Fixing the tip - concerned about breathing problems following the procedure. (Photos)

Hello and thank you for your question. Just to clarify, if you're interested in improving your nasal tip, this is a common complaint and something that can definitely be addressed with surgery. Many people complain that their nasal tip is too "bulbous" or "boxy" and that they would like it to be smaller, cuter, more defined, or more feminine. An open rhinoplasty can best address the entire nose, and is particularly effective for addressing a bulbous, boxy, or asymmetric nasal tip. It is also very effective for performing complex, precise maneuvers to refine the nasal shape and size to a particular aesthetic and look.
Rhinoplasty is arguably the most difficult procedure to perform in all of plastic surgery. That said, I would recommend only going to see a surgeon who feels very comfortable with both primary and revision rhinoplasty procedures, and who has significant training and experience in these types of surgeries. This is a surgery of millimeters, so if the surgeon you're going to only does 1-2 per month, you are not going to get the best result possible.
Regarding the anesthesia- generally, most patients would not tolerate such an invasive procedure done under local, and most surgeons feel that it is easier to perform such involved and complex procedures with patients at least sedated if not fully asleep so they can assure the patient remains perfectly still to facilitate all the complex maneuvers and super precise work involved in properly doing a rhinoplasty well. My personal preference is similar to most- full general anesthesia to assure the most controlled environment and facilitate the best possible aesthetic results for such a complex procedure. Everything ultimately comes down to surgeon and patient preference, so always have the conversation with your surgeon so you both know exactly what to expect, and so you both feel comfortable with how the procedure will be performed prior to proceeding.
Of course it is always difficult to provide tentative surgical recommendations, as there is only so much information to be gained from the photos provided. I recommend for you to come see me or another plastic surgeon comfortable with rhinoplasty procedures for a formal consultation to thoroughly discuss your surgical goals, undergo a formal examination, evaluate all your options (surgical and nonsurgical), and decide on the best procedure(s) and type of anesthesia for your specific case. I hope this helps!
Best wishes,
Dr. Donald Groves
Plastic Surgeon

Have you had the inside of your nose examined well? There could be a deviated septum or other blockage that restricts your breathing. In a well performed rhinoplasty, this obstruction is corrected while making your nose look nicer. The droop of the tip can be lifted and your breathing should be better after the procedure. You would have to undergo anesthesia though. Be sure to find a rhinoplasty expert for consultation.

Hey people, especially young women, suffer from panic attacks. Panic disorder is a condition where people can have shortness of breath, palpitations, sweating, and a feeling that they are losing control of their bodies. Additionally, generalized anxiety disorder is a well-known condition that can lead to chronic anxiety. Thankfully, both of these conditions are treatable, and in my opinion, these should be addressed before rhinoplasty surgery. The best specialist to treat chronic anxiety would be a psychiatrist.

Based on your photos, you appear to have a wide nasal appearance with a bulbous droopy tip and a hanging Columella. When you smile, this is associated with a dorsal hump. After your anxiety is controlled, please consider meeting with several reputable rhinoplasty specialists who offer computer Imaging so you could see what might be best for you moving forward. I hope this is helpful! Sincerely, Dr Joseph

Very likely, based on these photos, that full rhinoplasty rather than tip-plasty would be procedure to consider in your case. However, it would be in your best interest to address your anxiety issue before undergoing nose surgery. Rhinoplasty is known to increase level of anxiety before and, in particular, after procedure. In person consultation with a good psychiatrist is recommended. Good luck.

You're not gonna be able to undergo a tip-only rhinoplasty procedure, you must undergo a full rhinoplasty to ensure that the entire components of the nose are balanced with each other in a three dimensional fashion. A closed rhinoplasty approach is less invasive, and involves reduction of the bulbous nasal tip, lifting the nasal tip and shaving down the dorsal hump that you have. Also important to release the depressor septi ligament, which dynamically pulls the tip downward when smiling. When patients have severe anxiety, you're gonna be much better off having this procedure done under general anesthesia. A steroid shot on the inside of the nose will help reduce the amount of swelling on the inside of the nose from the rhinoplasty, so that you can still have some airflow in the postoperative recovery.