Rhinoplasty, local anesthesia or sedation? (Photo)

What is better and why?

Doctor Answers (14)

General Anesthesia Is More Comfortable For the Patient

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In my experience, it is usually best to have some degree of sedation (anesthesia) when you have a rhinoplasty.  

Firstly, the nose is very sensitive and being fully awake during the procedure will impact your comfort, especially since some of the work may make it difficult for you to breathe out of your nose.  Under anesthesia your breathing will be better monitored and supported.

Secondly, there are several steps in a rhinoplasty that can cause bleeding.  Feeling the blood go down your throat can be very uncomfortable and in some occasions can compromise your airway.  

Finally, the degree of sedation correlates with the type of rhinoplasty being performed.  The more extensive the work being done, the better it is to get anesthesia.  

Rhinoplasties are complicated surgeries that required a skilled physician.  You want to be sure that the physician is able to achieve a comprehensive result and, with rhinoplasty, the risks to the patient are often reduced when your breathing is monitored and supported by some form of anesthesia.  


Albuquerque Facial Plastic Surgeon
4.5 out of 5 stars 13 reviews

Rhinoplasty and dorsal hump removal under general anesthesia

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Rhinoplasty is a surgical procedure on the nose that is best performed under general anesthesia, not local anesthesia or sedation. For patient safety, its important to have a controlled airway with a breathing tube in place to prevent bleeding down the back of the throat. Since the hump must be removed, osteotomies of the nasal bones are required which involves breaking the nasal bones. Most patients do not wish to have conscious awareness of the nose being broken during the sedation procedure. In our practice we perform all rhinoplasty under general anesthesia in a certified outpatient surgery center( not a clinic) by a board-certified physician anesthesiologist. 

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 56 reviews

Rhinoplasty and type of anesthesia- local, sedation or general anesthesia

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Thanks for your question and photo. Rhinoplasty can be done either under general, Sedation or Local anesthesia. The amount of work that needs to be done as well as the comfort level of your surgeon will determine the type of anesthesia used. when there is need for septoplasty, or airway correction or when narrowing of the bone is needed, rhinoplasty is typically done with sedation or general anesthesia. In situations where only small amount of work needs to be done for the tip of the nose, a local anesthesia can be used very effectively.
Best wishes,
Dr Sajjadin

Ali Sajjadian, MD, FACS
Orange County Plastic Surgeon
5.0 out of 5 stars 117 reviews

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Rhinoplasty - local anesthesia or sedation?

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Thank you for your question.  Depending on your surgeon's comfort level along with how involved your nasal surgery will determine what type of anesthesia will be needed. A rhinoplasty may be performed under any type of anesthesia, but typically at least sedation is often needed.  

Given your photo, it appears as if you will need some tip and septal cartilage work along with work on your nasal bones.  Sedation, if not even general anesthesia will likely be needed for your comfort, your surgeon's ability to do the work needed, as well as a better overall experience for you. Best wishes for a wonderful result!  Hope that this helps!

Lewis Albert Andres, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 12 reviews

Local anesthesia for rhinoplasty

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Local anesthesia is only a good idea if the amount of work that is planned is small, say a minor modification to the nostrils or the tip of the nose.  Anyone who is considering work on the bones also (such as humps of the nose, etc), would be better off asleep (either sedation, or as is more commonly used, general anesthesia with a tracheal tube throughout he mouth to protect the lungs against fluids from surgery seeping into the lungs).  

This is a critical decision and you should consult with your doctor carefully to make the SAFE choice, not the one that sounds "nicer."

Reza Momeni, MD
Summit Plastic Surgeon
5.0 out of 5 stars 1 review

Rhinoplasty, local anesthesia or sedation? (Photo)

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Better yet endotracheal general would be my recommendation for you. But you need to have at least sedation with the local especially sin=ce you will need fractures of the nasal bones... 

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.5 out of 5 stars 62 reviews

Rhinoplasty and anesthesia

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Patients require at the minimum sedation, but most have it done under general anesthesia.  Best of luck.

Steven Wallach, MD
Manhattan Plastic Surgeon
4.5 out of 5 stars 17 reviews

Either can be used but the more work needed the better sedation will be

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Dear Tess52,

Although it is hard to know without an examination, discussion, and full view of your nose I suspect the work that is likely to be needed will be best done under sedation.  If septal cartilage work needs to be done to use cartilage for your nose shaping use of IV sedation will be of tremendous help keeping you comfortable and allowing your plastic surgeon to accomplish the goal that you and him/her have set out.

All the best,

Dr. Remus Repta

Remus Repta, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 91 reviews

Rhinoplasty, local anesthesia or sedation?

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   General anesthesia allows the patient to be comfortable, the airway to be protected, and the patient to be without movement - critical for precision work.

Kenneth Hughes, MD

Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 203 reviews

Local vs Sedation

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Thank you for your question and all the techniques have there pros and cons as you have seen by the responses here.  I would go with the technique recommended by my surgeon as he or she is obviously most comfortable with that method.  Personally I prefer general anesthesia administered by a board certified anesthesiologist.

Dr Corbin

Frederic H. Corbin, MD
Brea Plastic Surgeon
5.0 out of 5 stars 26 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.