Is It Possible to Fix Nose Bump Under Local Anesthesia?

Question

I've always been insecure about the bump on my nose and I want to get a nose job but I'm afraid of having anesthesia. Is it possible to have it done with only local anesthesia? Thanks.

Philip S. Schoenfeld, MD, FACS · Answer

I think that performing rhinoplasty under local anesthesia, although possible, is difficult.  It is difficult for the patient and the surgeon.  Shaving a simple bump off of ones nose might be suitable for local anesthesia, however, most hump removals result in the need to perform osteotomies (they break your nose) and that can be a very unpleasant experience.  Not only will the case take longer, but, your surgeon will be worrying about your pain and emotional status rather than focusing on your nose.  I would suggest asking your surgeon about "Twilight anesthesia" before writing off any anesthesia and subjecting yourself to local.  Most of my patients have been extremely pleased with this form of sedation.

Daniel Reichner, MD, FACS · Answer

Good question. 

	What appears to be a simple "bump" on your nose is actually quite complex. It is composed of a hump of cartilage under the bony hump all supported by your septum.  On the inside of the hump is the inside lining of your nose and 2 air passages for you to breathe.   Therefore, the hump removal process can not only affect the look of your nose, but also how you breathe.  

	While local anesthesia is possible, most patients (and surgeons) find this approach very uncomfortable, thus limiting the surgeon's ability to achieve the optimal results.

	Intravenous sedation with a local is a very good option in many cases such as yours.

	I recommend general anesthesia for most rhinoplasty cases, because it is both a safe and efficient way to achieve the best results.

Paul S. Nassif, MD · Answer

Hello,
Some individuals may do it under local anesthesia.  It is safe but can be uncomfortable. You may also have the procedure done under iv sedation.  But general anesthesia is safe and usually the best option.

Tanveer Janjua, MD · Answer

Fixing the nasal hump is easy but during the procedure there can be bleeding which trickles down the throat and can also go in the wind pipe and lungs. That can lead to pneumonia which can be fatal. It is a lot safer to have an endotracheal tube to protect your windpipe against any blood or secretions going into the lungs.
Regards

Toby Mayer, MD · Answer

That is the way we did did almost all noses 35 years ago. There are many doctors who still so them that way. It is more of a mental problem for some patients and that is we do most noses under some form of sedation or general anesthesia.

Ran Y. Rubinstein, MD · Answer

Princess
I would not advise having hump reduction under local anesthesia.  Hump reduction usually requires osteotomies (breaking the nasal bones) which would be very uncomfortable and also results in some bleeding which could be more difficult to manage while you are awake.  The rare exception would be a minor filing of the bridge.  Please don't make decision in who is going to perform your surgery based on the type of anesthesia.
Good luck!

Otto Joseph Placik, MD · Answer

Not all bumps or humps are the same and therefore not all require general or local anesthesia. Minor humps can be peformed under local. However, it is generally an unpleasant experience. As you know the nose easily bleeds and controlling that bleeding is essential during the procedure. This is sometimes more difficult to do under local anesthesia.

Michael A. Persky, MD · Answer

Hi Princess,
Yes it is possible to have rhinoplasty under local anesthesia.  For many years that was the way the majority of rhinoplasty surgeons trained in the 70's and 80's performed rhinoplasty.
You not only now have to choose your rhinoplasty surgeon carefully based on their experience, skill, and results, but also upon how comfortable they are performing the procedure under local anesthesia.
Good luck and enjoy your bumpless nose.
Dr. P

William Portuese, MD · Answer

It is just not a good idea or practical to have a rhinoplasty performed under local anesthesia. Local numbing anesthetic injections hurt quite a bit, and for that reason, we place patients under general anesthesia. After the bump is removed the sidewalls of the nose will have to be narrowed, which requires breaking the nasal bones, making general anesthesia the best choice for the patient and their comfort. Additionally, this type of surgery is not done under local anesthesia for fear of swallowing blood down the back of the throat, losing the airway.

Laxmeesh Mike Nayak, MD · Answer

Local anesthesia alone is certainly a possibility for rhinoplasty, whether just a bump or with tip resculpting and/or septal work, as long as the surgeon is experienced in this technique.
I have done several with local anesthesia alone, although my preference is to use light sedation to minimize the stinging sensation that comes from the local anesthesia, as well as the nervousness that might accompany surgery.
Surprisingly, I find that surgery done this way goes more smoothly, with less blood loss, and in a shorter time in the operating room than when surgery is done under general anesthesia. Recovery, bruising, and swelling are also generally less when done without general anesthesia.
Good luck!

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