Septoplasty and Rhinoplasty Using Local Anesthesia?

I need a Septoplasty due to a broken nose. I am considering getting a Rhinoplasty at the same time too. I have a HUGE fear of being "put under". I'm also emetophobic as well and general anesthesia frightens me since I've had past surgeries and thrown up for about 2 days after. Can I get this done with local anesthesia? I really hope so because I don't think I will ever get this fixed if anyone won't do it that way.

Doctor Answers 21

Most surgeons prefer general anesthesia, here's why...

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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.

Septoplasty under local.

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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.

Nasal procedures can be done under local anesthetic

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Nasal procedures can be done under local anesthetic.  A major rhinoplasty can be a long and complex operation and many surgeons prefer to do this under general anesthesia. If you must have the procedure under local, find a surgeon who is comfortable operating under these conditions.

Robert Mounsey, MD
Toronto Facial Plastic Surgeon

IV sedation for rhinoplasty

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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.

General anesthesia and anesthesia options

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It is generally not a good idea to have rhinoplasty under local anesthesia. We have tried and abandoned this procedure due to patient intolerance of the pain, the injections and the surgery itself. Making cuts in the nasal bone and resetting both nasal bones will be extremely painful under local anesthesia. You will also have conscious awareness of the surgery under sedation. It is also best to be placed under General anesthesia by a board-certified  physician anesthesiologist. There are multiple different medications that are now available to help prevent nausea and vomiting in the postoperative phase.

Local anathesia Rhinoplasty

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Yes, rhinoplasty and septoplasty can be accomplished with local anathesia. However, the multiple injections required are very uncomfortable. I strongly suggest some IV sedation at the least during the numbing process. If an more aggresive surgery is indicated a general anathesia may be a safe avenue.

Talk to your surgeon

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For some rhinoplasty procedures, local anesthesia can be used. I would caution though, these are very limited circumstances. IV sedation or even general anesthesia are very safe for patients and if you are prone to nausea, a good anesthesiologists can adjust the medications used and help to decrease your risk of post operative nausea. In the end, I would talk to your surgeon about your concerns.

D.J. Verret, MD
Dallas Facial Plastic Surgeon
3.9 out of 5 stars 14 reviews

Rhinso and Septoplasty Option

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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.

Rhinoplasty and anesthesia

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Yes, it could be done. However, you probably would be more comfortable under gneral or at least deep sedation. Most office based anesthesiologists are trained to deal with patients that are prone to nausea. They can minimize the risk of nausea with many different medications. I would not worry too much about this.

Rhinoplasty is possible under local, sedation, or general anesthesia

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All types of anesthesia can work well for nasal shaping. Over many years we have moved toward general anesthesia though sedation was excellent for most. Local without sedation is possible from a comfort perspective though patients we treat never seem to want to be so aware during their procedure. Patients most often will tell our anesthesia staff to just put them out for the procedure and therefore our trend to general anesthesia rather than sedation. You may find it interesting that we use the local regardless, so recovery for all is the same. The agents used in a general anesthesia tended to cause more nausea than sedation, though this is probably no longer true with modern anesthetic medications and agents. You should also know that most surgical procedures in the US are ambulatory or outpatient, with patients sent home shortly after. All are safe, and the choice can be yours.

Best of luck,


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.