Will I Feel Pain During Alarplasty and Tip Plasty?

Question

im getting alarplasty and tip plasty to reduce my wide and bulbous nose. the doctor told me that it would be performed under local anesthesia with sedation. My question is whether I would feel any pain during the surgery, and does this mean im asleep or am i awake. Thanks

Kenneth Hughes, MD · Answer

Local anesthesia with IV sedation will probably be comfortable, but I perform rhinoplasties under general anesthesia in all but the simplest of cases.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties and rhinoplasty revisions each year.  Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results.

	Kenneth Hughes, MD Los Angeles, CA

Elliot W. Jacobs, MD · Answer

If you have both local anesthesia as well as IV sedation, you should be lightly asleep during your procedure.  You will not be conscious of any pain.  We use this combination in our practice for nearly every surgery we do, including almost all nose jobs.  The main advantage is comfort--our patients wake up quickly and naturally after surgery with very minimal grogginess, no nausea and no "hangover" many general anesthesia patients suffer.  Our M.D. anesthesiologist and I have been performing surgery side by side using IV sedation (also known as twilight sedation), for more than two decades.  We monitor our patients very closely to ensure their comfort and safety.

	Please be sure to have a discussion with your plastic surgeon about his or her anesthesia protocol.  This is a facet of your procedure you should understand thoroughly.  Don't be afraid to ask all the questions you have.

	Elliot Jacobs, M.D.

	New York Plastic Surgeon

Steven Wallach, MD · Answer

Twilight anesthesia is fine for a tip and alarplasty for most patients. Remember patient comfort is key so that the surgeon can also be comfortable and focus on giving you the best result possible.

William Portuese, MD · Answer

Rhinoplasty should be performed under general anesthesia with a board certified physician anesthesiologist. There are lots of nerve endings in the nose and is very difficult to get the nose numbed up with local anesthetic, even with sedation. For patient safety and comfort its best to be placed to sleep under a brief general anesthetic

Jeffrey Zwiren, MD · Answer

There are two types of sedation, oral and IV. In either case the only discomfort would be the initial infiltration of local anesthetic. If you want to be in a deeper sleep then IV would be the route to go. There is no one anesthetic technique that will be best for all individuals.

Stephen Weber MD, FACS · Answer

IV sedation will typically eliminate any recollection of pain. Further, the only painful part of rhinoplasty is the injection of the local anesthetic which typically only requires a couple of minutes. The actual procedure is usually pain free as the nose has already been numbed. It is not uncommon to perform rhinoplasty under IV sedation. I hope this information is helpful.

Thomas Hubbard, MD, FACS · Answer

Certainly this surgery can be done in this manner with very little or no pain since local anesthetia works well when properly placed, especially with sedation. Personally I use general anesthesia in all rhinoplsties and so this is not an issue.

Donald Nunn, MD (retired) · Answer

With good local anesthesia and sedation you should be OK. Every case is different. Some patients need general anesthesia no matter how simple the procedure. Donald R. Nunn MD Atlanta Plastic Surgeon.

Richard W. Fleming, MD (retired) · Answer

I have done this work under just local anesthesia at the request of some patients. I recommend that you discuss your anesthesia with your surgeon, not us. There are too many choices.

Will I Feel Pain During Alarplasty and Tip Plasty?

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