Is rasping painful!? I love my results, my bridge has a slight hump still and my surgeons willing to rasp in office.

Question

6 months post Rhino-septoplasty, thick skin.

Semih Yildiz, MD, FEBOPRAS · Answer

When performed with adequate local anesthesia, nasal rasping is usually well tolerated. Most patients describe pressure or vibration rather than sharp pain, followed by temporary tenderness, congestion, or bruising.

The more important issue is timing and diagnosis. At 6 months, residual swelling can still make a small hump look more prominent, particularly with thicker skin. If the contour is edema or scar rather than bone or cartilage, rasping will not help and could remove needed support or overcorrect the bridge. Your surgeon should palpate the area and compare it with your preoperative and early postoperative photos.

A small, stable bony irregularity may sometimes be treated in the office under local anesthesia, while a cartilage problem or larger correction may require formal revision surgery. Many surgeons prefer to wait until healing is more mature—often around 12 months, and sometimes longer with thick skin—unless there is a specific reason to intervene earlier. Follow the operating surgeon’s individualized recommendation.

Eric M. Joseph, MD · Answer

Whenever we file a bump off the bridge of the nose, we immediately see that the patients bridge becomes wider at the top. This is then corrected by performing osteotomies. In general, procedures like you are talking about maybe performed with general anesthetic and minimal inconvenience. Not perform any bony work in the office with local anesthetic. Thank you for this question, and I hope it's helpful. Sincerely, Dr Joseph

Philip S. Schoenfeld, MD, FACS · Answer

A couple of thoughts.  The first is that I would wait another 4-5 months prior to undergoing any revision of the nose either large or small.  If rasping in the office is what has been decided, the procedure is performed under local anesthesia.  The only painful part of the procedure is the initial injection of local anesthesia.  Ask your provider for an oral sedative like Valium or nitrous oxide to take the edge off.

Pawel Szychta, MD, PhD, DSc · Answer

If the hump is small and localized, rasping is a great option for refining your nose without going through a full revision surgery. It’s generally not painful due to local anesthesia, and recovery tends to be quick with minimal discomfort.
Before your procedure, make sure to ask your surgeon about what to expect specifically based on your anatomy and skin type, but it sounds like you’re in good hands.

Mats Hagstrom, MD (license on probation) · Answer

It’s possible to adequately anesthetize the nose completely to do all aspects of rhinoplasty surgery under local anesthesia only.
Potential discomfort depends on technique used for both injecting, local anesthetic and surgical procedure.
Best,
Mats Hagstrom MD

Is rasping painful!? I love my results, my bridge has a slight hump still and my surgeons willing to rasp in office.

Answers (5)

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