Twilight sleep for rhinoplasty - I'm terrified!

Thanks for your
question.  The anesthesia that is used is
really dependent on the plastic surgeon. 
I prefer to perform rhinoplasty procedures under general anesthesia just
to make sure the patient is completely comfortable.  You will have to decide if you trust your
surgeon and are comfortable with having the procedure under twilight
anesthesia.  There is no contraindication
with using this method, but if there is any worry, you should really either
discuss it further with your surgeon or find another surgeon who you are more
comfortable with.  I hope this
helps. 

The safety of this approach depends not only on the surgeon but also the anesthesiologist. You need a highly experience team to perform twilight anesthesia safely for rhinoplasty. During my fellowship we performed every rhinoplasty under "twilight" and the cases went beautifully because the anesthesia staff and my mentor worked together well. In my own practice, I've tried this a dozen times in a dozen different facilities and the anesthesia is never as predictable as general anesthesia. The short answer is if you trust your surgeon and they operate in a fully accredited facility using MD anesthesiologist staff and this is their process, you're in good hands. If not or your gut tells you something is not right for you, keep looking.Stephen Weber MD, FACSLone Tree Facial Plastic Surgeon

Although most surgeons perform rhinoplasty under general anesthesia for various reasons (including myself), there are surgeons who do an excellent job under conscious sedation (twilight anesthesia) only. This heavily depends on the surgical technique utilized, extent of surgery, and surgeon comfort. You should discuss this with your surgeon. However, I would not categorically exclude a surgeon based on the anesthesia administered. We all have the patient's comfort and safety in mind and you should not feel anything in either scenario. Best wishes!

 Different surgeons will use different types of anesthesia for rhinoplasty, but all good surgeons have the safety and comfort of their patient in mind.   what you have not set is whether or not you discussed the concern with your surgeon and his staff to see what their experiences with patient's likely.  In our practice, we perform all manner of operations under sedation/twighlight, and in the hands of a good experience board-certified anesthesiologist,   twilight anesthesia is not only safe, but also less likely to cause complications such as nausea and vomiting.

Hello and thank you for your question.  I perform rhinoplasty using general anesthesia with a board-certified MD anesthesiologist administering general anesthesia.  Particularly if you are having osteotomies performed, I personally believe general anesthesia is better.  However, I am sure there are many surgeons who do this procedure with twilight sedation and have great results.   The
most important aspect is to find a surgeon you are comfortable with.  It sounds like you have found that, so I recommend you stay with your surgeon.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon