Changing the shape of the nose is done by making small incisions inside and sometimes around the nose allowing the surgeon to modify the nasal bones and cartilage. Skin removal is occasionally done around the nostril area. The procedure is done under local anesthesia with sedation (“twilight anesthesia”) or general anesthesia and takes between one and two hours. Modification of the septum of the nose is frequently done at the same time if the patient is complaining of problems breathing. No overnight stay in the hospital is needed.