Can I get a closed rhinoplasty with local anesthesia to shave down the nose hump just a little? (Photo)

In general, when we reduce somebody's nasal pump, there is a naturally wider appearance to the nose. We create what is called an open roof deformity. Generally the nose needs to be narrowed by performing lateral osteotomies. Since this can cause bleeding into the nasal airway, we perform all rhinoplasty surgery under general anesthetic to prevent blood from entering your airway. I hope this helps! Sincerely, Dr. Joseph

Thank you for your query. You can certainly get a closed rhinoplasty for the “bump” on your nose. There is often a small element of extra bone along with cartilage in this situation. Both can be dealt with in a closed manner, and I often do these under local anesthesia , depending on the individual’s comfort. Please find an experienced board certified Plastic surgeon who can help you with all your queries.

Nasal humps are mostly composed of cartilage, probably less than a third of a hump is bony. Endonasal rhinoplasty can certainly be performed to reduce a hump, you may need spreader grafting depending on how much of the hump is taken down. Additionally, the tip position may need to be altered to match the new profile. A formal consultation with a surgeon to review all aspects of your nose would be necessary to give you a legitimate treatment plan.

I typically do not suggest having rhinoplasty under local anesthesia as it is a surgical procedure that can have some bleeding into your airway. Having said that, though it may appear that the hump simply needs to be shaved down and that is all you need, if the hump is high and you shave down the bone enough, you may end up with what we call an open roof deformity and then you would need your bones narrowed which is a bit more aggressive than local anesthesia would help you with. If the cartilage is also an issue in your nose then that needs to be addressed as well. The key is to get the best result and not the least invasive procedure that gives a mediocre result, even if you love the rest of your nose.

Although rhinoplasty can be done under local I suggest you do not use this a a main criteria for selecting your surgeon. Although I do only closed rhinoplasty, most surgeons now do it open, so that may limit your options as well.

Closed rhinoplasty for nasal hump: A closed rhinoplasty can easily be performed to remove a dorsal hump. However there is more to removing a dorsal hump then just filing it. Filing the hump away leaves an open roof which must then be closed with nasal bone osteotomies. This can be done under local anesthesia, and in fact used to be done that way decades ago. However it is a very unpleasant way to do it, and anesthesia in a generally healthy person is extremely safe. I would not recommend doing a rhinoplasty under local anesthesia, even closed.