Ivan Wayne, MD

While the majority of the 400 plus nasal surgeries I perform each year are done with patients under general anesthetic it is definitely possible to use local anesthetic. To do that you will need to be tolerant of full awareness of the surgery and some discomfort while the local anesthetic is injected into your nose and cheeks to numb the area before starting the surgery. Packing will be placed in the back of your nose to prevent anything dripping down your throat during the surgery so will need to breath through your mouth. Most people will require and appreciate some form of sedation drugs such as versed, or valium and IV medications such as fentanyl and propofol to reduce discomfort and increase relaxation as well helping you disconnect from the somewhat uncomfortable process. In conclusion if you are motivated and can tolerate the above issues you are a candidate for nasal surgery under local anesthesia.

Thank you for posting your question and photos. Based on the photos provided it appears that your septum is deviated (obstructing the right nostril). An open Rhinoplasty will address the internal medical concerns, putting the septum back in place, allow for better breathing, and make the nose straight. Scheduling an in-person consultation with a Facial Plastic Surgeon, who has extensive experience with the Rhinoplasty surgery, is the best way to determine if you are a good candidate for the Rhinoplasty surgery and the best treatment plan for you. I have attached a link below to a previous patient of mine who had a similar case to yours. You can see their results by clicking the link. I hope this was helpful & best of luck!Dr. Ivan Wayne

Thank you for posting your question and photos. Based on the photos provided I believe the results you are looking for are realistic. Of course, the best way to determine if you are a good candidate for a Rhinoplasty and the best treatment plan for you is through an in-person consultation with a Facial Plastic Surgeon who has extensive experience in the Rhinoplasty surgery. I also suggest looking at the surgeon's before and after photos to see if you like their work. A good Rhinoplasty is invisible to others and will enhance the surrounding facial features - looking through the photos provided a Rhinoplasty using gentle surgical techniques can address and correct the hanging, bulbous tip and slight dorsal hump without any major bruising and minimal swelling. I have provided a link below to a previous patient of mine who had a similar case to yours. You can see their results by clicking the link. I hope this was helpful & best of luck!Dr. Ivan Wayne

Thank you for posting your question and photos. From observing the photos provided, a Rhinoplasty can definitely address the nose to better enhance your already existing facial features. Using gentle surgical techniques the large hump, drooping tip, and wide, bulbous tip can be corrected without any major bruising and minimal swelling. Scheduling an in-person consultation with a facial plastic surgeon is the best way to determine if you are a good candidate for a Rhinoplasty, and the best treatment plan specifically for you. A good Rhinoplasty is in invisible to others and will enhance the surrounding facial features. Below I have attached a link to a previous patient of mine who had a similar case to yours. You can see their results through the link. I hope this was helpful & best of luck, Dr. Ivan Wayne

Thank you for posting your question and photos. Based on the photos provided, yes, your expectations are very reasonable. A Rhinoplasty can correct your wide drooping tip and also address the slight dorsal hump giving you a more feminine, perky nose. My best advice is to research and look for a Facial Plastic Surgeon who has extensive experience with the Rhinoplasty procedure. Book an in-person consultation to discuss what it is you do not like/wish to change, ask to see their Rhinoplasty before and afters. It is also a good idea to seek out a surgeon who utilizes photo morphing, this will give you an idea of what kind of result you can expect post Rhinoplasty procedure. I have provided a link to a previous patient of mine who had a similar case to yours, where she wanted a more feminine nose to match her facial features. I hope this was helpful and best of luck, Dr. Ivan Wayne

Thank you for posting your question along with photos.Yes, a rhinoplasty using the Origami technique will address your concerns with the dorsal hump, and a tip refinement will correct the over-projected drooping tip. Your expectations are very reasonable. The best way to determine what will look best on your face is to schedule an in-person consultation with a Facial Plastic Surgeon who has extensive experience with the Rhinoplasty procedure. Doing this will allow you to discuss what it is you do not like/wish to change and in return your potential surgeon can give their professional advice on their best treatment plan for you and your facial features. It is also a good idea to search for a Facial Plastic Surgeon who utilizes photo morphing, this will give you a visual of what kind of results you can expect from your surgeon post procedure. I have provided a link to a previous patient of mine who had a very similar case to yours, you can view her before and afters by following the link to my Rhinoplasty before and after page on RealSelf. I hope this was helpful and best of luck,Dr. Ivan Wayne

Hello, and thank your for your question. In the 20 years I have been doing surgery on noses I have rarely seen empty nose syndrome-the few patients I have encountered with that problem had very aggressive removal of essentially all of their inferior turbinates (this was done by other doctorsNasal turbinates  provide many functions for the nose. They moisturize the air we breath. They filter out many particles from the air we breath. They also provide a sense of nasal resistance and provide information to the brain that is telling us how our breathing is. I think this is where taking out too much turbinate tissue can cause problems-even though our nose is wide open without the turbinate telling us that air is flowing through that can be sensation of resistance-this is the "empty nose syndrome". Where I practice in Oklahoma-we have a dry climate and we are very careful with surgery on turbinates. I typically do not remove any tissue from turbinates during a rhinoplasty and if they are blocking they can be treated successfully by repositioning them laterally. Every patient is treated for their individual goals with respect for their nasal anatomy. A frank discussion with your surgeon about what they are planning to do to your turbinates is essential.Good luck and I hope this helps you.Dr. Wayne

Thank you for posting your question. Because there are so many surgeons out there who do perform the revision rhinoplasty surgery these are my three tips on finding the right surgeon for you:1. Look for a surgeon who is a board certified facial plastic surgeon by AAFPRS (American Academy of Facial Plastic and Reconstructive Surgery) and ABFPRS (American Board of Facial Plastic and Reconstructive Surgery). These surgeons dedicate their skills to just the face. Once you have found a board certified facial plastic surgeon make sure they have extensive experience with the nose as well, primarily and especially the Rhinoplasty surgery. 2. Look at their before and after photos of the exact surgery you are interested in. Then look at their patient reviews. Both of these are very good indicators at what you can expect from the surgeon. 3. Meet the surgeon in person, this can help tremendously in determining if the surgeon is right for you and your case. I hope this was helpful and good luck in your search! Dr. Ivan Wayne

Thank you for posting your question as well as your photos. In regards to the tip-plasty being done under local anesthesia/sedation, it is definitely possible. Anything between just the tip to a full rhinoplasty can be done under local anesthesia, however this needs to be something that the patient has to be very determined and set on. If you were to go ahead with just the tip-plasty you may end up with results that are not in balance or harmonious with the rest of your facial features, especially with the bridge of your nose being so wide. To determine if you are a good candidate for either just the tip or full rhinoplasty (under local anesthesia) you will need to be seen in-person by a facial plastic surgeon. Seeing a surgeon in person is critical for determining the best treatment plan for you based on what you are trying to achieve, which may or may not include a full rhinoplasty addressing the entire nose. Make sure to do extensive research and find a surgeon who is board certified with many years of experience in the Rhinoplasty field. I hope this was helpful, Dr. Ivan Wayne

Thank you for posting your questions and pictures. Based on the side profile pictures only, a rhinoplasty using the origami technique will gently get rid of your dorsal hump and to be able to determine what else can be corrected I would need to see additional photos of the nose at different angles (front, 3/4 angle, and side). The origami technique is a skill I have created and adopted over the few several years, and seen great results with. This technique uses gentle handling of the tissue/cartilage, resulting in minimal bruising and swelling. With an in-person consultation I will be able to listen to what it is you do not like/wish to change, give my professional advice and then a treatment plan tailored to your needs. I will also use computer imaging to show the results you can expect post procedure. A rough estimate for a Rhinoplasty is around 8,500, including anesthesia and facility fees. After an in-person consultation and evaluating the nose, an exact number will be given based on your treatment plan. My advice to anyone looking into plastic surgery is to do extensive research, find a skilled board-certified facial plastic surgeon. Also look at their reviews and before and after photos of previous patients. Best of luck,Dr. Wayne