I want to reduce tip of nose & want it in local anaesthesia; can it possible?
GreetingsThank you your question and photos. After consulting a plastic surgeon only then can you know what will be best.Some patients have only nasal tip problems like dropping nose. These minor problems does not require a major surgery performed under general anesthesia. In the suture correction of nasal tip technique there is no need for surgical dissection or incision. We can fix these problems under local anesthesia with special equipments and sutures.
Tip surgery under local anesthesia
Firstly, one has to be sure that only the tip cartilages or nasal base needs surgery. If so, then local can be used. Since the injections are so painful, a preoperative, intramuscular injection of an opiod, may take the edge off. Otherwise sedation by an anesthesiologist could be considered.
Tip-plasty under local anesthesia
While it is theoretically possible to do this under local anesthesia, you must understand that local anesthesia requires multiple injections in and around the nose. And the nose is a very sensitive part of the body -- the injections would be very very painful. When there is pain the patient cannot help but react, squirm around etc, and the result is that the anesthetic may not have full effect.
My best recommendation is for twilight sleep anesthesia administered by an anesthesiologist. Why subject yourself to an exquisitely painful process when you could sleep gently and peacefully while the surgeon works on a patient who is not moving on the operating table? This is a once in a lifetime operation -- make it easy on yourself.
Elliot W. Jacobs, MD, FACS
New York City
Although it is possible to do small works on the nose with local anesthesia. For better results and more control, majority of the rhinoplasty surgeon perform the surgery under general anesthesia.