Closed Rhinoplasty with Local Anesthesia? (photo)

Question

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!

Andres Bustillo, MD, FACS · Answer

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.

Deepak Raj Dugar, MD · Answer

Hello,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, MDScarless Rhinoplasty ExpertBeverly Hills, CA 90210

Theda C. Kontis, MD · Answer

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.

Kenneth Hughes, MD · Answer

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

Darryl J. Blinski, MD · Answer

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 with Local Anesthesia? (photo)

Answers (7)