Septoplasty and Rhinoplasty Using Local Anesthesia?

Rhinoplasty can dramatically impact the appearance of the
nose. When this procedure is performed with local anesthesia alone the response
varies from patient to patient. Unfortunately, we frequently see patients who
have significant pain and discomfort during the injection process when local
anesthesia is used alone.For
this reason, many surgeons supplement local anesthesia with I.V. sedation or
general anesthesia to minimize pain and discomfort during the procedure. When
utilizing this approach the procedure is more comfortable and there’s less
break through pain for the patient.It’s
important to realize that all surgical procedures and anesthetic techniques
have risks. This is true whether local anesthesia, IV sedation or general
anesthesia are utilized.The
vast majority of rhinoplasty surgeons prefer general anesthesia when performing
this procedure. They realize that when this approach is utilized patients seem
to have a better overall experience. Exceptions do exist, and for this reason
it’s important to thoroughly discuss anesthesia with your surgeon before
proceeding.

Yes you can have a Septoplasty or even a Septorhinoplasty under local anesthesia. Whether you tolerate the procedure depends both on the surgeon and anesthetist. However the skill of the anesthetist is foremost. Local anesthesia with sedation is the best technique but also the most difficult to master. Its like walking a tight rope. Too little sedation and you will be aware during the procedure, but too much and you stop breathing. Its easier on every one to just have it done under general. If your fear of a general anesthesia is due to your concern over the risks, perhaps knowing the risks are always higher with local and sedation or 'twilight anesthesia' than with a general anesthesia.

You are not alone in you fear of general anesthesia.  Although I still occasionally use general anesthesia for rhinoplasty and septoplasty I prefer using IV sedation and use that 95% of the time.  I have performed thousands of rhinoplasty/septoplasty with IV sedation and patients do much better with IV sedation than general.

Local alone would be very difficult for you and the surgeon. You want the best possible result and trying to do all this work under local anesthesia is a compromise. Local with sedation is an option but the best way of doing the surgery is under general anesthesia where everything is very well controlled.
There are medications you can take before the surgery like Emend that will help decrease the possibility of nausea after the surgery. Also you need to mention this to the plastic surgeon as well as the anesthesiologist so that they can give you medications before, during and after the surgery to help with the nausea.
Good luck.

I read your concerns. I don't think it's feasible to perform Rhinoplasty Surgery with just local anesthetic. You can experience nausea even if you receive Intra-venous sedation, and no general anesthetic.

I prefer general anesthetic for Rhinoplasty Surgery since your airway is involved. During surgery, there is always bleeding into your throat, so I like to protect the airway with an endotracheal tube.

Your best source advice right now would be from an Anesthesiology Consultation. You may want to try to get a copy of your previous surgical records, so an Anesthesiologist might be able to determine what you're sensitive to.

I hope this is helpful, and best regards.

Yes, it can be done but is very tricky. While having it done you can get a severe nosebleed and it can trickle down into your windpipe and cause serious penumonia.
There are very few surgeons who can do this well i.e., under local anesthesia. I have seen Norman Pastorek do it and I would trust him to do it to my nose. He is New York City. I know its far for you but thats where I would go.
Regards

 The nasal surgery can be done with only local anesthesia, with or without sedation. You should find a rhinoplasty specialist who is familiar with doing noses this way. 

Rhinoplasty can be a fairly traumatic experience. If you are under straight local anesthesia you probably will not like what is going on and your surgeon will be concerned that you are too aware of what is happening so they are uncomfortable as well. I would suggest light sedation. You don't have to have general anesthesia, although it is extremely safe, and you will not likely have the post op nausea associated with general.

Although I perform most rhinoplasties under IV sedation, an even "lighter" anesthesia approach is sometimes used in our office. At the end, this decision is one between you and your rhinoplasty surgeon because both have to be comfortable with the anesthesia option.

Patients have a fear of "general" anesthesia for rhinoplasty. I did many nosejobs under sedation, safely for the first 12 years of my private practice. With the advent of LMA, we have a happy medium. The anesthesia used is practically the same as for sedation but just a smidge more. LMA is a triangular "mask" that fits over your voicebox. Patients tolerate it very well. Most of my pateits are actually breathing on their own yet are unaware of the surgery. This reduces the anxiety of patients knowing what is going on. Also, in a minority of patients, sedation has a very small threshold between breathing and not.
If you ask any anesthesiologist, they will tell you that sedation has a higher risk of medical and breathing complications. We have some great medications to reduce nausea and vomiting. Discuss these optons with your chosen surgeon. Please make sure they are a rhinoplasty specialist.