Can I choose to go under local anesthesia for a Rhinoplasty if I'm planning to get my tip and bridge narrowed?

Question

I'm planning on getting my tip and bridge narrowed, and sill excision. Thank you

Jeremy Hunt, MBBS, FRACS · Answer

It is possible to have a rhinoplasty under a general or local anaesthetic. and there will be surgeon and patient preferences for each.One of the fundamentals though of all surgery is going to be patient safety and some surgeons will feel that for some procedures the patient will be safer under a general anaesthetic.  This applies to rhinoplasty as for any procedure.  You need to discuss the options with your surgeon and decide the best way forward for both of you- remembering your safety is key to a successful resultAll the bestJeremy Hunt.

Kenneth Hughes, MD · Answer

I would only perform these maneuvers under general anesthesia as pain and movement may affect results.Kenneth Hughes, MDLos Angeles, CA

Michael Stefan, MD · Answer

I would not recommend using local anesthesia. If you were just going to modify thetip of the nose, then it would be feasible. However, surgical cosmetic improvement of the bridge can be complicated. The extent of the surgery may involve quite a deal of pain. The surgeon would have to be concerned about your level of pain and also concentrate on the surgery.

William Portuese, MD · Answer

In our practice, we perform all rhinoplasty procedures under general anesthesia, not local anesthesia for patient safety and comfort. We used board certified physician anesthesiologists to place the patient under anesthesia. It's very important to have a controlled airway during the procedure so that blood does not trickle down the back of your throat/lungs. Trying to perform a rhinoplasty under local anesthesia, especially with osteotomies you will have conscious awareness of yourr nasal bones being broken and will have a very unpleasant experience. Please see the link below for many examples of closed rhinoplasty performed under general anesthesia

Stephen Weber MD, FACS · Answer

I would not recommend local anesthesia (even with oral sedation) if you require bridge narrowing. That portion of the procedure should not be painful but osteotomies create sounds and vibrations that can make people anxious. In most cases, IV sedation or general anesthesia make for a safe and much more comfortable rhinoplasty experience. I hope this information is helpful for you.Stephen Weber MD, FACSDenver Facial Plastic Surgeon

Louis W. Apostolakis, MD · Answer

Hello,I offer local anesthesia rhinoplasty for all of my patients, but, not surprisingly, get very few takers.  A surgeon who is skilled at placing the local anesthesia can make the nose completely numb.  You have to realize that the injections to get the nose numb will hurt and it takes about 5 minutes to get them all placed.  A compromise is to have IV sedation during the first 10 minutes allowing for all the numbing shots, then you can be allowed to wake up.  In fact, I just did a nose this way yesterday.It you are not having any bony work or internal nasal work done (in other words,. a tip-plasty), local anesthesia is really quite reasonable.  Bony work is a bit less gentle which may provoke anxiety, but it can be made totally numb.If you are having internal work such as a septoplasty or turbinate surgery, it will be much more anxiety provoking.  The issues are that your palate will be numb, you will have some drainage into your throat, and it will not feel normal when you breath and swallow.  In fact, I had my own septum and turbinates operated on under local anesthesia so I can speak with first hand knowledge.

Matthew Hansen, MBBS, FRACS (retired) · Answer

Two things are paramount in performing rhinoplasty surgery, patient safety and precise accurate execution of the surgical plan. The most controlled situation is when the patient is under general anaesthesia with a specialist anaesthetist in a fully accredited facility . Local anaesthetic plus supervised sedation (again with a specialist anaesthetist) is the next best option but if the patient becomes agitated or restless in this situation the surgical plan may be compromised so I perform all my rhinoplasties under GA. What is unacceptable is where the surgeon gives the sedation and anaesthesia as well as doing the operation but unfortunately this is being done in some non accredited facilities , usually the surgeons private office. This puts the patient at risk and also diverts the surgeon from performing the surgery with full concentration and care as they are attempting to do two things at once. In Australia this is recognised as risky practise and most medical defence companies will not insure the practitioner for this meaning that if something does go wrong the doctor (and therefore ultimately the patient) will not be covered for the consequences.find an expert rhinoplasty surgeon who works with a specialist anaesthetist in a fully accredited facility so you have a good chance of getting the result you want without undue risk.

Can I choose to go under local anesthesia for a Rhinoplasty if I'm planning to get my tip and bridge narrowed?

Answers (7)

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