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Rhinoplasty Under Local Anesthesia?

asked 2 years ago by smith388 in nyc
Latest answer by Ramtin Kassir, MD
Question viewed 2,255 times
Tags: female, anesthesia, local anesthesia, twilight sedation

I am nervous about anesthesia and wanted to know if I would be able to do a type of anesthesia that doesn't require you to be put to sleep for a Rhinoplasty. Also, I know I need to go in for an official consultation, but I wanted some feedback on my nose and what I could do to adjust it and therefore enhance my face.

I don’t want anything too invasive and was trying to avoid breaking the bridge. I was looking at possibly having the tip of my nose sculpted and maybe fillers on my bridge for my profile. I just wanted to know if I wanted a straighter bridge and wanted to fix my depressed tip, that I believe I have, would I be able to use a twilight anesthesia? Any suggestions?

23 answers to Rhinoplasty Under Local Anesthesia?

Rhinoplasty surgeons may or may not use local anesthesia.

I have used primarily general anesthesia for more than 30 years without any problem. However, if a patient wants the nose done under local anesthesia with sedation, that can be done as well. As to what desires you have regarding the look of the nose, you should discuss this with several surgeons who are experienced and go with the one whose noses you like the best.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon

www.bevhills.com

Local or General Anesthesia for Rhinoplasty (nose job) or septoplasty

Both forms of anesthesia are possible with well trained anesthesiologists. For tip work or other minor rhinoplasties we do local anesthesia only (meaning no sedation); otherwise we like general anesthesia. Be sure to speak with your surgeon about his/her preferences. I think the main issue here though is what you want to do to your nose and what's realistic. First you have to decide what you want and if you really want to do your nose; the rest of the issues... more

Ramtin Kassir, MD
New York Facial Plastic Surgeon

Rhinoplasty - General Anesthesia vs I.V. Sedation

Step number one is to see a nasal surgeon and point out your concerns. He/she will formulate a plan for you. Based only upon the photos you posted it appears you would need a reduction of the bridge of the nose and repositioning of the nasal bones with an infracture of the nasal bones. The tip may require some form of cartilage grafting as well. All of this could be done under sedation with local anesthesia if desired. My personal preference is general anesthesia but there are a number of... more

Jon F. Harrell, DO
Miami Plastic Surgeon

www.westonsurgery.com

Rhinoplasty under local anesthesia is not recommended

The anesthesia is very safe in today’s standards. It is important that you have your anesthesia administered by a board-certified physician anesthesiologist, not a nurse attempting to do conscious sedation. The nose is extremely difficult to get completely numbed up during a rhinoplasty and we have stopped performing any twilight anesthesia. Patients had recollection and memory of the procedure and it is not a good idea. It is also much safer to have a controlled airway in place... more

William Portuese, MD
Seattle Facial Plastic Surgeon

www.seattlefacial.com

Anesthesia selection in rhinoplasty

Find the right surgeon first and judge him/her by natural appearing results that are aestehtically balanced and pleasing with the other facial features of their patients. Select them by their training, and hospital priviledges to perform this surgery. If they only work in their office be a little circumspect. If you like their results (more important than their personality) than you both should select the most suitable anesthesia choice for you. I have done this operation under local, with... more

Julian Henley, MD
New Haven Facial Plastic Surgeon

General anesthesia for rhinoplasty is preferred

Rhinoplasty can be performed under local anesthesia without complication. The real issue is whether this is the safest choice for anesthesia and whether your surgeon is compromising your result by minimizing the type of anesthesia. I generally prefer to perform the surgery under general anesthesia as I prefer to meticulously sculpt the nose during rhinoplasty.

Raffy Karamanoukian, MD
Los Angeles Plastic Surgeon

Anesthesia for Rhinoplasty

During my training, I used local anesthesia with mild sedation. Over the past 35 years I've usually done the surgery with light general anesthesia because of improved anesthetic techniques. Either approach will provide a safe, pleasant experience. After your consultations you will be able to consider the changes which will be best for your nose.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon

Rhinoplasty can be done under local anesthesia

I regularly perform rhinoplasty under local anesthesia. To help patients we usually will give a mild sedative in pill form. The surgery takes 1 to 1 and a 1/2 hours. There is usually less bruising and no nausea with this technique. I suggest it to patients who think they can do it.

Andrew Jacono, MD
New York Facial Plastic Surgeon

Anesthesia choices for rhinoplasty

Sedation for rhinoplasty is possible as a choice. However, I prefer general anesthesia for the airway safety that comes with this technique. In experienced hands, rhinoplasty can be done under local anesthesia with sedation, but it does not mean it is safer nor does it mean you will get the best result. The best anesthesia for rhinoplasty really depends on what needs to be done and who is doing it. Evaluate your choices carefully and you will wind up with the right arrangement for you.... more

Jay Calvert, MD
Beverly Hills Plastic Surgeon

Rhinoplasty and anesthesia

A rhinoplasty procedure can be performed under local anesthesia with some sedation to make you comfortable. Obviously, you will need to have a consultation before deciding on the appropriate procedure and anesthesia for you.

Steven Wallach, MD
Manhattan Plastic Surgeon

Rhinoplasty under local anesthesia

Local only anesthesia for rhinoplasty, especially from your photos, is a BIG MISTAKE. You are too young, you need a full rhinoplasty with fractures. Just these issues makes me think you are not ready to proceed. You MUST have realistic expectations not only concerning the results but also the procedure to accomplish the result. I would refuse to operate upon you if I could not do deep sedation or endotracheal tube general anesthesia. Best of Luck in your quest.

Darryl J. Blinski, MD
Miami Plastic Surgeon

Rhinoplasty under Twilight Sedation

Hi, Yes a rhinoplasty can be performed under twilight sedation. This is my preferred method of anesthesia. Its better than general anesthesia because it provides faster recovery and I believe its safer. Straightening the bridge typically requires breaking of the nasal bone due to the fact that the bones contribute to position of your bridge. However, your septum may also need to be straightened. The best way to figure out what needs to be done is to have a consultation and computer imaging... more

Oleh Slupchynskyj, MD
New York Facial Plastic Surgeon

www.facechange.org

Rhinoplasty can de done under local anesthesia with sedation.

Hi. 1) We commonly do rhinoplasty with local anesthesia. The key is to have a very competent, board certified anesthesiologist, an accredited operating room and recovery room, and an artistic plastic surgeon. 2) A good rhinoplasty begins with a thorough exam, understanding exactly what you want, and a detailed, step by step surgical plan. So it would not be useful to suggest how your procedure should be done just based on one photograph.

George J. Beraka, MD
Manhattan Plastic Surgeon

General Anethesia with LMA for Rhinoplasty

Local anesthesia may initially sound like a good idea for Rhinoplasty, but it's not necessarily the safest, nor the easiest circumstance for you or for the surgeon. As other posters have noted, anesthetic techniques are very safe in healthy patients. I routinely use General Anesthesia for Rhinoplasty (usually with LMA). As far as evaluating for your nose, I would recommend a consultation with a local Rhinoplasty surgeon; your picture is not adequate to give any meaningful advice. New York... more

Stephen Prendiville, MD
Fort Myers Facial Plastic Surgeon

www.drprendiville.com

Be more nervous about the rhinoplasty than the anesthesia.

While fear of general anesthesia is common, it is largely unfounded. The greater fear--in all seriousness--should be the rhinoplasty itself! Getting a good result from surgery requires a lot of judgment, experience, training, and ability. Find a good rhinoplasty surgeon first, then discuss your concerns/fears about anesthesia with him/her. Modern anesthesia in properly selected and examined patients is remarkably safe and comfortable compared to years ago. The patient is most comfortable... more

David C. Pearson, MD
Jacksonville Facial Plastic Surgeon

I prefer General anesthetic for Rhinoplasty Surgery.

You appear to have a wide nasal tip and nostrils. This can be refined with well-performed Rhinoplasty Surgery. You should consult several board-certified, experienced Rhinoplasty specialists with many photos before you proceed. Although many prominent Rhinoplasty surgeons use local anesthetic with intravenous sedation for Rhinoplasty Surgery, I think general anesthetic with an orotracheal tube is the safest way to protect your airway. Even if you only require a tip-plasty, and no bridge work... more

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon

www.ericmjoseph.com

Anesthesia for Rhinoplasty

The nose is a very sensitive region of the face. Although local only anesthesia is feasible, it is a very unpleasant experience for both the patient and the doctor. Even giving the numbing injection can be too much for most patients. At a minimum I would suggest local with sedation (twilight anesthesia). As opposed to full general anesthesia, patients tend to have less nausea afterwards and recover a little quicker (1 hour versus 2 hours for general). Other than that, there is no real... more

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon

Rhinoplasty under local is less comfortable

Some smaller rhinoplasty procedures can be under local anesthesia but as the procedure gets more involved and takes a little longer, you will be more comfortable with a nice gentle general anesthesia. It is very easy to have a little drainage into the back of your nose or throat and then you will need to cough or spit and this disrupts the procedure. The exact changes you want with your nose will have to be examined in person with your surgeon so the right modifications can be made. Best... more

Marcus L. Peterson, MD
Saint George Plastic Surgeon

Rhinoplasty and anesthesia

I personally recommend general anesthesia for almost all of my rhinoplasty patients. It is very safe and the patient is comfortable. Local anesthesia with sedation can be done in selected patients as well. Some surgeons do local anesthesia only, but this is generally very uncomfortable for the patient. Unfortunately I can't see your nose well enough in the photo, so I can't comment on fillers versus surgery. I recommend seeing a board-certified surgeon who can give oyu more specifics... more

Nina S. Naidu, MD
New York Plastic Surgeon

Seek an experienced rhinoplastic surgeon

Although it is important for you to have imput into the type and extent of surgery you will have, you have to remember that the Doctor has much more experience than you and you should listen to their opinion. You would not be happy having your nose done under straight local, although it could be done that way. Come and see an experienced professional and talk to them.

William B. Rosenblatt, MD
New York Plastic Surgeon

Rhinoplasty can be done under local anesthesia with sedation but its not safer

I initially trained by doing rhinoplasty under sedation (drowsy) and did so for over 15 years. Anesthesia drugs and monitoring has improved to the point where light general anesthesia is safer and with just as fast a recovery as sedation. The drugs used are actually the same with just a teeny bit more given so you don't feel (or remember) a soft device called and LMA that sits on top of your voicebox. Patients really don't want to hear us working on their noses. If you ask any... more

Steven J. Pearlman, MD
New York Facial Plastic Surgeon

Rhinoplasty under Local Anesthesia can be done

Hello, Rhinoplasty was traditionally done under local anesthesia in years past on a routine basis. Now, more and more are done under general Anesthesia because the anesthesia techniques have become better and safer. That having been said, certain aspects of rhinoplasty can certainly be performed under local anesthesia with some mild sedation such as tip refinement, nostril narrowing etc. When bony shaping and manipulation is required, it is usually best to be under a deeper form of... more

Louis M. DeJoseph, MD
Atlanta Facial Plastic Surgeon

Rhinoplasty under local anesthesia

Smith, Rhinoplasty can be done under local anesthesia with a mild sedative. When the surgery is done this way, the swelling and bruising is minimal. Patients done this way are usually very comfortable and do not feel any pain or discomfort. You are in fact lucky that you are from NY, as there is a fantastic and highly skilled surgeon there that does all his rhinoplasties like this. His name is Norman Pastorek. I know because I trained with him.