I am looking for thoughts on the procedure to remove this mole.
Is it risky due to size, could stitches/recovery alter the direction of the nostril?
Also any recommendations for London-based surgeons?
Based on the picture ( very limited view) excision of the mole will have a scar and possibly nostril shape change.
other possibilities is to remove the mole and let it heal by secondary intension. possible skin graft or flap.
It is important to send the mole for pathology examination.
As for Board Certified Plastic Surgeon, you have Harley Street Consultant in London that can give you an advise and a good consult. Expensive but worth it.
No matter what, you are going to have some form of scarring and deformity after removal that would most likely be better than what you have now.
consider also that the lesion is most likely going to keep on growing and the more it grows, the larger the defect and difficulty of removal. There are many ways to handle this problem and every plastic surgeon would know what to do. You need to see a plastic surgeon near you for a consultation and then both of you decide which method would be best for you.
I would just shave it off keeping the contours of the nostril. You could send the shave for biopsy to be sure it is not malignant. It will likely grow back over time, but this would be over the course of several years in most instances. However, this generally leaves an acceptable scar (if not shaved too deeply).
This appears to be benign. A minimalistic approach will be best here based on location. Have it shaved with the contour of your nose and sent for pathologic analysis. See a board certified plastic surgeon to care for you on this.
From your given photo, it's possible to remove the mole by minimal invasive surgery and possible to keep a good shape of the nostril. Please consult Board Certified Plastic Surgeon for physical examination and treatment plan.