Can Tip Reduction Be Performed Under Local Anesthesia?

While local anesthetic may seem easy, it limits the surgeon with regards to what can easily be addressed. For example, if cartilage needs to be harvested from the septum, the procedure becomes more involved than a local will allow. The best option is to find an experienced rhinoplasty surgeon and discuss in depth what he/she is most comfortable with- sedation may be an option for you. Some tip narrowing may be advantageous, but your bony width also must be factored in- if you are not going to have your bones broken/narrowed your tip must not seem overly narrow for the upper nose. Also, it appears that you have a weak chin- have you considered a chin implant? With a soft chin, the nose appears larger. Balancing proportions and features is the artistic part of rhinoplasty- and the reason experience is so crucial. Good luck!

Revision rhinoplasty for the wide nose with asymmetrical tip can be done to give a better looking nose. You should see an experienced revision rhinoplasty surgeon who does natural noses.

As long as you mean local anesthesia with sedation in the OR, my answer is yes. I would be comfortable with reduction of your tip.

Yes it can be done. But based on your posted photos you need to allow the rhinoplasty surgeon you used to do a complete corrected operation. If you are directing the operation by first having a rasping than now wanting a tip plasty. YOU NEED a combination under local/sedation at best. 

Conservative rhinoplasties are always better tha overly aggressive rhinoplasties.

You don't need to have your tip-plasty.

If you did need it, it could be done under local anesthesia with sedation or general anesthesia.  

Just local anesthesia without sedation will be very uncomfortable and NOT RECOMMENDED by me.

local with sedation tip modification can be done. do not recommend it under straight local. I would advise however that it seems you are trying to micromanage your surgery. That never comes out well. Pick a good surgeon, one where you like his or her results, and let them do the surgery. If you change only one part of a nose, other parts do not work with other parts that are not touched. An experienced surgeon will advise you of that and avoid revisions after revisions.

Nasal tip surgery is one of the most difficult of all surgeries. You can do any thing under local but, i don't advise it. Your surgeon has enough to do without worrying about you squirming around

Although technically a tip-plasty could be performed under a local anesthetic I personally would not agree to do so. I find the performance of virtually any aspect of nasal cosmetic surgery under any anesthesia but general anesthesia to be highly problematic. This is due to the common occurrence of blood inevitably running down the back of the patients throat causing them to involuntarily cough and therefore move their head. Rhinoplasty and specifically tip-plasty is extremely delicate surgery and any sudden unsuspected head bob by the patient can be disastrous. In addition, sometimes tip-plasty requires a cartilage graft for the best result. Oftentimes this cartilage graft is harvested from the nasal septum via a septoplasty technique.  Setoplasty is extremely difficult to perform under anything but general anesthesia. The surgeon should always be prepared to utilize this technique on a moment notice. If the operation is not being performed under a general anesthetic setoplasty may not be possible and the result compromised.

 

Hi,

The straight answer is yes, any facial cosmetic procedure can be performed under local anesthesia. However, it's not recommended or wise. A little sedation, such as 5mg of Versed, makes a  big difference.

Best,

Dr.S.

 

Your lateral photographs show very nice tip anatomy.  The frontal view shows a little extra width at the tip, but this may come down over the next several months as scar matures and the soft tissue settle down.

If you are left with a tip that is still too wide after 6-8 months a revision my be indicated.  I don't see how this can properly be performed under local anesthesia.