Can I shave a tiny bump off my nose with local anesthesia? I would love to smooth it out but I don't want a huge change. (photo)

Question

I've always liked my nose, its small and looks good from the front. But lately I've been noticing that I have a minor bump in certain angles when I look at photos of myself. I heard its possible just to rasp the hump under local anesthesia, am I a good candidate for this? Would the cost be less than normal rhinoplasty?

Thomas A. Mustoe, MD, FACS · Answer

Very small humps or irregularities can indeed easily be rasped down under local anesthesia as an office procedure. We do this through a small incision inside the nose that does not require suturing.  However, the goals have to be limited. If the bump is lowered significantly, it can leave the area looking wider and flattened. From your photos, I think it is likely that you would benefit from a small procedure as long as your expectations are suitably modest.

Michael Kulick, MD, DDS · Answer

Hello and thank you for your questions. Do not try and cut costs as what you really want is the best result. In terms of obtaining your  desired final result, you would need a "real" rhinoplasty. Don't know a doctor that would provide you with the best result by just shaving the hump under local anesthesia in the office. Sorry about this. In terms of the anesthesia, you can have your procedure performed by IV conscious sedation vs. general anesthesia.In terms of the cost, while not seeing you in person to determine your actual cost, the range of cost for someone requesting such a change in their nose would be in the range of $5,000 - $6,000. Hope this helps. You can look at the link provided to see patients that had similar desires like you have. Go to the picture gallery and look at patient  #2391.Sincerely,Dr. K

Gerald Minniti, MD, FACS · Answer

Hello,It's not as simple as 'shaving down a small bump'. That bump is both bone and cartilage, and involves a very important functional area known as the internal valve. Simply lowering the profile will widen your nose, something you don't want. You need a full rhinoplasty, and most surgeons perform this under general anesthesia for comfort AND for safety. That's right: general anesthesia is safe, safer than sedation or twilight. Go visit a few ABPS certified/ASAPS member surgeons (or AAFPRS members - facial plastic surgeons) that specialize in rhinoplasty. Best of luck! Instagram: drgeraldminniti

Toby Mayer, MD · Answer

Rhinoplasty for a more feminine and attractive nose.  You need a full rhinoplasty to narrow the nasal bones etc. after the hump is removed. Patients do not like to hear the sounds associated with this so I would advise you to do this under general anesthesia.  See a very experienced rhinoplasty surgeon who obtains natural noses and do not rely on imaging.

Brent Moelleken, MD · Answer

In the old days, doctors would simply use a large sharp tool and take off the hump:  bone, septum and upper lateral cartilages.  Unfortunately, that exposed the underlying anatomy, causing an open roof deformity.

It is now possible to deal directly with the septum that is ultimately causing the problem, and preserve the natural covering that the upper lateral cartilages afford.  However this requires a specific step.  Whether or not an osteotomy will also be required is a judgment call that comes from many years of experience doing the procedure.

The nose is quite delicate and great care should be taken when designing a surgical plan... not just shaving off the bump!

Philip J. Miller, MD, FACS · Answer

Hello:Thank you for your question and for posting photos. I can see the small bump, typically referred to as a dorsal hump on your nose. There are numerous options to consider when considering rhinoplasty. I would like to start by asking if you meet any of the following criteria for a MicroRhinoplasty™ is:Are you frustrated with a "nasal hump" or bump?Is this nasal hump along the bridge of your nose?Secondly, I would like to explain what the procedure entails:It is performed in office under local anesthesia;I utilize a very small, innovative, microsaw;This allows me so remove the layer of bone along the nasal bridge;The end result is an attractive, aesthetically pleasing nose;All done without breaking the bone or requiring stitches.Not all patients are a candidate for this procedure. Rhinoplasty (nose job) surgery is complex and each patient is different. No two noses are the same. My recommendation would be for you to seek out consultation with a board certified facial plastic surgeon that specializes in rhinoplasty surgery. You don't want to put your nose in the hands of an inexperienced surgeon. Our New York City office offers patients the opportunity to have a virtual consultation with 3-D imaging. This allows you to have a very good idea of what your nose would look like post-operatively. If you have any questions, please feel free to contact our office with any questions.I wish you the best on your journey toward finding a surgeon that has a unified vision with your desired results.Sincerely,Philip J. Miller, MD, FACSDouble Board Certified Facial Plastic Surgeon

R. Laurence Berkowitz, MD · Answer

The nose is not a solid structure but a hollow one, like a tunnel. If you remove the roof of the tunnel, an open roof will ensue which will require careful remodeling of the outer walls to close the gap.  We have found that ultra high frequency power tools such as the Piezo delivers a more finely finished product than hand tools like rasps, chisels and hammers.  Think of what you expect from your dentist in terms of delicate and refined equipment.

Elbert T. Cheng, MD · Answer

Hello,Thank you for your question and pictures.  Your nasal hump is at the juncture of bone and cartilage and when your expectation and the actual changes needed are minimal, I think rasping/shaving the hump is possible.  If this is done, it can be done under local anesthesia.  As you know, when you meet with your surgeon, an examination will be very important to determining if the plan will have a high chance of success.  Best of luck!

Chase Lay, MD · Answer

Thank you for the photos. What we can see is a little limited with these photographs but shaving down the hump what involve conservative removal of a little bit of the nasal bones and septal cartilage and upper lateral cartilages.   Your nasal tip from what I can see appears to be nice and in good position. You may want to consider slight tip projection which deemphasizes the nasal hump. You can do this in addition to hump reduction.  There's a good chance this can be done under local anesthesia without difficulty but get a consultation with more than a few board-certified facial plastic surgeons before proceeding.Chase Lay, MD

William Portuese, MD · Answer

From the limited photograph presented, the  dorsal hump is composed mostly of cartilage and only a small amount of bone.   Rasping is only good for bone, while a knife or scissors is required for the cartilaginous hump. Once the hump has been removed, a flat top, open roof nasal deformity will be created from the frontal view.   Osteotomies placed in the nasal bones are then required to narrow the bridge line.  Remember, the nose is a three-dimensional structure, and the side views  are only one dimension.Trying to perform a rhinoplasty under local anesthesia is a very bad idea and cannot be tolerated due to the significant amount of pain associated with the injections and the surgery itself. In our practice, the procedure is performed under general anesthesia monitored by a board-certified physician anesthesiologist for patient safety and comfort.

Can I shave a tiny bump off my nose with local anesthesia? I would love to smooth it out but I don't want a huge change. (photo)

Answers (13)

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