I want to make my bulbous tip and nostrils smaller and more refined. Looking for Rhinoplasty with Local + IV Sedation in CA?

I'm looking to have Rhinoplasty with IV Sedation or Twilight Sedation. I live in California and my budget is $5k-6k. I want to remove the bump on the bridge of my nose, and want to make my bulbous tip and nostrils smaller and more refined. Is there anyone who does Rhinoplasty with IV Sedation or Twilight Sedation for around $5-6k in CA? Thank You.

Doctor Answers 8

Rhinoplasty done with local anesthesia and sedation.

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Local anesthesia with sedation is one of the standard ways to do a rhinoplasty.  So you will have no trouble finding a surgeon who uses this approach.

Manhattan Plastic Surgeon

Rhinoplasty under Local Anesthesia

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Nasal surgery can be done under general anesthesia and under local anesthesia with sedation. Your surgeon will make an appropriate choice based on the degree of internal nasal work required in conjunction with the cosmetic work. In our practice each patient is assessed individually for their ability to undergo Rhinoplasty under local anesthesia. The most important point is to choose a surgeon with skills, talent and experience to perform a successful Rhinoplasty. Another consideration is to make sure your surgeon performs this procedure in a certified surgery center for the utmost in your safety.

Boris M. Ackerman, MD
Newport Beach Plastic Surgeon
4.8 out of 5 stars 62 reviews

Rhinoplasty with Local Anesthesia?

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I am a Rhiniplasty surgeon. While there are many different types of anesthesia one must assess what needs to be done and how realistic the type of anesthesia will be to accomplish those goals safely. If you had a simple dorsal hump that was being taken down by a closed approach maybe twilight sleep would work. I still to this day do not understand why patients always want to sell themselves short by cutting cost in the most important aspect of the case. For what it sounds like you want, tip modification, bump removal, and who knows what else is really needed, GO TO SLEEP!!!!!! If I were you I would continue to save money, no matter how long it takes so that you can be put to sleep. I do my best work knowing that the patient is asleep and comfortable and under the control of a board certified anesthesiologist. Nothing worse then a surgeon who is distracted by a moving patient or moaning patient while trying to literally change your face. Rhinoplasty surgery is a series of very well planned maneuvers and requires nothing short of your surgeon being excellent. I totally disagree with one of the comments here in that a person does not have to have done a specific facial cosmetic fellowship to win your business. I did more Rhinoplasties in my residency than almost any resident in the country, and I will bet my license on that. What you need to find is a board certified surgeon who does a ton of noses. Then you need to trust that person implicitly and feel nothing but confidence and comfort with that person you choose. I would interview as many doctors as it takes until you walk away saying, this is the one!!!! Do yourself a favor, if you have saved 4-5 K then wait until you can save a little more and spring for the general anesthesia. You will find a ton of docs that do not agree with me but I attend all the Rhinoplasty meetings in this country with the best of the best and almost every single one I know puts patients to sleep under general. This is your face. Not time to skimp on cost. You pay less, you get what you pay for.

Richard J. Brown, MD
Scottsdale Plastic Surgeon
5.0 out of 5 stars 54 reviews

Rhinoplasty and price

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I do not know the specific fees in California, but in NYC that is very low. Be careful what you wish for. Sometimes low prices may be at that level for a reason. Be careful.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

When Shopping by Price Only, You Must Do Lots of Homework. Be Careful!

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We all budget for what we want; that is healthy. However, when searching for a highly-specialized, very experienced rhinoplasty super-specialist, which is what most people want, you need to do lots of homework. For example, ideally, you want a board-certified specialist who also did additional facial cosmetic surgery fellowship training. Do enough research and you will find such a specialist and particularly one whose practice is mainly nose surgery.

Having the procedure under local anesthesia with IV sedation mandates having a board-certified MD anesthesiologist. Their fee must be considered.

Also, you want to be comfortable that the facility is safe, whether a hospital, doctor's office surgery facility or outpatient surgery center. The " stamp of approval" that you want is certification by the US Dept of Health and Human Services or  a license by the State of California, or accreditation by one of several independent accrediting organizations.


When you do the homework you may find that your budget, as noted here, does not match the charges of those doctors and facilities who are properly qualified and credentialed, as noted above. The principles I have outlined for you what I would look for, either personally, or for a family member. The best can never be the cheapest.


You are better off waiting longer, saving more money so that you can afford the most sophisticated doctors doing nose work. You  want to do it once and do it right!

Robert Kotler, MD, FACS






Robert Kotler, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 90 reviews

Rhinoplasty with Twilight Sleep

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Dear IVSedationRhinoplasty,

Rhinoplasty may performed under general anesthesia, local anesthesia with intravenous sedation (twilight sleep), or local anesthesia.

Most rhinoplasty surgeons offer a variety of anesthesia techinques. Please consult with an experienced, Board Certified rhinoplasty (ie. Plastic Surgeon or Facial Plastic Surgeon) for an evaluation.

Warmest wishes,

Larry Fan, MD

Larry Fan, MD
San Francisco Plastic Surgeon

Rhinoplasty with IV sedation

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      I perform closed rhinoplasties (no external scar) routinely under general anesthesia.  However, sedation can be used as well.  The procedure usually lasts an hour or so, and patients usually look very nice at three to four weeks.  However, some people stay swollen for longer.  As per your financial considerations, I am sure that we can work within your budget. 

       Good luck.

Looking for Rhinoplasty with Local + IV Sedation in CA?

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 IMHO, it's never in your best interest to seek a Rhinoplasty Surgeon based upon price.  Aesthetic understanding to create a naturally  more attractive nose and face should be your primary focus and once sure of that fact, you could factor in the cost.  IV sedation does not allow airway security and therefore is not as safe as a general anesthetic where the airway is secured with either an ET tube or LMA.  Patient safety should always be the top priority.

Francis R. Palmer, III, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 28 reviews

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.