Maxillofacial surgery

One of the busiest in the UK, the QVH maxillofacial surgery department has nine consultant surgeons supported by surgical staff, specialist nurses, dietitians, physiotherapists, psychological therapists and speech and language therapists and is based in a new modular building on the East Grinstead site.

Our maxillofacial consultant surgeons have a number of interests in the sub-specialisms of their services including head and neck cancer, orthognathic surgery, trauma, salivary glands and surgical dermatology. The service is also provided across a widely distributed network hosted in acute trusts and community hospitals.

From 3 April 2017, East Sussex Healthcare NHS Trust brought together its inpatient and emergency service for Oral and Maxillofacial Surgery with our service at QVH. Inpatient procedures and pre-assessments for surgery are now carried out at our site in East Grinstead.

Our Macmillan Head and Neck Clinical Nurse Specialists, Clare Lancaster, Bincey Joseph and Michelle Dubber, act as a point of contact for patients, relatives, carers and other healthcare professionals and coordinates care and psychological support for patients receiving treatment for head, neck and thyroid cancer at QVH.

Patient information video

Awake fibre-optic intubation (AFOI) for maxillofacial surgery

Clinical effectiveness

Orthognathic (jaw surgery) outcomes

Orthognathic surgery is a complex process, taking approximately two years, which usually involves a treatment program comprising of a pre-operative orthodontic phase, a surgical phase, and then a post-operative orthodontic phase. You can find a pathway explaining this here.

We collect PROM data (patient recorded outcome measures) from our patients at the end of their treatment, and then at two years post treatment and five years post treatment to assess the quality of orthognathic surgical care by surgeon and satisfaction with facial appearance by surgeon. The British Orthodontic Society has created short films about jaw surgery you can find online.

Mr Keith Altman

Surgical Interests: Mr Keith Altman has an international and national reputation for facial feminization surgery in transgender females and has authored papers and book chapters on this subject. His other main interests are orthognathic surgery, skin cancer surgery, salivary gland surgery and jaw joint disorders.

Mr Altman graduated in both dentistry and medicine from King’s College Hospital, University of London and holds an Award in Medical Leadership (2012) and Diploma of Legal Medicine (2014). He undertook his specialty training at Queen Mary’s Hospital, Roehampton and The Royal Surrey County Hospital, Guildford.

Keith was appointed as Consultant Maxillofacial Surgeon to Brighton & Sussex University Hospitals NHS Trust in 1997 and was Deputy Medical Director and Lead for Revalidation & Appraisal 2013-17. He was appointed to The Queen Victoria Hospital NHS Foundation Trust in 2017.

Nationally, he has been an Intercollegiate Specialty Examiner in Oral & Maxillofacial Surgery since 2016.

Keith was medical director at QVH from October 2019 until January 2022.

Mr Brian Bisase

Specialist interests: Head and neck cancer ablation and reconstruction, including micro-vascular surgery and surgical dermatology; maxillofacial trauma surgery; salivary gland disease; and routine oral surgery.

Mr Brian Bisase graduated in dentistry and medicine from the University of London, where he was awarded the Newland Pedley Medal and Scholarship. After completing his surgical training, Mr Bisase undertook higher training in oral and maxillofacial surgery over a five year period, working across the Royal Surrey County Hospital in Guildford, Guys and Kings College Hospitals in London, and here at QVH.

He was awarded the British Association of Oral and Maxillofacial Surgery Gold Medal for coming top in the intercollegiate maxillofacial surgery FRCS exams in 2009. He undertook further specialist training in Toronto, Canada and at the Royal Marsden Hospital where he developed experience in thyroid, anterior skull base and sarcoma surgery, laryngo-pharyngeal reconstruction and advanced reconstruction of the complex defect. He joined QVH in January 2012.

Mr Bisase is an active member of the British Association of Oral and Maxillofacial Surgery and British Association of Head and Neck Oncologists where he has presented clinical research projects and been published in their journals. He is also published in other peer reviewed journals and plays an active part in research at QVH and collaboration with other hospitals. He is a member of the NICE (National Institute for Health and Care Excellence) quality assurance and framework group.

In addition to his clinical work at the Trust, he is the Trust clinical lead for head and neck (H&N) cancer. He also works closely with the Surrey and Sussex Cancer Alliance and is its clinical lead for head and neck cancer. He also devotes time to teaching, professional training and  steers the clinical outcomes group for head and neck surgery at QVH. He is national leader for question writing section 1 for the JCIE (Joint Committee for Intercollegiate Examinations) for the FRCS maxillofacial consultant examinations. Mr Bisase is also project lead for the introduction of a number of programmes aimed at improving patient care such as – Tracheostomy Care and the Enhanced Recovery Programme for patients undergoing major Head and Neck surgery (ERPHN), sentinel node biopsy and electrochemotherapy. QVH is the only provider of the latter two services in the South East of England. Together with allied healthcare professionals at QVH, Mr Bisase has introduced a process for collating the feedback of head and neck cancer patients.

Mr Bisase’s major cases are all fully discussed in a multi-disciplinary team, he ensures that they have received sufficient testing for diagnosis, and treatment plans are in line with national standards.

Mr Bisase also runs clinics at Horsham and Maidstone hospitals.

Mr Aakshay Gulati

Specialist interests: Head and neck oncology and microvascular facial reconstruction, surgical dermatology and reconstruction, salivary gland surgery, complex oral surgery and implantology.

Mr Aakshay Gulati is a dually qualified oral and maxillofacial surgeon. He obtained his Bachelor’s degree in Dental Surgery in 1996 and worked in a series of hospital posts in oral surgery around the London region for five years, successfully obtaining the Fellowship in Dental Surgery (FDSRCS), awarded by the Royal College of Surgeons of England in 2001.

Thereafter he graduated in Medicine (MBBS) from King’s College London in 2006 and completed generic surgical training, which culminated in the Membership of Royal College of Surgeons (MRCS) in 2009. His higher surgical training in oral and maxillofacial surgery was based in the south coast of England and this led to the award of the Fellowship of the Royal College of Surgeons in Oral and Maxillofacial Surgery (FRCS-OMFS) in 2014. He has completed a head and neck and microvascular reconstruction fellowship in a renowned centre in Munich in 2012 and was subsequently also selected for the highly coveted national interface head and neck fellowships. He has also developed an interest in implantology and has completed advanced training in the field.

Mr Gulati is the clinical tutor for oral and maxillofacial surgery in East Grinstead. He is on the review panel and has publications in various peer reviewed journals. He is passionate about teaching and regularly lectures in oral and maxillofacial surgery and implantology. He has had the opportunity of being invited as guest lecturer and keynote speaker on head and neck reconstruction at international scientific meetings.

Mr Gulati was the recipient of the Leibinger Prize in 2012. He is also actively involved with leadership roles as an executive board member of the European Association for Cranio-Maxillo-Facial Surgery.
Mr Gulati’s surgical interests lie in head and neck oncology and microvascular reconstruction, salivary gland surgery, surgical dermatology, complex oral surgery and implantology. His clinics are based in East Grinstead and the Medway region, and he is also a member of the West Kent Head and Neck Multidisciplinary team.

Mr Nikhil Maini

Specialist Interests: Orthognathic surgery for jaw discrepancies skin cancer, complex oral surgery, maxillofacial trauma, facial feminisation surgery.

Mr Nikhil Maini graduated in both medicine and dentistry from the University of Glasgow. After completing his surgical training in Scotland, he undertook his higher surgical training in oral and maxillofacial surgery here at Queen Victoria Hospital East Grinstead, at the Royal Sussex County Hospital in Brighton and at Eastbourne Hospital. This led to the award of the Fellowship of the Royal College of Surgeons in Oral and Maxillofacial Surgery in 2018.

Mr Maini is one of the only surgeons in the UK to have comprehensive formal training in facial feminisation surgery, through his work with Keith Altman. Mr Maini is a member of the British Association of Oral and Maxillofacial Surgeons and a member of the East Sussex Skin Cancer Multidisciplinary Team.

Mr Maini is also a member of the Virtual Reality in Medicine and Surgery Group at Brighton and Sussex Medical School.  He is a clinical and educational supervisor for both doctors and dentists in training.

Mr Maini’s other clinics are based in Brighton, Eastbourne and Uckfield.

Mr Laurence Newman

Specialist interest: Maxillofacial surgery

Mr Laurence Newman has been a Consultant Maxillofacial / Head and Neck Surgeon since 1997. His clinical practice is focused on the management of benign and malignant head and neck tumours. He operates on approximately 70 major head and neck cases annually.

He is also the Chair of the head and neck multidisciplinary team at the Kent Oncology Centre.

Mr Newman was a member of the Guideline Development Group at NICE (the National Institute for Health and Care Excellence) responsible for writing national guidelines for the management of head and neck cancers that were published in 2016.

He has a Master in Laws Degree (LLM) and is actively involved in medicolegal matters, particularly involving clinical negligence. He works closely with NHS Resolution and the NHS Ombudsman.

Mr Newman is currently an Assessor of Examiners for the FRCS examination in Maxillofacial Surgery and was the Chair of the Court of Examiners from 2010-2013. He helps to quality assure the examination process which impacts on patient safety.

Mr Paul Norris

Specialist interests: Oral and skin malignancy of the head and neck, particularly reconstruction of the post-ablative defect including microvascular surgery; surgery involving salivary gland disease; facial trauma; and dentoalveolar surgery.

Mr Paul Norris works at the world famous Queen Victoria Hospital in East Grinstead, Darent Valley Hospital Dartford and Maidstone Hospital.

He graduated in medicine from the University of London (Kings College Hospital) in 1998. As he specialises in the surgical ablation and reconstruction of head and neck cancer patients he also studied dentistry, gaining another degree from the University of London. He is a Fellow of the Royal College of Surgeons of both England and Edinburgh.

After experience in general, vascular, plastics, orthopaedics and urology surgery, Paul entered higher surgical training in oral and maxillofacial surgery working at Addenbrooke’s Hospital Cambridge, QVH, University College London Hospital, The Eastman Dental Hospital and Great Ormond Street Hospital in London. He passed the Intercollegiate Examination in Maxillofacial Surgery in March 2007 and has been on the Specialist Register of the General Medical Council since September 2008. He took up appointment as a consultant at QVH in November 2008.

Mr Norris devotes a significant amount of time to teaching, professional training and continuing medical education. He lectures internationally and was honoured to be asked to undertake head and neck cancer educational courses recently for the International Association of Oral and Maxillofacial Surgery in Indonesia and Malaysia.

Qualifications: BDS, MBBS, FDSRCS (Eng), FRCS (Ed), FRCS(OMFS)

Mr Zaid Sadiq

Mr Zaid Sadiq joined Queen Victoria Hospital in 2020 after working as a consultant for several years at University College London Hospital and Great Ormond Street Hospital.

Mr Sadiq is qualified in both dentistry and medicine. He completed higher surgical training in Oral and Maxillofacial Surgery in the London KSS region. He completed a Head and Neck reconstruction fellowship in Edinburgh and is accredited by the Royal College of Surgeons of England.

He is an honorary lecturer at University College London.

Mr Sadiq has a keen interest in cancer, reconstructive surgery and tissue engineering, as well as providing a spectrum of oral and maxillofacial practice. He has authored many scientific articles and contributed to various surgical books on head and neck surgery.

Mr Mike Shelley

Specialist interests: All aspects of oral and maxillofacial surgery with special interests in orthognathic surgery, the treatment of facial deformity including post-traumatic cases, and surgical dermatology.

Mr Mike Shelley read medicine and dentistry at King’s College Hospital, University of London, qualifying in dentistry in 1990 and medicine in 1997. After completing general surgical training he continued his post-graduate experience with higher specialist training in maxillofacial surgery at major centres in the South-East of England, including the Queen Victoria Hospital, East Grinstead. He subsequently passed the Intercollegiate Examination in Oral & Maxillofacial Surgery in March 2006 and has been on the Specialist Register for OMFS of the General Medical Council since February 2007.

After a three year period as a Consultant at Queen Alexandra Hospital, Portsmouth, where he gained invaluable experience in trauma management, Mr Shelley transferred to the renowned Queen Victoria Hospital in January 2010. As well as his duties at East Grinstead he also has peripheral clinics at Darent Valley Hospital, Kent.

Mr Shelley is experienced in all aspects of maxillofacial surgery but he has special interests in the treatment of facial deformity, orthognathic surgery and facial trauma.

Mr Shelley has a commitment to continuing medical education both in terms of his own practice and the teaching of junior surgical and paramedical staff. He has published peer reviewed papers in the medical and scientific literature and has presented and lectured nationally and internationally.

Mr Ken Sneddon

Specialist interests: Orthognathic surgery and facial reconstruction following trauma

Mr Ken Sneddon qualified in both dentistry and medicine at Kings College Hospital, University of London and obtained his specialist training in maxillofacial surgery at major UK centres in Glasgow, Queen Victoria Hospital and University College Hospital in London.

Mr Sneddon joined Queen Victoria hospital as a Consultant Maxillofacial Surgeon in 1999 and is also postgraduate dental tutor at Tunbridge Wells.

Mr Sneddon has special interests in orthognathic surgery and facial reconstruction following trauma.

Mr Stefano Stea

Specialist interests: Temporomandibular joint disorder; orthognathic surgery and dentoalveolar surgery.

Mr Stefano Stea has degrees in both dentistry and medicine from the University of Bologna, Italy. He then specialised in maxillofacial surgery at the University of Parma, Italy. Mr Stea completed his qualifications with the awarding of the European Board of Oral-Maxillofacial Surgery Diploma. He also has a Master’s in Surgical Therapy for TMJ Disorder.

Mr Stea  is an active member of the British Association of Oral Maxillofacial Surgery (BAOMS); the European Association for Cranio Maxillofacial Surgery (EACMFS); the Italian Maxillofacial Surgery Society (SICMF); and the Italian Medical Society of Great Britain (IMSoGB).

Mr Stea is experienced in all aspects of oral and maxillofacial surgery, with special interest in the treatment of temporomandibular joint (TMJ) disorders. He is the author of more than 70 published articles and has been a speaker at numerous international scientific conferences.

He joined the staff at Queen Victoria Hospital in East Grinstead in January 2019. Mr Stea also consults at clinics in Dartford and Medway hospitals.

Mr John Tighe

Clinical Director for Head and Neck Services

Specialist interests: Management of patients undergoing surgical treatment and reconstruction for head and neck malignancy.

Mr John Tighe is a Consultant Oral & Maxillofacial Surgeon at Queen Victoria Hospital in East Grinstead and has been in post since 2002.

Mr Tighe is qualified in both dental surgery (U. Bristol 1986) and medicine (U. London 1990) and carried out his higher surgical training locally on the South Thames rotation. As well as his duties at East Grinstead he carries out a peripheral clinic at Uckfield Community Hospital and a rapid access clinic at East Surrey Hospital.

Mr Tighe has a special interest in the management of patients undergoing surgical treatment and reconstruction for head and neck malignancy and is a core member of the Brighton Head and Neck Oncology Multidisciplinary Team. In addition, Mr Tighe carries out a broad spectrum of oral and maxillofacial surgical procedures including salivary gland surgery, surgical dermatology and dental implantology.

His latest major cases show that he ensures all his patients are fully discussed in a multi-disciplinary team, and ensures that they have received sufficient testing for diagnosis and treatment plans.

John Tighe, year ending October 2014:
No. of major surgical procedures: 12 cases.
Pre-treatment multi-disciplinary team discussion: 12 cases (100% of cases).
Resective pathology multi-disciplinary team discussion: 12 cases (100% of cases).