Septoplasty and Rhinoplasty Using Local Anesthesia?

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.