Tip only rhinoplasty, local anesthesia? (photo)

There are only a few people were able to undergo a tip-plasty alone. Most patients need to undergo a full rhinoplasty to make sure the nose appropriately shaped and balanced with its own features, and/or your facial features. Performing only a tip-plasty in this particular case will be a mistake because the tip will not balance with the remainder of the nose. There are far too many nerve endings in the nasal tip to successfully perform this surgery comfortably, so we recommend general anesthesia for all tip plasty surgeries and all rhinoplasty surgery. We do this is for patient safety and comfort.

I disagree with the other responses. While some minor modifications of the tip can be done with local anesthesia only, I don't believe that is the case with you. In order to rotate your tip and decrease the bulbousness, you will need a cephalic trim of the lower lateral cartilages (either open or closed with dome delivery) and a columellar strut graft. You will also need to lower the septum in the supratip and probably caudally. Finally, while I agree that your tip is the most important part of your rhinoplasty, you need your dorsum lowered (including the radix). While not everyone needs a full rhinoplasty, some need only a tip or only the dorsum, that is not the case with you. Through sad experience I can recommend that you do it right the first time. Do a full rhinoplasty and save yourself repeat trips to the OR.

Your tip can be done with a tuboplasty under local anesthesia without any problem. Based on the information you discussed you shouldn't have no problem with doing it this way.