ASHWIN KERAI

FACIAL SURGERY

Consultant oral and Maxillofacial surgeon

BDS(Hons) MFDSRCSEd MBChB MRCSEd MSc(Dist) RCPathME FRCSEd(OMFS)

Mr Kerai is a UK fellowship trained Consultant Oral and Maxillofacial Surgeon and has undergone comprehensive training in all aspects of Oral and Maxillofacial surgery at Alder Hey Children's Hospital and Liverpool Head & Neck Centre, Aintree Hospital, renowned for being one of the busiest centres in the UK and Europe. He was awarded a Certificate of Completion of Training (CCT) in July 2024 and is on the GMC Specialist Register for Oral & Maxillofacial Surgery.


With over 15 years of experience in oral and maxillofacial surgery, he has developed expertise across a wide range of procedures.

His subspecialty interests include correction of facial deformity and management of cutaneous cancers with both conventional surgery and Mohs Micrographic surgery. He also carries out the full remit of dentoalveolar and salivary gland surgery.

He has performed over 2,000 operations in oral and maxillofacial surgery across the entire breadth of the speciality with focuses on correction of facial deformity, dentoalveolar surgery, cosmetic facial surgery, skin cancer surgery and salivary gland surgery.


He is one of only a handful of surgeons in the UK who has successfully completed the TIG Mohs Micrographic Surgery fellowship.

Outside of work and study, he enjoys skiing in the French Alps, running and keeping fit in the gym and reading. He has carried out hiking trips and motorbike expeditions through the Indian Himalayas crossing the highest motorable pass in the world.

Procedures

  • What are wisdom teeth?
    Wisdom teeth are the third molars that usually emerge between the ages of 17 and 25. In many people there is insufficient space for them to come through properly.

    Why might they need to be removed?
    Wisdom teeth are commonly removed if they cause:

    • Recurrent infection or pain

    • Swelling of the gums or face

    • Damage to neighbouring teeth

    • Tooth decay or gum disease

    • Cysts or other pathology around the tooth

    • Problems due to impaction (teeth trapped in the jaw)

    The procedure
    Wisdom tooth removal is a routine procedure performed under:

    • Local anaesthetic

    • Sedation

    • General anaesthetic (when appropriate)

    The approach is tailored to the position of the tooth and your individual needs.

    Recovery
    Most patients experience mild swelling and discomfort for a few days. Clear aftercare advice is provided to promote healing and reduce the risk of complications.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I manage both straightforward and complex wisdom tooth extractions, including teeth close to nerves or deeply impacted, ensuring safe treatment and optimal outcomes.

  • What is a jaw cyst?
    A jaw cyst is a fluid-filled sac that develops within the jawbone, often associated with a tooth that has failed to develop or erupt normally. Many jaw cysts grow slowly and may cause no symptoms initially.

    Why is removal recommended?
    Jaw cysts are usually removed to:

    • Prevent expansion and weakening of the jawbone

    • Reduce the risk of infection or swelling

    • Protect nearby teeth and nerves

    • Exclude or treat more serious pathology

    The procedure
    Jaw cyst removal is performed under:

    • Local anaesthetic

    • Sedation

    • General anaesthetic (depending on size and location)

    The cyst is carefully removed and sent for laboratory analysis. Advanced imaging is used to plan safe treatment, particularly when nerves or teeth are nearby.

    Recovery
    Most patients recover well with mild swelling and discomfort. Larger cysts may require closer follow-up to monitor bone healing.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I have extensive experience managing jaw cysts of varying complexity, ensuring accurate diagnosis, safe removal, and appropriate long-term follow-up.

  • What does this involve?
    These are common skin lesions that may be removed for medical, functional, or cosmetic reasons. Removal is usually straightforward and performed as a day-case procedure.

    Why might removal be recommended?
    Lesions may be removed if they:

    • Change in size, shape, or colour

    • Cause pain, bleeding, or recurrent infection

    • Catch on clothing or interfere with shaving

    • Cause cosmetic concern

    • Require diagnosis to exclude skin cancer

    The procedure
    Removal is typically performed under local anaesthetic. Techniques may include surgical excision, curettage, or other minor surgical methods depending on the lesion type and location. Any removed tissue can be sent for laboratory analysis where appropriate.

    Recovery
    Most procedures take only a short time. Mild swelling or bruising may occur, and stitches—if used—are usually removed within 5–10 days. Clear aftercare advice is provided to optimise healing and minimise scarring.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with expertise in skin surgery, I provide accurate diagnosis, safe removal, and meticulous wound closure to achieve the best functional and cosmetic outcomes.

  • What is scar revision?
    Scar revision is a procedure designed to improve the appearance, texture, or function of a scar following injury, surgery, or previous skin procedures. While scars cannot be completely removed, they can often be made less noticeable.

    Why might scar revision be recommended?
    Scar revision may help if a scar:

    • Is raised, thickened, or widened

    • Is painful, itchy, or tight

    • Restricts movement

    • Is poorly positioned or cosmetically concerning

    • Has healed unpredictably

    The procedure
    Treatment is tailored to the type, location, and age of the scar. Options may include surgical revision, steroid injections, or other techniques to optimise healing. Most procedures are carried out under local anaesthetic.

    Recovery
    Recovery is usually straightforward. Temporary swelling or redness is common, and scars continue to mature and improve over several months. Detailed aftercare advice is provided to support optimal healing.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with expertise in facial and skin surgery, I aim to improve both appearance and function using precise surgical techniques and careful planning.

  • What is a chin implant?
    A chin implant is a procedure that enhances the shape and projection of the chin, improving facial balance and profile. It can be performed as a standalone procedure or alongside other facial or jaw surgery.

    Why might a chin implant be recommended?
    Chin augmentation may be considered to:

    • Improve facial harmony and profile balance

    • Correct a weak or recessed chin

    • Enhance jawline definition

    • Complement orthodontic or orthognathic treatment

    The procedure
    Chin implant surgery is usually carried out under local anaesthetic with sedation or general anaesthetic. A carefully selected implant is positioned through a small incision, typically inside the mouth or under the chin, to achieve a natural and balanced result.

    Recovery
    Most patients experience mild swelling and tightness for a short period. Normal activities can usually be resumed within a few days, with full settling of the result over several weeks. Detailed aftercare guidance is provided.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with expertise in facial aesthetics and jaw surgery, I focus on precise planning and anatomical accuracy to achieve safe, natural-looking outcomes.

  • What are cheek implants?
    Cheek implants are used to enhance the contour and projection of the mid-face, improving facial balance and definition. They can help restore volume or correct under-development of the cheekbones.

    Why might cheek implants be recommended?
    Cheek augmentation may be considered to:

    • Improve mid-face contour and facial symmetry

    • Enhance cheekbone definition

    • Restore volume lost with ageing

    • Complement other facial or jaw surgery

    The procedure
    Cheek implant surgery is usually performed under general anaesthetic or local anaesthetic with sedation. Implants are placed through small incisions, typically inside the mouth, and positioned precisely over the cheekbones to achieve a natural result.

    Recovery
    Swelling and bruising are common for the first 1–2 weeks and gradually settle. Most patients return to normal activities within a short period, with the final result becoming apparent as swelling resolves.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with specialist training in facial skeletal surgery, I use detailed anatomical planning to achieve balanced, natural-looking results while prioritising safety.

  • What is orthognathic surgery?
    Orthognathic surgery corrects misalignment of the jaws to improve bite function, facial balance, and long-term oral health. It is often carried out in combination with orthodontic treatment.

    Why might orthognathic surgery be recommended?
    Jaw surgery may be advised to:

    • Correct severe bite problems

    • Improve chewing, speech, or breathing

    • Address facial imbalance or asymmetry

    • Treat jaw-related pain or dysfunction

    • Improve long-term dental stability

    The procedure
    Orthognathic surgery is performed under general anaesthetic. The jaws are repositioned with precision and stabilised using small titanium plates and screws. Treatment is carefully planned using advanced imaging and digital surgical planning.

    Recovery
    Initial swelling and bruising are expected and gradually settle over several weeks. Most patients return to normal activities within a few weeks, with full recovery and final results continuing to improve over several months.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with specialist expertise in orthognathic surgery, I work closely with orthodontic colleagues to deliver safe, accurate treatment with predictable functional and aesthetic outcomes.

  • What is skin cancer surgery?
    Skin cancer surgery involves the careful removal of cancerous or pre-cancerous lesions from the skin. The goal is complete removal while preserving surrounding healthy tissue and achieving the best functional and cosmetic outcome.

    Why might surgery be recommended?
    Surgery is usually advised to:

    • Remove basal cell carcinoma, squamous cell carcinoma, or other skin cancers

    • Prevent local spread or recurrence

    • Restore appearance and function, especially in visible areas such as the face, scalp, or neck

    The procedure
    Skin cancer surgery may include:

    • Excision with clear margins

    • Reconstruction of the surgical site using meticulous techniques to optimise healing and aesthetics

    Procedures are usually performed under local anaesthetic, with sedation or general anaesthetic in selected cases.

    Recovery
    Healing time varies depending on the size and location of the excision. Mild swelling, bruising, or scarring may occur. Detailed aftercare instructions are provided to support optimal recovery and monitor for recurrence.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with extensive skin surgery experience and fellowship trained, I provide precise removal, expert reconstruction, and careful follow-up to ensure safe, functional, and cosmetically pleasing results.

  • What is salivary gland surgery?
    Salivary gland surgery involves the removal or treatment of disorders affecting the salivary glands, such as stones, infections, cysts, or tumours. The major glands include the parotid, submandibular, and sublingual glands.

    Why might surgery be recommended?
    Surgery may be advised to:

    • Remove salivary stones causing pain or infection

    • Treat chronic or recurrent gland infections

    • Remove benign tumours

    • Restore normal saliva flow and gland function

    The procedure
    The approach depends on the gland and condition. Surgery is usually performed under general anaesthetic. Techniques are carefully chosen to preserve facial nerves and surrounding structures while addressing the underlying problem.

    Recovery
    Recovery typically involves mild swelling or discomfort for a few days. Most patients return to normal activities within 1–2 weeks. Detailed post-operative instructions are provided to support healing and minimise complications.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I have expertise in complex salivary gland procedures, including tumour removal and nerve preservation, ensuring safe treatment with optimal functional and cosmetic outcomes.

conditions Managed

  • What is jaw joint pain?
    Jaw joint pain, often related to the temporomandibular joint (TMJ), can cause discomfort, clicking, limited movement, or facial pain. It may result from muscle strain, arthritis, injury, or misalignment of the bite.

    Why might treatment be recommended?
    Treatment is advised if you experience:

    • Persistent jaw pain or stiffness

    • Difficulty opening or closing your mouth

    • Clicking, popping, or grinding sounds

    • Headaches or facial discomfort related to jaw movement

    The approach to treatment
    Management is tailored to the underlying cause and may include:

    • Non-surgical therapies: splints, physiotherapy, and pain relief

    • Minimally invasive procedures: injections or arthroscopy

    • Surgical intervention in selected cases for structural problems

    Recovery
    Recovery depends on the treatment method. Non-surgical therapies usually provide gradual improvement, while surgical or minimally invasive procedures may require a short recovery period and follow-up care.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I diagnose and manage complex jaw joint problems, combining expertise in both surgical and non-surgical treatments to relieve pain, restore function, and improve quality of life.

  • What is oral ulceration?
    Oral ulcers are small, painful sores that appear on the lining of the mouth, tongue, or gums. They are common and usually heal on their own, but some persistent or recurrent ulcers require specialist assessment.

    Why might treatment be recommended?
    Assessment is advised if you have:

    • Ulcers lasting longer than two weeks

    • Recurrent or severe pain

    • Bleeding or unusual appearance

    • Difficulty eating, drinking, or speaking

    • Suspicion of underlying medical conditions

    The approach to treatment
    Management depends on the cause and may include:

    • Topical or systemic medications to reduce pain and inflammation

    • Identification and treatment of underlying causes

    • Biopsy or further investigation for persistent, unusual, or suspicious ulcers

    Recovery
    Most ulcers heal within 1–3 weeks. Persistent or recurrent lesions may require ongoing monitoring and treatment to prevent complications. Clear aftercare guidance is provided to promote healing.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I provide expert diagnosis and management of complex or persistent oral ulcers, ensuring appropriate treatment, early detection of serious conditions, and relief from discomfort.

  • What is trigeminal neuralgia?
    Trigeminal neuralgia is a chronic condition that causes sudden, severe, electric-shock-like pain in the face, often triggered by everyday activities such as talking, chewing, or touching the face. It affects the trigeminal nerve, which carries sensation from the face to the brain.

    Why might treatment be recommended?
    Treatment is advised if you experience:

    • Recurrent, severe facial pain

    • Pain triggered by normal activities (e.g., brushing teeth, eating)

    • Reduced quality of life due to pain

    The approach to treatment
    Management may include:

    • Medications to reduce nerve pain

    • Minimally invasive procedures such as nerve blocks or injections

    • Surgical interventions for cases not controlled by conservative measures

    Recovery
    Recovery and relief depend on the treatment method. Medication may provide gradual improvement, while surgical procedures can offer longer-term relief with a short recovery period. Follow-up is essential to monitor effectiveness and adjust treatment.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I have expertise in diagnosing and managing trigeminal neuralgia, offering tailored medical and surgical options to relieve pain and improve daily function.

  • Basal Cell Carcinoma (BCC)

    What is basal cell carcinoma?
    Basal cell carcinoma is the most common type of skin cancer. It usually appears as a slowly growing, non-healing patch, bump, or sore on sun-exposed areas of the skin, especially the face and neck.

    Why might treatment be recommended?
    Treatment is necessary to:

    • Remove the cancer and prevent local spread

    • Minimise damage to surrounding healthy tissue

    • Reduce the risk of recurrence

    • Restore appearance and function, particularly in visible areas

    The approach to treatment
    Treatment may include:

    • Surgical excision to remove the lesion with clear margins

    • Reconstruction to optimise cosmetic and functional outcomes

    Recovery
    Most patients recover well with mild swelling, redness, or scarring at the surgical site. Follow-up appointments ensure healing is progressing and check for any signs of recurrence.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon with experience in skin cancer surgery, I provide precise removal, careful reconstruction, and ongoing follow-up to ensure safe, effective, and cosmetically sensitive outcomes.

  • What is squamous cell carcinoma?
    Squamous cell carcinoma is a common type of skin cancer that develops in the outer layers of the skin. It often appears as a persistent, scaly, or crusted patch, nodule, or ulcer, usually on sun-exposed areas such as the face, ears, and neck.

    Why might treatment be recommended?
    Treatment is essential to:

    • Remove the cancer completely

    • Prevent local spread or invasion into deeper tissues

    • Protect surrounding structures, including nerves and bones

    • Restore appearance and function, particularly in facial areas

    The approach to treatment
    Surgical options include:

    • Excision with clear margins

    • Reconstruction as needed to achieve the best cosmetic and functional result

    Recovery
    Recovery varies depending on the size and location of the lesion. Mild swelling, bruising, or scarring may occur. Follow-up appointments are provided to monitor healing and check for recurrence.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I provide expert surgical removal, careful reconstruction, and ongoing follow-up to ensure safe, effective, and aesthetically sensitive management of squamous cell carcinoma.

  • What is oral lichen planus?
    Oral lichen planus is a chronic inflammatory condition that affects the lining of the mouth. It may appear as white, lacy patches, red swollen areas, or painful sores, and can cause discomfort or sensitivity.

    Why might treatment be recommended?
    Treatment is advised if you experience:

    • Pain, burning, or sensitivity in the mouth

    • Difficulty eating, drinking, or speaking

    • Persistent or widespread lesions

    • Risk of secondary infection or irritation

    The approach to treatment
    Management may include:

    • Topical or systemic medications to reduce inflammation and pain

    • Regular monitoring for changes or signs of dysplasia

    • Lifestyle and oral hygiene advice to support healing

    Recovery
    Symptoms often improve with treatment, though lichen planus may be chronic and require ongoing management. Regular follow-up is important to monitor the condition and adjust treatment as needed.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I provide expert assessment, diagnosis, and management of oral lichen planus, helping to relieve discomfort and monitor for potential complications.

  • What is a neck lump?
    A neck lump is a swelling or mass in the neck, which may arise from lymph nodes, salivary glands, thyroid, or other neck structures. Most neck lumps are benign, but some require investigation to exclude serious conditions.

    Why might assessment be recommended?
    Evaluation is advised if you have a lump that:

    • Persists for more than a few weeks

    • Grows in size

    • Is hard, irregular, or fixed

    • Causes pain, difficulty swallowing, or voice changes

    The approach to investigation and treatment
    Assessment typically includes:

    • Clinical examination and medical history

    • Imaging such as ultrasound or CT scans

    • Fine-needle aspiration or biopsy if necessary

    • Surgical removal in selected cases

    Recovery
    Recovery depends on the procedure performed. Simple investigations have minimal recovery time, while surgical removal may involve a short period of swelling or discomfort. Follow-up ensures proper healing and monitoring.

    Why see a specialist?
    As a consultant oral and maxillofacial surgeon, I have expertise in evaluating and managing neck lumps, ensuring accurate diagnosis, safe intervention, and appropriate long-term follow-up.

where to find

 

Spire Murrayfield Hospital, Wirral

Holmwood Dr, Thingwall, Barnston, Wirral CH61 1AU

Contact:

Secretary: Victoria Douglas
Telephone: 07876 525916
Email: secretary@ashwinkerai.com