Is there a Local Anesthesia Rhinoplasty option for my nose?

Question

Hi there, My main concern with my nose is mainly the droopiness of the tip from the side and front profile, as well as the bulbous/wideness of it from the front (especially when I smile). Is their lets say a more minimal rhinoplasty option (with potentially local anesthesia) that we can do to address the specific things I mentioned prior?

Eric M. Joseph, MD · Answer

Since your nose is part of your Airway, we recommend that everyone utilize general anesthetic to protect their airways from inadvertent aspiration of blood. There are some surgeons who advocate utilizing intravenous sedation, and this would truly depend upon the expertise of your surgeon. I do not think it's feasible to have rhinoplasty performed with only local anesthetic. I hope this helps. Sincerely, Dr Joseph

Steven M. Denenberg, MD · Answer

The tip cartilages are not bulbous or wide. It's the bridge part, at and just above the tip, that makes that part of the nose look wide. Also, the tip is only perhaps a teeeeny bit droopy. It's the nature of the curve of the bridge above the tip that makes the tip *appear* droopy. I agree with a previous poster that if you don't want anything done to your bridge, you shouldn't have a rhinoplasty. Any attempt at *only* modifying the tip will probably make your nose look worse in your eyes.

Jeffrey H. Spiegel, MD · Answer

We can do essentially every rhinoplasty maneuver with just local anesthesia in the office.  That should be no problem.

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Based on your photographs, you are a great candidate for a Rhinoplasty. This should be done under general anesthesia for the best and safest results. Maneuvers for your surgery would include dorsal hump reduction, tip deprojection, slight tip elevation, tip refinement, among other maneuvers. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty 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

William Portuese, MD · Answer

Trying to perform a full rhinoplasty under local anesthesia would be very painful and you will not be able to tolerate the bone work that's going to be required in order to remove the hump and perform osteotomies. Just trying to numb up your nose with lidocaine would be very painful and not recommended. It's very important to be asleep under general anesthesia for about an hour monitored by a nurse anesthetist or anesthesiologist for patient safety and comfort. It's also important to have a controlled airway so that you don't get blood done into your lungs during the procedure. Rhinoplasty is the most difficult procedure to perform correctly in the entire field of cosmetic surgery, therefore choose your surgeon wisely based on extensive experience

Is there a Local Anesthesia Rhinoplasty option for my nose?

Answers (5)

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