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Rhinoplasty Under Local Anesthesia?

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?

Doctor Answers (23)

Rhinoplasty - General Anesthesia vs I.V. Sedation

+2

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 patients who are fearful of general anesthesia. Although the anesthesia is a significant concern of yours, first make sure you're getting the right procedure by the best doctor you can find - then address the anesthesia issues. Best of Luck

 


Miami Plastic Surgeon
5.0 out of 5 stars 32 reviews

Rhinoplasty under local anesthesia is not recommended

+2

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 so that when there is bleeding it does not get trapped into the trachea and below the vocal cords, which can be dangerous to the airway and can result in severe complications.

According to the picture shown you will need to have osteotomies performed on your nose since it is quite wide. Avoid fillers in the nose because of the disasters that have occurred with those. Taking the bump and the convexity off the bridge of the nose would enhance your profile and narrowing the nasal bridge would help as well. The depressed tip can be lifted up by surgically releasing the depressor septi muscle that causes the tip to droop when smiling.

William Portuese, MD
Seattle Facial Plastic Surgeon
5.0 out of 5 stars 60 reviews

I prefer General anesthetic for Rhinoplasty Surgery.

+2

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, I would typically harvest a cartilage graft from your septum to be used as a supporting colulella-strut. This septal work inside your nose leads to post-nasal bleeding that could compromise your airway if you only have local anesthetic, and no breathing tube.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
5.0 out of 5 stars 287 reviews

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

+1

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 are secondary.

Ramtin Kassir, MD
Wayne Facial Plastic Surgeon
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Anesthesia selection in rhinoplasty

+1

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 sedation, and under general anesthesia. The approach and surgery are customized for each patient.

Good luck.

Julian Henley, MD
Greeley Facial Plastic Surgeon

General anesthesia for rhinoplasty is preferred

+1

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, FACS
Los Angeles Plastic Surgeon
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Anesthesia for Rhinoplasty

+1

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
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Rhinoplasty can be done under local anesthesia

+1

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
Great Neck Facial Plastic Surgeon
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Anesthesia choices for rhinoplasty

+1

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.

Jay Calvert, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 25 reviews

Rhinoplasty and anesthesia

+1

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
4.5 out of 5 stars 18 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.