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Your options for anesthesia are: 1) Local: You are fully awake and a local anesthetic is injected to numb the nose. 2) Local with sedation You have been given a sedative in addition to the local anesthesia. Here you may wake up and fall back asleep at times during surgery, but you will not remember. 3) General You are fully sedated such that your breathing has to be done for you via an endotracheal tube. You can choose any of these options based upon medical history, your comfort level, and your surgeon's preference. Some aspects of rhinoplasty (such as cutting the nasal bones) can be uncomfortable for some patients. Know your pain/anxiety threshold! But keep in mind, it is easier to recover from those options that involve less anesthesia (perhaps you have a history of bad nausea and vomiting with general anesthesia). If you are healthy and want general anesthesia, you should not be concerned with the length of surgery. General anesthesia is like flying a plane: the tough part is the takeoff and the landing. Everything in between is automatic pilot. However, if you are not a healthy patient, it may not be as safe to have general anesthesia because there can be more blood pressure/volume fluctuations that can put a strain on your heart and lungs. Also, if you've been told you are a "tough intubation" that might indicate that general anesthesia has a higher risk for you. Don't feel that you have to make this important decision on your own! Your surgeon and your medical doctor will work together to determine the safest option for you. Trust them, that is what they are trained to do.
I perform my rhinoplasty surgeries under general anesthesia. I believe it's the safest option.General anesthesia means that the patient is completely asleep and not aware of any surroundings during the operation. The patient is intubated, which means that a tube is placed in one's throat which is connected to an anesthesia machine. Breathing function is managed by this breathing machine and the anesthesiologist who monitors the patient's heart rate, blood oxygen level, and blood pressure. The qualified anesthesiologist determines which inhalation gases and intravenous medications to use for the patient before the operation. Best of luck to you.
Your nose is part of your airway, and we feel general anesthetic with a cuffed orotracheal tube is the safest option for preventing blood from getting into your lower airway during rhinoplasty. Thank you for this important question. Dr Joseph
The options that can be available regarding Anesthesia for a Cosmetic Rhinoplasty in general terms are:1. Local infiltration of a numbing agent (such as lidocaine with epinephrine) only.2. Intravenous sedation ('twilight anesthesia'), this is often combined with number one.3. General Anesthesia.In the first case you are fully awake, this may be acceptable for the right individual, especially if a very limited rhinoplasty is being considered. And if the surgeon feels it is an appropriate choice allowing him, or her, to reach the desired goal reliably. The second and third options are chosen more so depending on the patients preference, the surgeons comfort level, and how complex the rhinoplasty is expected to be. As far a my practice (after having tried at one time all of the above over many years) I typically recommend a general anesthesia, but I am willing to consider the other options. I hope this helps.Sergio Pasquale Maggi, MD, FACSdrmaggi.com
Local or general can be administered, but I generally perform the surgery under general anesthesia for the safety and comfort of patients.
Most of my rhinoplasty patients are young females - they are all in a high-risk group for post-operative nausea associated with general anesthesia. For this reason, I prefer 'IV sedation' or 'twilight sedation' for rhinoplasty surgery - it avoids the use of inhalational anesthesia and breathing tubes.
