Cosmetic surgery is now a common practice, with both men and women choosing to make changes that help them feel more confident in how they look and present themselves. However, it remains a highly considered decision, where trust, discretion and a surgeon’s track record of delivering consistently excellent results matter.
For this reason, the Spear’s Index of the best cosmetic surgeons brings together practitioners who are known not just for their technical precision, but also their eye for balance and natural-looking outcomes. The names featured in the list are known for surgical innovation and clinical expertise, with a consistent record of exceptional patient satisfaction.
[See also: The best non-surgical cosmetic practitioners in 2026]
Related
In 2026, the Spear’s Research Unit has integrated leading hair loss treatment specialists into our cosmetic surgery rankings, reflecting the increasingly holistic approach to aesthetic medicine. Indeed, our research found that different kinds of surgical, dermatological and regenerative treatments are increasingly seen as part of one joined-up approach to care, with surgeons often combining different treatments to achieve the most natural and long-lasting results.
This year’s research also found that doctors are becoming increasingly skilled at delivering results that are almost impossible to detect, in line with growing demand from UHNW and celebrity clients for subtle, natural changes.
As a new addition to the index, Dr Julian de Silva noted, his patients are often looking for extremely subtle improvements: ‘They often don’t want anyone to know that they’ve had a procedure. Sometimes I can do an entire procedure to change one millimetre on a face,’ he told Spear’s.
Content from our partners
This focus on refinement rather than reinvention runs through the whole field. The surgeons in this year’s list are at the cutting edge of their work, from those developing new sedation and anaesthetic techniques to make procedures more comfortable and recovery smoother, to others who bring an artistic eye to facial and body surgery.
Click the links below to jump to a section of this article:
- Methodology
- Best cosmetic surgeons for HNWs: some names to know
- Best cosmetic surgeons for HNWs: the complete list
- Contact us
Methodology
Each year, the Spear’s Research Unit reassesses and refreshes its rankings of the leading providers in each sector by gathering data from and about the advisers and firms themselves, assessing submission forms, collating nominations, carrying out peer reviews, reviewing data from third-party sources, gathering references and recommendations, canvassing experts and conducting hundreds of interviews.
Advisers are evaluated using a proprietary scoring system that assigns different weightings to certain attributes. These scores feed directly into each new set of rankings in the Spear’s Indices. Each of these indices are published first online (according to the research calendar) and then in print. Print publication takes the form of the annual Spear’s 500 directory, which includes the top advisers in every index.
[See also: A guide to The Spear’s 500: Everything you need to know]
Each featured adviser is profiled on spears500.com. The site allows users to search the Spear’s database of more than 4,000 entities to find one (or more) to meet their specific requirements by filtering for specific attributes such as an adviser’s location, their specialist expertise and information about their client base.
Best cosmetic surgeons for HNWs: some names to know
Julian De Silva
- Focus: Oculo-facial plastic surgery
- Firm: Centre for Facial Cosmetic and Plastic Surgery
Dr Julian De Silva is a cosmetic surgeon specialising in oculo-facial plastic surgery. Based on London’s Harley Street, he treats an international clientele – including celebrities, senior executives and UHNW individuals – who often travel to the UK in search of results that are as natural-looking as possible.
De Silva focuses exclusively on facial procedures, namely blepharoplasty, neck and facelifts and rhinoplasty, and his patients are often looking for very subtle improvements. ‘They often don’t want anyone to know that they’ve had a procedure,’ he tells Spear’s. ‘Sometimes I can do an entire procedure to change one millimetre on a face.’
Operating from a custom-built private facility, his clinic can also arrange accommodation for international patients who travel to London and remain under his care during their recovery.
Read Julian De Silva’s full profile on Spears500.com
Paul Tulley
- Focus: Facelifts and rhinoplasty
- Firm: Several private clinics across London
Mr Paul Tulley is a London-based plastic and reconstructive surgeon whose practice is centred on advanced aesthetic procedures, particularly facelifts and rhinoplasty.
With nearly two decades of experience as a consultant, he treats a high-profile clientele that includes media executives, celebrities and politicians, as well as international patients who travel to the UK for surgery. Tulley trained at Charing Cross and Westminster Medical School before completing specialist plastic surgery training in London. He later undertook further fellowships abroad, including microsurgical training in Taiwan and cosmetic surgery training in the US.
He now practises across several private clinics and hospitals in London, where he works closely with his patients, from initial consultation to recovery and aftercare. ‘We’ll usually see [patients] two or three times before the surgery as we come towards a plan, and then keep a very close and regular relationship after the procedure,’ he tells Spear’s.
Read Paul Tulley’s full profile on Spears500.com
Georgios Orfaniotis
- Focus: Facelifts and facial rejuvenation
- Firm: Orfaniotis Plastic Surgery
Considered a rising star who might one day rival the likes of industry stalwarts, Rajiv Grover and Norman Waterhouse, Dr Georgios Orfaniotis is commended for his facial rejuvenation work. As the popularity of facelifts increases, Orfaniotis says, his services are in demand.
‘Face and necklifts are very popular,’ he tells Spear’s. ‘Most of my patients are looking for a comprehensive face refresh.’
He expects this to continue, regardless of the prevalence of Botox and fillers. ‘The honeymoon period is now over, and people are beginning to realise that anti-ageing is not just about fighting volume loss,’ he has told the press. In his view, permanent solutions are needed, and with technological advancements, facelifts are becoming the desirable option.
Read Georgios Orfaniotis’s full profile on Spears500.com
Rajiv Grover
- Focus: Facelifts and facial rejuvenation
- Firm: Rajiv Grover Clinic
Harvard Medical School alumnus Dr Rajiv Grover’s eponymous Harley Street practice specialises in surgical procedures including rhinoplasty, brow lifts, blepharoplasty, facelifts, liposuction and breast enlargement and reduction.
He also consults at the London Clinic and King Edward VII Hospital, which holds a charter to serve the royal family. Considered one of the country’s top plastic surgeons, his services don’t come cheap, but they’re certainly worth the end result.
Commended for his experience and expertise, Grover is ‘recognised for his ability to provide a natural look by combining an artistic element with his surgical technique’. He is a former president of the British Association of Aesthetic Plastic Surgeons and has contributed to lectures on the art of aesthetic surgery at the Royal College of Art in London and the Louvre in Paris.
Read Rajiv Grover’s full profile on Spears500.com
Mark Tam
- Focus: FUE hair procedures
- Firm: Dr Mark Tam
A specialist in hair loss and transplants, Dr Mark Tam holds a diploma from the American Board of Hair Restoration Surgery and is a member of the International Society of Hair Restoration Surgery and the British Association of Hair Restoration Surgery.
At his Harley Street clinic, he specialises in follicular unit extraction (FUE) – in which follicles are taken from a donor area of the head and implanted in a patient’s thinning areas – using a specially developed small punch, leaving less evidence of surgical work at the donor sites on the sides or back of the head.
‘Some clinics are very commercial, but when I started mine, I wanted to do things differently,’ Tam tells Spear’s. ‘I’m very low production; we do two transformations per week, and that gives us more energy to focus on the work itself and give patients direct access to their doctor.’
Read Mark Tam’s full profile on Spears500.com
Best cosmetic surgeons for HNWs: the complete list
Contact us
- To apply for inclusion in The Spear’s 500, complete our submission form.
- For further information about rankings, please email research@spearswms.com; we aim to respond to all queries within two working days.
- For commercial enquiries and questions relating to enhanced profiles, please contact Commercial Director Shady Elkholy: shady.elkholy@spearswms.com
- To keep up to date with the Spear’s 500, subscribe to our magazine, newsletter and follow Spear’s on Linkedin and Instagram.
- If you have missed calendar deadlines for our research cycles in 2025, you can still register your interest for updates about upcoming research and rankings.
- Click here to order a print copy of The Spear’s 500.
With additional reporting by Livia Giannotti.
