Questions & Answers The Surgical Experience About Anaesthesia 

I would like a small revision, the tip is a bit too upturned so just want it bringing down so it looks more natural.

Your questions answered by our surgeon, Lucian Ion, FRCS(Plast)

Asked on 25 February 2014


I had a primary rhinoplasty about 18 months ago and would like a small revision. The tip is a bit too upturned so just want it bringing down so it looks more natural.

I had a graft put into the tip to increase support so maybe that needs shortening? Can this be done under local anaesthetic? I really would prefer it to be done under local.


To a great extent, it depends whether the correction of the upturned tip involves true or apparent lengthening of the nose.

Apparent lengthening is related to the position of the tip defining points, and the contour of the columella and as such, can be carried out under a local anaesthetic.

True lengthening involves cartilage grafting and will require harvesting and a more significant augmentation for stability, and in my practice this is not really suitable for a local anaesthetic.

It is possible to evaluate in consultation, on a computer simulation, based on the type of nasal shape that you want to achieve whether this would involve one type of lengthening or the other and provide you with appropriate guidance.

Lucian Ion Cosmetic Surgeon Mr Lucian Ion FRCS(Plast)
129 Harley Street

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