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

I am planning to have a endoscopic brow lift to correct a tired, sad looking eyes and eyebrows, rhinoplasty to correct a counter roated tip which makes my nose look piggy,i may have some cartilage added... and a lip lift. Can i have this under local anesthetic with sedation? I am scared of general and really want to avoid it...

Doctor Answers 12


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

New York Plastic Surgeon
4.9 out of 5 stars 14 reviews

Is general anesthesia necessary?

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!

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

General anesthesia best for brow lift and rhinoplasty

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.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.8 out of 5 stars 143 reviews

General anesthesia for surgery?

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

Mennen T. Gallas, MD
Katy Plastic Surgeon
5.0 out of 5 stars 19 reviews

What type of anesthetic for browlift and rhinoplasty?

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.

Ronald Schuster, MD
Baltimore Plastic Surgeon
4.9 out of 5 stars 77 reviews

What kind of anesthesia is best for a brow lift and rhinoplasty?

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.

Todd C. Miller, MD
Newport Beach Facial Plastic Surgeon
5.0 out of 5 stars 34 reviews

Anesthesia for Endoscopic Brow Lift and Rhinoplasty

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.

Richard W. Fleming, MD
Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Choice of anesthesia

These operations can be done with any of the anesthesia scenarios that have been discussed. The choice is whatever is most comfortable for you and your surgeon. Your fear of general anesthesia may make even light sedation an issue. Also, your surgeon can do his/her best work when the patient is being operated on with anesthesia that is customary to the practice. Be sure that your surgery is being done in an accredited operating facility. 

Sheldon S. Kabaker, MD FACS
San Francisco Facial Plastic Surgeon
4.4 out of 5 stars 35 reviews

Brow Lifts

I prefer local anesthesia with I.V. sedation because general anesthesia is way "over the top" with stinky gases, intubation, and muscle paralysis.  General anesthesia increases the risk of Cosmetic Surgery!

Robert Shumway, MD
San Diego Facial Plastic Surgeon
5.0 out of 5 stars 12 reviews

Endoscopic Browlift and Revision Rhinoplasty under Local Sedation

Yes. Most if not all of facial cosmetic procedures can be done under local sedation. The trick is to have a good anesthetist that knows how to work with propaphol. It's definitely less risky than general anesthesia, especially if the surgery is more than 3 hours.

Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 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.