Can an Alarplasty Be Done Under Local Anasthesia?

Hello,

Yes, it is possible to perform this procedure under local anesthesia. Rhinoplasty can also be performed under local anesthesia.  During a consultation, your options will be discussed with your surgeon and he/she will help you choose the best possible option depending on your individual circumstances. Thank you and best of luck to you.

Dr. Nassif

 

Nasal surgery can definitely be performed under local anesthesia.  Typically general anesthesia would be used if some internal functional work needs to be performed at the same time.  More importantly, make sure that the choice of local anesthesia does  not dictate what type of surgery is done for the optimal results.  Excellence in nasal surgery requires, experience, talent and wealth of experience, make sure your surgeon has all of the above.  Do not be shy of requesting numerous examples of your surgeon’s work, photos of prior patients of even meeting his patients that had similar type of nasal surgery that you are contemplating.

Local anesthesia is often used for smaller nasal procedures like alarplasty. I often give patients minimal oral sedation with Xanax or Valium to relax them prior to injecting their nose with local anesthesia that can sting and burn. Once the nose is numb and you are relaxed alarplasty can be done comfortably.

Yes, limited alar base reduction (such as wedge excisions) can be done with an injection of numbing medicine in certain situations.

A large determinant of whether it's a good idea to do a procedure like this with only local anestesia is the patient's motivation and demeanor.

That depends on what you mean by an alarplasty. If it is just removing a small wedge of skin to narrow the alar base sure that can be done under local. If fine manipulations of the alar cartilages are required with shaping sutures and/or cartilage grafts I would not advise doing it under straight local anesthesia if you want a reliable result. More invasive rhinoplasty procedures with infractures etc. are actually safer when performed under general anesthesia. That is because if blood from the nasal area gets past the back nasal openings into the back of the mouth/throat in a sedated person the results can be disastrous with loss of airway control. In such cases general anesthesia is safer with a tube past the vocal cords, the patient fully asleep and some packing in the back of the mouth so no blood whatsoever can go down south.

I hope you realize that this format of posting questions and receiving answers lacks the face to face direct communication required for you to make an informed decision regarding your surgery.

My response to your question/post does not represent formal medical advice or constitute a doctor patient relationship. You need to consult with i.e. personally see a board certified plastic surgeon in order to receive a formal evaluation and develop a doctor patient relationship.

Yes, under the right circumstances in the right patient, an alarplasty can be done under local anesthesia.  It really has to do with your anxiety level, ability to remain calm if you are awake having surgery and what other procedures you are having at the same time.  That said, IV sedation or "twilight anesthesa," is a nice alternative to general anesthesia for small procedures which can be done in the office if the surgeon has a accrediated OR facility.

 

Good Luck.

Yes, alar reshaping can be done under straight local anesthesia. However, rhinoplasty reshaping of the nasal tip and bridge does necessitate going under a full anesthetic in order to be done under ideal conditions. 

Certainly an alarplasty can be done under local anesthesia since the area being operated upon is simply located at the base of the nose.  Any remainder of the nose is very difficult to completely numb, so it is best to have a full rhinoplasty done under general anesthesia.

If you mean narrowing the alae (Weir procedure) then it certainly it can be done under local. If you mean tip plasty then perhaps some sedation would be advisable. For complete rhinoplasty it maybe more comfortable to do under general anesthesia although conscious sedation is also acceptable. The most important point is the experience of the surgeon

I would say that most patients will tolerate reduction alar surgeries under local.  By that I refer to techniques designed to reduce the size of the tip, refine the tip, reduce nostril size etc.  Weir incisions and alar base reductions are commonly completed under a local anesthetic in an operative suite.  Composite grafts or other surgeries to increase the tip size, projection, etc., are usually best performed under a general for the comfort and safety of the patient. Great question.