Closed Rhinoplasty with Local Anesthesia? (photo)

I found a doctor who only does closed rhinoplasty under local anesthesia, in his own office. He is board certified and I heard he does natural noses. My nose needs a bit tip work ( it is droopy, but nothing severe ) and I have a thin and long hump which probably needs a little bit of touch ( I don't want the bone to be completely gone ) Do you think this can happen safely? I am very nervous, all I want is a natural nose which is a bit less droopy, not a lifted baby-nose!

Doctor Answers 7

Closed Rhinoplasty with Local Anesthesia

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When I was in training over 35 years ago we did many noses with just local anesthesia but that was done in a teaching hospital where many patients did not have the financial ability to have the procedure done with IV sedation or general anesthesia, which provide a much more comfortable operation. If possible, meet with other patients who have had a full rhinoplasty with just local anesthesia. 

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 43 reviews

Closed Rhinoplasty with Local Anesthesia?

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Closed rhinoplasty under local anesthesia can be done but this is not the majority view in surgery. Either IV sedation with the local or general anesthesias with local is the more common approach. Best to discuss in MORE detail with your surgeon. As an aside if it was me "put me out!":

Closed rhinoplasty under local anesthesia

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There are some surgeons that can perform the rhinoplasty under local anesthesia with good results. I would focus on the surgeon and his abilities more than anything else. If he is experienced doing it in this fashion, it is certainly safe.

Andres Bustillo, MD, FACS
Miami Facial Plastic Surgeon
4.9 out of 5 stars 123 reviews

Yes Closed Rhinoplasty

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The closed rhinoplasty is the best if you want refinement and a natural looking nose. If you are a primary nose with no previous surgery, you should ONLY consider closed scarless rhinoplasty (preferred by actresses and celebrities) because there is no risk of external scarring and much less healing and recovery time.  The goal is to finesse and enhance the nose without drastic change. Also all the same surgical maneuvers your nose requires can be performed with a skilled closed scarless surgeon. 

All the best, 

Deepak Dugar, MD
Scarless Rhinoplasty Expert
Beverly Hills, CA 90210

Deepak Raj Dugar, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 20 reviews

Why I don't do rhinoplasty surgeries under local anesthesia

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Certainly the type of anesthesia used for rhinoplasty is a decision made by both surgeon and patient, but I do my cases under general anesthesia. That way, I have the patient's airway secure (to avoid blood aspiration) and I do not have to inject a lot of numbing medication to keep the patient comfortable The addition of excessive amounts local anesthesia during surgery distorts the nose and makes finesse changes of surgery difficult to visualize for the surgeon. (In addition, local anesthesia injection can be toxic at high doses!) With the patient under general anesthesia, the airway is secure, the patient is comfortable, I can work faster and safer.

Theda C. Kontis, MD
Baltimore Facial Plastic Surgeon
5.0 out of 5 stars 42 reviews

Rhinoplasty under local anesthesia

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 It is simply not a good idea to have rhinoplasty under local anesthesia due to potential aspiration of blood down the back of the throat. It will the very painful to get the nose numb with local injections and it will be impossible to get the nasal bones completely anesthetized  when the osteotomies are performed. For patient safety, it is best  to have this procedure performed under general anesthesia by a board-certified anesthesiologist.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 158 reviews

Closed Rhinoplasty with Local Anesthesia?

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      To remove the hump, I would recommend that you get the procedure performed with general.  Once the hump is reduced and the bones are infractured you will want to be asleep.  Find a plastic surgeon with ELITE credentials who performs hundreds of rhinoplasties 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

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.