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Septoplasty and Rhinoplasty Using Local Anesthesia?

asked 2 years ago by tiaboo in sacramento california
Latest answer by Shepherd G. Pryor, MD
Question viewed 4,669 times
Tags: anesthesia, local anesthesia

I need a Septoplasty due to a broken nose. I am considering getting a Rhinoplasty at the same time too. I have a HUGE fear of being "put under". I'm also emetophobic as well and general anesthesia frightens me since I've had past surgeries and thrown up for about 2 days after. Can I get this done with local anesthesia? I really hope so because I don't think I will ever get this fixed if anyone won't do it that way.

20 answers to Septoplasty and Rhinoplasty Using Local Anesthesia?

Rhinoplasty and anesthesia

Rhinoplasty can be a fairly traumatic experience. If you are under straight local anesthesia you probably will not like what is going on and your surgeon will be concerned that you are too aware of what is happening so they are uncomfortable as well. I would suggest light sedation. You don't have to have general anesthesia, although it is extremely safe, and you will not likely have the post op nausea associated with general.

Philip S. Schoenfeld, MD
Chevy Chase Facial Plastic Surgeon

Rhinoplasty under local anesthesia

The risk of anesthesia is the same risk as walking outside and getting hit by a bolt of lightening. Rhinoplasty and septoplasty are the single most complicated three dimensional procedure in all of cosmetic or reconstructive surgery. You will absolutely WANT to be under anesthesia during this surgery . Otherwise, the reality of the surgery will FAR outweigh your fears as it will come with significant discomfort during the osteotomies (controlled fractures), rebuilding... more

Shepherd G. Pryor, MD
Scottsdale Facial Plastic Surgeon

Septoplasty under local.

Yes you can have a Septoplasty or even a Septorhinoplasty under local anesthesia. Whether you tolerate the procedure depends both on the surgeon and anesthetist. However the skill of the anesthetist is foremost. Local anesthesia with sedation is the best technique but also the most difficult to master. Its like walking a tight rope. Too little sedation and you will be aware during the procedure, but too much and you stop breathing. Its easier on every one to just have it done under... more

Oakley Smith, MD
Toronto Facial Plastic Surgeon

Nasal procedures can be done under local anesthetic

Nasal procedures can be done under local anesthetic. A major rhinoplasty can be a long and complex operation and many surgeons prefer to do this under general anesthesia. If you must have the procedure under local, find a surgeon who is comfortable operating under these conditions.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon

revesse.ca

IV sedation for rhinoplasty

You are not alone in you fear of general anesthesia. Although I still occasionally use general anesthesia for rhinoplasty and septoplasty I prefer using IV sedation and use that 95% of the time. I have performed thousands of rhinoplasty/septoplasty with IV sedation and patients do much better with IV sedation than general.

Sam Naficy, MD
Seattle Facial Plastic Surgeon

General anesthesia and anesthesia options

It is generally not a good idea to have rhinoplasty under local anesthesia. We have tried and abandoned this procedure due to patient intolerance of the pain, the injections and the surgery itself. Making cuts in the nasal bone and resetting both nasal bones will be extremely painful under local anesthesia. It is also best to be placed under anesthesia by a board-certified anesthesiologist. There are multiple different medications that are now available to help prevent nausea and... more

William Portuese, MD
Seattle Facial Plastic Surgeon

Local anathesia Rhinoplasty

Yes, rhinoplasty and septoplasty can be accomplished with local anathesia. However, the multiple injections required are very uncomfortable. I strongly suggest some IV sedation at the least during the numbing process. If an more aggresive surgery is indicated a general anathesia may be a safe avenue.

Rodger Wade Pielet, MD
Chicago Plastic Surgeon

Talk to your surgeon

For some rhinoplasty procedures, local anesthesia can be used. I would caution though, these are very limited circumstances. IV sedation or even general anesthesia are very safe for patients and if you are prone to nausea, a good anesthesiologists can adjust the medications used and help to decrease your risk of post operative nausea. In the end, I would talk to your surgeon about your concerns.

D.J. Verret, MD
Dallas Facial Plastic Surgeon

Rhinso and Septoplasty Option

Local alone would be very difficult for you and the surgeon. You want the best possible result and trying to do all this work under local anesthesia is a compromise. Local with sedation is an option but the best way of doing the surgery is under general anesthesia where everything is very well controlled. There are medications you can take before the surgery like Emend that will help decrease the possibility of nausea after the surgery. Also you need to mention this to the plastic... more

Farbod Esmailian, MD
Orange County Plastic Surgeon

Rhinoplasty and anesthesia

Yes, it could be done. However, you probably would be more comfortable under gneral or at least deep sedation. Most office based anesthesiologists are trained to deal with patients that are prone to nausea. They can minimize the risk of nausea with many different medications. I would not worry too much about this.

Steven Wallach, MD
Manhattan Plastic Surgeon

Rhinoplasty is possible under local, sedation, or general anesthesia

All types of anesthesia can work well for nasal shaping. Over many years we have moved toward general anesthesia though sedation was excellent for most. Local without sedation is possible from a comfort perspective though patients we treat never seem to want to be so aware during their procedure. Patients most often will tell our anesthesia staff to just put them out for the procedure and therefore our trend to general anesthesia rather than sedation. You may find it interesting that we... more

Peter E. Johnson, MD
Chicago Plastic Surgeon

Sort of

This is a traumatic procedure, and it may take a several hours to do. If you can find a surgeon willing to accomodate (based mainly on safety concerns and concern for outcome), it would be better to have sedation with the local, closely monitored.

Scott E. Kasden, MD
Dallas Plastic Surgeon

I prefer general anesthetic for Rhinoplasty Surgery.

I read your concerns. I don't think it's feasible to perform Rhinoplasty Surgery with just local anesthetic. You can experience nausea even if you receive Intra-venous sedation, and no general anesthetic. I prefer general anesthetic for Rhinoplasty Surgery since your airway is involved. During surgery, there is always bleeding into your throat, so I like to protect the airway with an endotracheal tube. Your best source advice right now would be from an Anesthesiology Consultation. You... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

Anesthesia for nasal surgery

I have more than 30 years experience performing nasal surgery and have used all types of anesthesia. For the last 15 years or more, my preference has been general anesthesia. The bottom line is: it is more pleasant for the patient! You don't see any thing, hear anything , or feel any thing! General for a rhinoplasty may in fact be safer than local. The surgeon and the anesthesiologist are " sharing" your airway. Under general, there is absolutely no risk to airway obstrucion. It... more

Richard L. Dolsky, MD
Philadelphia Plastic Surgeon

Septoplasty & Rhinoplasty Under Local Anesthesia

Yes, it can be done but is very tricky. While having it done you can get a severe nosebleed and it can trickle down into your windpipe and cause serious penumonia. There are very few surgeons who can do this well i.e., under local anesthesia. I have seen Norman Pastorek do it and I would trust him to do it to my nose. He is New York City. I know its far for you but thats where I would go. Regards

Tanveer Janjua, MD
Bedminster Facial Plastic Surgeon

This best to be discussed with your surgeon

The best advise is to discuss your fears with your doctor. Do not push your doctor to do something that he is not familiar or comfortable with. The risk of anesthesia for a healthy person is very small and may be less than IV sedation. If you need septoplasty in combination with rhinoplasty, there is a concern with internal bleeding and compromising the airway. Please talk to your doctor .

Kamran Khoobehi, MD
New Orleans Plastic Surgeon

Yes, you should see a rhinoplasty specialist.

The nasal surgery can be done with only local anesthesia, with or without sedation. You should find a rhinoplasty specialist who is familiar with doing noses this way.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty can be performed under local anesthesia with mild sedation

Although I perform most rhinoplasties under IV sedation, an even "lighter" anesthesia approach is sometimes used in our office. At the end, this decision is one between you and your rhinoplasty surgeon because both have to be comfortable with the anesthesia option.

Frank P. Fechner, MD
Worcester Facial Plastic Surgeon

The choice of anesthesia for rhinoplasty doesn't necessarily affect post-op nausea

Patients have a fear of "general" anesthesia for rhinoplasty. I did many nosejobs under sedation, safely for the first 12 years of my private practice. With the advent of LMA, we have a happy medium. The anesthesia used is practically the same as for sedation but just a smidge more. LMA is a triangular "mask" that fits over your voicebox. Patients tolerate it very well. Most of my pateits are actually breathing on their own yet are unaware of the surgery. This reduces the... more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Local or general anesthesia for rhinoplasty septoplasty (nose job)

Yes this can be performed under local anesthesia but more commonly with IV sedation which may or may not be associated with emetogenic medications. The procedure really depends on how complicated the rhinoplasty will be and whether grafts or other associated procedures may make general anesthesia a preferable option.