Plastic surgery (or reconstructive surgery) is used to repair and reconstruct damaged tissue and skin in order to restore normal function and appearance.

It is sometimes confused with cosmetic surgery. Cosmetic surgery, such as a ‘nose job’, is usually carried out to achieve a more desirable look for patients, whereas plastic surgery is used to correct existing medical conditions or ‘flaws’.  

Our world-renowned plastic surgeons provide innovative plastic surgery techniques to NHS patients and private patients. 

They cover a wide range of procedures, from simple operations like laser wart removal to pioneering surgeries.

The team have extensively researched and planned procedures for full face transplants, which have been performed elsewhere.

The Royal Free Hospital was established as a centre of excellence for plastic and reconstructive surgery in memory of those who died and were injured in the 7/7 London bombings of 2005. 

Patients are usually admitted to our plastic surgery clinic as day-cases or inpatients, but you can usually leave the hospital after a short period of time. 

This depends on the plastic surgery you require and your individual circumstances

The craniofacial unit at the Royal Free Hospital offers complex craniofacial reconstructive surgery for adults and children with congenital and traumatic conditions, and post-cancer resections.

We carry out bone and soft tissue reconstruction using alloplastic (synthetic material), your own cells (autotransplantation) and composite tissue (more than one tissue). 

The multidisciplinary team includes plastic surgeons, ear, nose and throat surgeons, oculoplastic surgeons, maxillofacial surgeons, psychologists and speech and language therapists.

They aim to provide you with a personalised, innovative, and comprehensive service using state-of-the-art customised 3D printing and artificial intelligence software for surgical planning. These techniques allow the team to tailor the surgery to suit patients' facial features.

We run monthly multidisciplinary craniofacial clinics, which patients can be referred to via their GP or a hospital consultant. 

The hand unit at the Royal Free Hospital is run by a multidisciplinary team of plastic surgeons, orthopaedic surgeons, hand therapists and psychologists. 

We offer complex reconstructive surgery for adults and paediatric patients. 

Our surgical group has subspecialty interests in:

  • arthritis 
  • peripheral nerve surgery 
  • congenital hand surgery 
  • microvascular surgery 
  • toe-to-hand transfer 
  • complex trauma  
  • tendon surgery  
  • wrist surgery 
  • osseointegration 
  • arthroplasty. 

Patients can be referred to our monthly multidisciplinary complex hand meetings by their GP or hospital consultant. 

Hand therapy

Our hand therapy service treats and rehabilitates patients who have injured their hand or forearm, which often requires hand surgery. 

Hand injuries can be very debilitating as everyday tasks require the hands to be in good shape. 

Our hand therapists combine knowledge of both hand physiotherapy and occupational therapy to restore patients’ hand function. 

After surgery, the team works closely with our plastic surgery and orthopaedic surgery teams to rehabilitate patients. 

Patients are usually referred to the hand therapy unit by their GP, or after having their surgery at the trust. 

Visit our hand physiotherapy service page.

The laser clinic at the Royal Free Hospital operates three types of lasers that can be used to treat a variety of skin conditions.

The lasers are built using the latest laser technologies so that healthy skin is protected, side effects are reduced and patient comfort is increased. 

Some laser treatments are one-off treatments but others, like port wine stain removal or hair reduction, need regular treatments. We have access to surgical theatres if patients need a general or local anaesthetic for their treatment. 

Patient progress is our priority. Tests are sometimes carried out on a patient’s first visit to the clinic to assess which laser skin treatment will work best. Photos are taken before and after treatments to see how things are going.

Some of our laser skin treatments

Pulsed dye laser treatments (targets red marks) for:

  • port wine stain removal
  • rosacea treatment
  • red scar removal
  • laser treatments for other facial ‘flaws’ or problems related to blood vessels

Alexandrite laser treatments (targets melanin and brown pigment) for:

  • hair reduction to treat excessive facial-hair growth 
  • Brown, hairy birthmark removal
  • hair reduction to prevent recurrent pilonidal sinus disease
  • hair reduction after reconstructive surgery with hair-bearing grafts

Carbon dioxide laser treatments (removes top layer of skin) for:

  • mole removal
  • birthmark removal
  • wart removal
  • removal of smaller sections of port wine stains

How you can be referred

Your GP will need to refer you to a consultant, who will assess your suitability for treatment first. 

If your condition is suitable for skin laser treatment, you will then be given an appointment at the laser clinic.

Ear reconstruction surgery is offered at the Royal Free Hospital. It is considered one of the most challenging plastic surgery procedures and is quite rare. 

Due to advances in reconstructive surgery, the results for this type of surgery are now excellent.  

We see two main groups of patients: those with an underdeveloped ear at birth (a condition known as microtia) and those who have lost their normal ear through trauma, disease or accident. 

Some patients, such as those with scarring or low hairline, may be less suitable for ear correction surgery and will need to speak to a specialist.

The alternative to ear reconstruction is a prosthetic ear, which is clipped onto titanium pins inserted into the skull. 

Microtia treatment

For patients with microtia — an underdeveloped ear at birth — there are three treatment options available at the Royal Free Hospital:

  • No treatment: in some cases, the child and parents may feel that the ear abnormality has no negative effect on social interaction or self-esteem, and treatment may not be needed.
  • Ear reconstruction surgery. For microtia, or ear birth defects, ear surgery is usually deferred until the age of nine or above.
  • Prosthetic ears, usually requiring titanium pins to be inserted in the bone. This is considered the alternative option to ear reconstruction surgery. If a patient opts for prosthetic ears, it is then very difficult to have ear reconstruction surgery later.

To avoid any delay, GP referrals should be addressed to a plastic consultant surgeon or a named consultant surgeon.

Routine and urgent appointments

GP referrals should be made via the NHS e-Referral Service. 

Trauma referrals

GP referrals for our trauma service should be made through Pathpoint, or by calling our switchboard on 020 7794 0500.

Laser service referrals

GPs will need to refer patients for a consultant appointment via the NHS e-Referral Service.
Patients should be referred to Mr Shadi Ghali or Mr Alexander Woollard. If they are suitable for laser treatment, the patient will be given an appointment at the laser clinic.  

Craniofacial unit referrals

GPs and hospital consultants can send their referrals to Catherine Kaniu, craniofacial unit administrator via email to catherine.kaniu@nhs.net, or by calling 020 7794 0500 ext 38589.

Hand unit referrals

Patients can be referred to our monthly multidisciplinary complex hand meetings by their GP or hospital consultant.

Referrals to our hand unit should be made to Mr Dariush Nikkhah by emailing d.nikkhah@nhs.net or catherine.kaniu@nhs.net.

Hand therapy unit referrals

Patients are usually referred to the hand therapy unit by their GP or after having their surgery at the trust. 

Referrals from Royal Free London consultants are accepted routinely for patients undergoing surgery at Barnet Hospital, Chase Farm Hospital or the Royal Free Hospital.

Camden GPs can refer patients to the hand therapy unit at the Royal Free Hospital. 

Hillingdon GPs can refer adult and paediatric patients to the hand service at Mount Vernon Hospital. 

Mount Vernon GPs can refer patients to the hand therapy unit at Mount Vernon Hospital.