Local anesthesia for rhinoplasty.

Hello 22 year old male who has been wanting to get his nose done for a long time but is having a hard time finding a dr who uses local anesthesia . I live in LA and it seems like everywhere I call they all use general anesthesia with mild sedation. I have gone to allot of consultations for this and it seems like none of them use local in LA. I did find one but thats in NY Dr. Andrew Jacono who does use local anesthesia to do rhinoplasty. I want to be awake not asleep during surgery.

Doctor Answers 9

Anesthsia for rhinoplasty

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it is true that most rhinoplasties are done under general anesthesia.  We actually used to do many under local anesthesia with sedation.  However, I would definitely not make my surgeon choice based on that criteria.  Find the best surgeon you can and don't ask the surgeon to perform the surgery under local if the surgeon is not comfortable performing it that way.

Rhinoplasty under local anesthesia ?

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 I do rhinoplasties under local anesthesia with an anesthetist to monitor patient. You can be as awake as you would like but while I am concentrating on doing the surgery the anesthetist watches your vital signs to make sure it is safe. When I trained we did all  rhinoplasties under local  anesthesia so this was quite common.  It's still can be done that way. 

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 36 reviews

Rhinoplasty best under general anesthesia

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If you can't find a surgeon to do a rhinoplasty under local anesthesia that should tell you something. It is simply not safe, in my opinion. Rhinoplasty is an incredibly complex procedure and the patient needs to be under general anesthesia. If this really frightens you, meet with your anesthesiologist before surgery and discuss. There are drugs to manage anxiety. But I would strongly recommend that you not have the procedure if you are unable to do it under general anesthesia.


Kouros Azar

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Anesthesia options for Rhinoplasty

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Many patients have the same fear of going under general anesthesia vs. local anesthesia. However, general anesthesia is very safe. A rhinoplasty is a very complex surgery that has many risk factors involved with the use of local anesthesia vs. general. Without photos provided I would need to see you in person to discuss whether your nose is only a minimal correction or more extensive which would require general. Please seek a Board Certified Plastic Surgeon who specializes in hyperesthetic facial procedures. 

Best Regards,

Dr. Randal Haworth

Local anesthesia for rhinoplasty

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Local anesthesia for rhinoplasty is a very bad idea. It's impossible to get the nose completely numb with local anesthesia, therefore you will have extensive amount of pain when breaking the nose bones. You will not be able to tolerate it. In addition, there will be blood going down the back of the throat. The local lidocaine injections will also be intolerable for you in order to help get the nose numb. For patient safety and comfort, we use board-certified physician anesthesiologists. All  of the  rhinoplasty patients on the  photo gallery below have undergone general anesthesia for their procedure.

Local Anesthesia for Rhinoplasty

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The fact that you've not ben able to find a surgeon to do your rhinoplasty under local anesthesia should tell you something such as it is safer and results are better when the procedure is done with at least light sedation. My response would depend on what needs to be done to achieve your rhinoplasty goals.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 40 reviews


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We perform rhinoplasties under local anesthesia and have be doing so for over 2 decades.  It is a safe procedure with no more need for revision than those done under general.  It all depends on how well the anesthesia or "block" is done.  You may send pictures to consult@facialinstitute.com.  Best wishes.

David Alessi, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 16 reviews

General or local anesthesia for rhinoplasty?

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Rhinoplasty is a finesse procedure that needs to be performed in a low stress environment to obtain the best results.  Under local anesthesia even with oral sedation there is a high likelihood that you will feel like moving about when someone is working inside of your nose.  A light general anesthesia is much less stressful on both yourself and your surgeon and likely to give you a better physical outcome.  Why not wake up feeling like you were asleep for 15 minutes to be told that the procedure has already been completed?  That would be the best advice for you to consider.  Good luck with your choice and best wishes,

Jon A Perlman MD FACS 

Certified, American Board of Plastic Surgery 

Extreme Makeover Surgeon ABC TV

Best of Los Angeles Award 2015, 2016 

Beverly Hills, Ca

Jon A. Perlman, MD
Beverly Hills Plastic Surgeon
5.0 out of 5 stars 31 reviews

Anesthesia and rhinoplasty

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dear Araboshah

The fact that you have looked and have not found anyone willing to do your rhinoplasty with local anesthesia should be enough to recognize that the significant majority of surgeons feel it is not the kind of procedure that is amenable to good outcomes with just local anesthesia. You should look at the reasons you don't want general anesthesia and make sure they are sound and based on correct information. 

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.