Is it commonplace to do ultrasonic rhinoplasties under local anesthesia?

Question

Is it commonplace to do ultrasonic rhinoplasties under local anesthesia? It’s been hard to find a doctor who will do it this way. Any recommendations or advice?

Caner Kacmaz, MD · Answer

The Piezzo technique is where we use ultrasonic waves to correct the nose. This surgery as well as any other type of nose surgery must be performed under general anesthesia

Donald Groves, MD · Answer

Hello and thank you for your question. In short- every surgeon's practice is different. Regarding the anesthesia- although most surgeons prefer putting patients fully asleep under general anesthesia for this procedure, some perform it under IV sedation ("twilight sedation") with local anesthesia, or just under straight local sedation, as you are describing here. Generally, most patients would not tolerate such an invasive procedure done under local, and most surgeons feel that it is easier to perform such involved and complex procedures with patients at least sedated if not fully asleep so they can assure the patient remains perfectly still. Everything ultimately comes down to surgeon and patient preference, so always have the conversation with your surgeon so you both know exactly what to expect, and so you both feel comfortable with how the procedure will be performed prior to proceeding. I hope this helps!
Best, 
Dr. Donald Groves 
Plastic Surgeon

Ronald J. Edelson, MD · Answer

I would get hung up on neither the ultrasonic or insisting on having it done under local. These things are far less important than finding a really good rhinoplasty surgeon regardless of the technique used

Jeffrey H. Spiegel, MD · Answer

Ultrasonic rhinoplasty is a gimmick.  The ultrasonic aspirator is a tool that has been around for many years and very slowly removes bone.  There are lots of ways to remove bone and ultrasonic is not better than anything else, but if your surgeon is comfortable with that tool then that's what they should use.
It is slower.  So, you may need more time with local anesthesia.

The key thing for you to realize is don't go looking for a technique, look for an outcome.  If you want to look a certain way after surgery let an experienced surgeon do it the way they are comfortable.  Seeking a specific method is missing the forest for the trees.

William Portuese, MD · Answer

You're not going to be able to tolerate any type of rhinoplasty under local anesthesia due to the fact  that bone work is required. In our practice, we use a very small osteotome to perform osteotomy's under general anesthesia by a board certified physician anesthesiologist. Study your prospective surgeon's before and after rhinoplasty photo Gallery.

Is it commonplace to do ultrasonic rhinoplasties under local anesthesia?

Answers (5)

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