Do I Need to Be Under General Anesthetic for My Endoscopic Brow Lift and Rhinoplasty?

Dear BrigetteLA
Thanks for your question. The procedures you asked specially in combination are usually done under general anaesthesia. Specially when you need some nasal tip work and cartilage graft. General anaesthesia in young and fit people is usually very safe. You would usually have a pre assessment clinic session when they would check your bloods and make sure you are fit for surgery. You could ask to meet the anaesthetist on that clinic and ask your questions and a good anaesthetist can reassure you and help manage your anxiety. The usual culprit is the fear of unknown and the remedy to that is information which the anaesthetist can provide for you. I hope you find this explanation useful.

I usually perform these procedures under general to ensure the comfort of the patient, but it is possible to perform them with local. I would recommend discussing your options for anesthesia during a consultation with your prospective surgeon. He/she will help determine the best method of anesthesia for you based on your individual needs. Under the care of an experienced board certified anesthesiologist, you will be in good hands. Thank you, and I wish you the best of luck with your surgery!

The browlift can certainly be done under sedation. I prefer a general anesthetic for rhinoplasty but other surgeon's prefer sedation. It can be done safely either way as long as your surgeon and anesthetist work that way regularly.

"Twilight sedation" is possible. This involved deep IV sedation without intubation or general anesthesia. In our office, this is our standard type of anesthesia for nearly all our facial procedures, whether browlift, facelift, or rhinoplasty.

A lot of this depends on the comfort level of the surgeon and/or the anesthesia provider.

Discuss this further with your surgeon. If you like your surgeon, and general anesthesia is what he is comfortable with, then you should not worry about the anesthesia so much. General anesthesia is extremely safe in nearly all cases.

Hi there,

Whilst its possible to do nearly anything under local anaesthesia, for surgery of the scale you're seeking, the risks of local anaesthesia and sedation probably (arguably) outweigh the risks of a general, and the experience will be quite difficult under local for both you and the surgeon.  

Personally, I would not offer you the surgery under local. Too stressful for me, and for you, and I think your airway and safety would be at higher risk of problems than under a general.

If you're fearful of a general, and you are healthy, then your fear is just misplaced.  With today's techniques and monitoring, provided you have a specialist anaesthetist, your risk of major anaesthetic complication is probably about the same as the risk you take travelling in a car. Everything you do has risk.  Many things you already do are more risky than a general anaesthetic.

 

You are having a lot of procedures done at the same time. Maintaining a secure airway is necessary for your safety

It is important to have rhinoplasty under general anesthesia because blood drains down the back of the nose, which could go into the lungs causing the patient to cough and aspirate blood and mucus.  It is very important to have a protected airway during the rhinoplasty procedure, which is achieved during general anesthesia.  It would also be extremely uncomfortable to undergo both an endoscopic brow lift and a rhinoplasty under IV sedation since there would be conscious awareness of the instruments tunneling under the forehead as well as breaking the nasal bones during the rhinoplasty.  For patient comfort and safety reasons, it is best to be placed under general anesthesia by a board certified physician anesthesiologist.

Patient safety is always the priority during surgery.  That being said, there is a lot of artistry associated with the surgeries you are considering.  In order to keep you as safe as possible and achieve the outcome you desire, it is most likely best that you are under a light general anesthetic. I encourage you to speak with your anesthesiologist to help you with your concern with general anesthesia.  I think you will be pleasantly surprised to find out just how safe it is! Good luck

I think that the best answer to this question is the type of anesthesia that the surgeon is most comfortable and experienced with. If the surgeon you choose gets great results on the procedures you are interested in using general anesthesia, then I would go with general, assuming that you are healthy and a good candidate medically. 

The other consideration which is equally as important is your comfort during the case. It is very important that you be comfortable through the entire case. Using general anesthesia essentially guarantees that you will be comfortable throughout the procedure. If you have an anesthesiologist who is experienced with sedation techniques you may be able to achieve the same level of comfort without the need for general.  It may be difficult to keep you comfortable, especially during the rhinoplasty portion of the procedure using local anesthetic.

The goal of anesthesia for these procedures is to make the patient comfortable so they have a safe pleasant experience. However we frequently get into semantics when describing various anesthetic techniques. In most situations sedation for these procedures is a mild form of general anesthesia. Choose an experienced surgeon who has good results because your primary goal is a natural result with minimal risks.