Should bump be rasped under local anesthesia? (Photos)

I had septorhinoplasty 6.5 months ago. Since then there has been a bump that formed on my nose that I want removed. My surgeon does this under local anesthesia. Does it appear that I'm a good candidate for this procedure? I'm very nervous about being awake. There is a flat spot on the other side of my nose. Is this from aggressive rasping during the initial surgery? If not, what could've caused this? Is there anything that can be done for the flat spot?

Doctor Answers 10

In-Office Revision

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Many surgeons, including myself, perform minor revisions under local anesthesia with or without an anti-anxiety medication such as Valium. If being awake sounds like it's not doable for you, though, general anesthesia is still an option. Different surgeons will take different approaches to your revision, so I recommend consulting with several doctors to fully understand your options. Best of luck to you.

Tucson Facial Plastic Surgeon
5.0 out of 5 stars 33 reviews

Anesthesia and revision

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It looks like you may need more than a little rasping which I prefer to do under anesthesia. Not just local.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Timing for revision rhinoplasty

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Based on your photos you may need more then just rasping of the nasal bump. Correction of dorsum irregularities may require secondary osteotomies, dorsum shaping, nasal tip grafts, etc. It is impossible to give you good idea about extent of revision surgery without detailed clinical exam. Type of anesthesia should be selected based on the extent of correction.

However, despite the fact that you may like to do this ASAP you should give yourself at least 1 year before undergoing revision surgery. You should voice your concerns when talking with your surgeon and make a plan of revision that will address multiple aspects. Possibly a second opinion consult should be considered. Good luck.

Zoran Potparic, MD
Fort Lauderdale Plastic Surgeon
5.0 out of 5 stars 22 reviews

Nasal surgery can be done under local anesthesia

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Yes, it is possible to do this opeartion under local anesthesia.  However in a nervous patient general anesthesia can be used. Discuss your all options with your surgeon and decide between two of you.

Vasdev Rai, MD
Dallas Plastic Surgeon
5.0 out of 5 stars 24 reviews

Nasal irregularities after Rhinoplasty

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The bump on the nose after rhinoplasty  could be caused from incomplete removal, callous formation, organized fluid or scar tissue. It is common to do the removal using local anesthesia, especially if an oral sedative is added pre-operatively. It is safer and certainly less expensive than general anesthesia. The flat spot can be corrected during the same procedure with a cartilage graft if necessary. Fillers, non-surgically are better at replacing volume loss than correcting raised bony or cartilage projections after surgery. Discuss your options with your surgeon and choose the best option for you.

John Standefer MD

Revision rhinoplasty candidate

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  The photographs demonstrated much more than just a small little bump on the bridge. There is still residual convexity to the entire dorsum, a droopy tip, in addition to 2 flat spots and dorsal hump. The nasal bones are also excessively wide, and shaving down the dorsal hump will most likely result in an open roof deformity. In our practice, it's important to wait closer to one year and address all the issues simultaneously under brief general anesthesia. Osteotomies of the nasal bones will most likely be required, which cannot be performed under  local anesthesia.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Rasping Nasal Bump Under Local Anesthesia

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The irregular fullness of your bridge can be removed using a rasp as long as the patient is comfortable having this done while awake. You can take pre-op medication by mouth for relaxation if desired.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Revision rhinoplasty

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Having some irregularities after the bridge of the nose has been modified does occasional occur.  This can be from surgeon error, bone shifting scarring or callous formation.  Yours should be corrected with a simple revision.  Filing the dorsum (bridge) can be simple done in the office under local.  Identifying the full extent of the bump and the flat area can be difficult after the local anesthesia injections, so make sure your surgeon is comfortable with this and does detailed markings pre-injection.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 18 reviews

Revision nose surgery

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Small irregularities, especially in patients with thin nasal skin, can happen after surgery.  Removing these areas or going back to surgery is an option, but injectable fillers can be used to correct small irregularities without surgery.  See a surgeon who not only does rhinoplasty but has experience with injectable fillers to see about getting your issue corrected non-surgically.

Jason J. Hall, MD, FACS
Knoxville Plastic Surgeon
5.0 out of 5 stars 12 reviews

Rhinoplasty revision

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You will get different answers from different surgeons.  This is because these issues are handled differently.  My suggestion would be to wait a few more months and go back to surgery.  For less significant revisions I would consider treatment under local anesthesia.  

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.