What are my options to make my nose more feminine without going under general anesthesia? (Photo)

Question

For reference I'd like a more feminine and I like a straight ethnic looking nose. My bulbous tip others me that's a bit longer and pointier than I'd like but I really want a natural change that is undetectable to others/family& friends. What are my options without general anesthesia? Attached are pics. I'm open to all advice and opinions. Thanks!

Jonathan Landon, MD · Answer

Hello and thank you for your question. Based on your photographs, if you are having a Rhinoplasty it should definitely be under general anesthesia. You have a bulbous tip, a slight dorsal hump, and an over projected tip. Performing a well done rhinoplasty on these features is not possible under local anesthesia. You will likely need a revision if it is done under local anesthesia. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Eric M. Joseph, MD · Answer

Believe it or not, most family and friends of people who undergo rhinoplasty surgery do not know that surgery was performed. If you have severe dissatisfaction with your nasal appearance, the best advice is to visit several reputable rhinoplasty specialists who offer computer Imaging so you can see what might be best for you moving forward. I hope this helps. Sincerely, Dr Joseph

Gianfranco Frojo, MD · Answer

I would highly recommend against performing any type of rhinoplasty without general anesthesia. Noses are highly vascular. Sometimes you can get oozing or dripping into the back of the throat. It is best to have a secure airway and general anesthesia for your own comfort as well.  I recommend finding a surgeon certified by the American Board of Plastic Surgery. Ideally, one with experience in facial aesthetic surgery.

Zoran Potparic, MD · Answer

We do most of rhinoplasties in local or twilight anesthesia. The difference is septoplasty part when nose obstruction needs to be addressed. In that case we found that use of general anesthesia and intubation improves safety. Only on the basis of in person evaluation an experienced rhinoplasty surgeon can decide whether you will need general anesthesia. Hope this helps.

Tanveer Janjua, MD · Answer

You have a good nose. The only thing that might make it more feminine in a subtle way is a tip-plasty. 
Tip-plasty
Tip-plasty is a great procedure to address a bulbous tip only and leave the rest of the nose alone. It can be accomplished through an open or closed approach. The goal is to refine the tip and make it smaller and smoother. 
In tips with strong cartilages but thin skin, all that is needed is removing some of the cartilage and softening the rest by gently crushing it (morselizing). 
In tips with thick skin and lot of soft tissue or fat, the excess fat and soft tissue is removed along with removing some of the cartilage.
Click on the video link below.
Regards
Dr. J

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, if you are having a Rhinoplasty it should definitely be under general anesthesia. You have a bulbous tip, a slight dorsal hump, and an over projected tip. Performing a well done rhinoplasty on these features is not possible under local anesthesia. You will likely need a revision if it is done under local anesthesia. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Stephen Kleid, MBBS, FRACS · Answer

You have a nice nose - it is feminine - do nothing is a perfectly reasonable, extremely cheap, and very safe option !
Since I doubt you will take that advice, I will give you more.
It is nearly as much surgical work to do a minimal Rhinoplasty as to do a lot - and nearly as many things can go wrong. 
However, a full Rhinoplasty can be done under Local anesthesia and sedation - I just don't recommend it.

Selcuk Inanli, MD · Answer

Hello! Thank you for your question.
As far as I can understand from your question I recommend rhinoplasty operation for your requests, but it must be under general anesthesia, we do not recommend rhinoplasty operation with local anesthesia.
It would be better face to face consultation.
Best Regards!

Darryl J. Blinski, MD · Answer

Based on your posted photos, you could have a full rhinoplasty under IV sedation and local anesthesia with the understanding that if you’re uncomfortable, you might be converted to a LMA anesthesia breathing device or even general Anesthesia. Best to virtual consult with so an explanation can be given. You need your hump shaved down and your tip reduced. I doubt you will need fractures but there’s always a possibility. Expect these to range from $8000-$20,000. Again best to virtual

Mats Hagstrom, MD (license on probation) · Answer

Ill aspect of rhinoplasty surgery can be done under General anesthesia, sedation, or local anesthesia only.
WhetherI’ll aspect of rhinoplasty surgery can be done under General anesthesia, sedation or local anesthesia only.
Whether a plastic surgeon is willing to do complex rhinoplasty surgery with only local anesthesia is another question.
I suggest focusing first and foremost provider selection.
The second most important variable is understanding your candidacy, and the various rhinoplasty procedures that could be used to improve your nose.
I suggest allowing the surgeon to dictate the form of anesthesia they recommended.
You can always discuss and share your concerns, fears and desires with them during in person consultations.
Some plastic surgeons prefer their patients to be put to sleep so they don’t have to deal with patients who are moving and talking during the procedure.
Best,
Mats Hagstrom, MD

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