the nasal passageway (nostrils) that help warm and moisten inhaled air. When they become swollen, many doctors recommend removing them via turbinate excision surgery. Making no cuts on the exterior of the nose, the surgeon removes the swollen tissue with a fine knife or laser from the inside of the nose. This tissue is sent to the laboratory for examination to determine the cause of the swelling. Nasal turbinate excision does not change the shape of the patient s nose. The nose often feels slightly sore and uncomfortable after nasal turbinate excision surgery.

Oesophagoscopy

Oesophagoscopy is the examination of your gullet (food or swallowing tube) while you are under a general anaesthetic. It is carried out to establish the reason for a patient's difficulty in swallowing. A long metal tube (oesophagoscope) is passed through your mouth into your gullet. This allows the surgeon to look at the inside the gullet to find the cause of the problem. Oesophagoscopy is quite a short procedure and usually takes less than 20 minutes.

Parotid gland removal

The parotid gland is the largest of the salivary glands. There are two parotid glands, one on each side of the face, just below and to the front of the ear. A duct through which saliva is secreted runs from each gland to the inside of the cheek.The main purpose of parotidectomy is to remove abnormal growths (neoplasms) that occur in the parotid gland. Parotid gland neoplasms may be benign (approximately 80%) or malignant. Tumors may spread from other areas of the body, entering the parotid gland by way of the lymphatic system.

Pre-auricular Sinus Excision

The sinus tract is found just in front of your ear and this can become blocked, which can then lead to an infection. Under a general or a local anaesthetic the ENT specialist makes an incision in front of your ear and removes the sinus. You may have a dressing or sutures put in place, which your practice surse can remove. This is normally a day procedure.

Prominent ear correction (Earfold procedure)

The Earfold procedure (earFoldTM) is a relatively new treatment option – compared to Pinnaplasty or Otoplasty) to correct prominent ears. This procedure is performed under local anaesthetic and involves small incisions (often two in each ear) through which a curved, wafer-thin strip of metal (approximately the same thickness as a human hair), which is plated with 24-carat gold to reduce the visibility of the implant, is slipped under the skin. When the implant has been released, it grips the cartilage of the ear and immediately folds it into the pre-determined required shape. The procedure normally takes a few minutes and the patient is allowed to go home shortly afterwards.

Salivary Gland Removal

The salivary(submandibular) gland is removed under a general anaesthetic The procedure usually takes approximately 1 hour. It involves a cut around two inches long in the upper part of the neck just below the jaw line. If the gland is being removed because of infection that is caused by a stone it may also be necessary to make a cut inside the mouth to remove that stone. Once the gland has been removed the wound is closed with stitches. At the end of the operation a small tube is usually placed through the skin into the underlying wound to drain any blood, which is usually removed the morning after surgery.

Septoplasty

The septum may be bent, perforated,or it has simply grown that way. People may complain of 'whistling' when breathing. The operation of Septoplasty is used to correct this abnormality in order to allow air to pass through either nostril more easily. Septoplasty is a common procedure and is not very painful. It is performed under general anaesthetic and lasts only about 20 to 20 minutes.

Sinus surgery

Functional endoscopic sinus surgery (FESS) is a surgical modality for some diseases of the nose and paranasal sinuses. It is the mainstay in the surgical treatment of sinusitis and nasal polyposis, including fungal sinusitis.FESS is a relatively recent surgical procedure that uses nasal endoscopes (using Hopkins rod lens telescopes) to minimize cutting and trauma to the skin. They provide good illumination of the inside of the head and can be introduced into the nose after anesthetising.FESS came into existence because of pioneering work of Messerklinger and Stamberger (Graz, Austria.).

Small vein removal (Sclerotherapy)

Sclerotherapy and Microsclerotherapy have been used for a number of years. Diseased veins are located with ultrasound scanning and injected with a chemical which is mixed into a foam to displace the blood in the vein. This will eventually cause the wall of the vein to collapse and seal up. This process is less successful if the underlying reflux is not dealt with first (usually by laser) as the varicose vein will simply come back. However, by mixing the STD sclerosant with air, or CO2 into a foam leads to a more effective closure of the vein.

Snoring surgery

LAUP is performed under local or general anaesthetic and is considered to be a safer, more economical and a more comfortable alternative to UPPP. It involves vaporising the free edge of the soft palate and uvula using a laser. Unlike UPPP, LAUP can be repeated in order to obtain the desired effect. The number of procedures needed varies with some patients requiring up to four sessions. The tonsils are not removed with this procedure. Although laser surgery is associated with fewer complications than UPPP, post-operative pain is still reported as being severe.

Thread and spider vein treatment

Veinwave is a technique that has been developed to complement sclerotherapy in order to treat smaller veins, which, usually, sclerotherapy cannot improve. It is therefore ideal for the treatment of rosacea, thread and spider veins. Veinwave uses high frequency microwaves where an ultra-fine insulated needle heats the vessels in the skin, which then creates a thermal lesion that destroys the vein. It is a relatively painless procedure. For facial veins, such as under-eye veins, laser treatments such as Cutera CoolGlide are usually preferred.

Tongue tie operation

Ankyloglossia, commonly known as tongue tie, is a congenital oral anomaly which may decrease mobility of the tongue tip[1] and is caused by an unusually short, thick lingual frenulum, a membrane connecting the underside of the tongue to the floor of the mouth.[2] Ankyloglossia varies in degree of severity from mild cases characterized by mucous membrane bands to complete ankyloglossia whereby the tongue is tethered to the floor of the mouth. The operation aims to smooth out the bone, effectively making the space larger and so decreasing pressure on the tendons.

Tonsil removal (adult)

Tonsillectomy is a common operation in childhood. Enlarged tonsils may cause chronic or recurrent sore throat, and upper airway obstruction causing difficulty with swallowing. Tonsillectomy is a surgical procedure performed to remove the tonsils.

Tonsil removal (child)

Tonsillectomy is a common operation in childhood. Enlarged tonsils may cause chronic or recurrent sore throat, and upper airway obstruction causing difficulty with swallowing. Tonsillectomy is a surgical procedure performed to remove the tonsils.

Voicebox and vocal chords examination by camera

Laryngoscopy is a medical procedure that is used to obtain a view of the vocal folds and the glottis. Laryngoscopy may be performed to facilitate tracheal intubation during general anesthesia or cardiopulmonary resuscitation or for procedures on the larynx or other parts of the upper tracheobronchial tree. Another type of procedure performed by many ENT specialists in clinics is referred to as indirect laryngoscopy. It utilizes a straight rod-mounted mirror (laryngeal mirror; vide Instruments used in otolaryngology) that is inserted into the throat and used to look at the laryngeal inlet

Features

I specialise in...

  • Facial cosmetic surgery
  • Non-surgical facial cosmetic treatments
  • Skin cancer of the face, head and neck
  • Revision Rhinoplasty