Could I get a Tip Rhinoplasty and Alar Base Reduction under local anesthesia?

Hey so could I get a tip refinement rhinoplasty and alar base reduction rhinoplasty under local anesthesia. If yes how much would it range from in NYC Manhattan location??

Doctor Answers 6

We prefer general anesthetic for the majority of patients requesting rhinoplasty surgeries in our practice.

Even if you do not require bony work, you may need to have cartilage harvested from your nasal septum to achieve a narrower tip appearance, and to add tip support. Since your nose is part of your airway, we advise protecting your airway with general anesthetic and an orotracheal tube. Some surgeons may consider performing tip rhinoplasty and alarplasty with local anesthetic, but IV sedation may be necessary to keep you comfortable. Hope this helps you. Dr Joseph

West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Rhinoplasty under local anesthesia as a very bad idea

Trying to perform a rhinoplasty under local anesthesia is A very bad idea since it will be  very painful and uncomfortable.  There are too many nerve endings in the nose to be comfortable trying to perform the surgery under local anesthesia.  In addition, blood will be pooling down the back of the throat.    In our practice, we perform all rhinoplasty procedures under general anesthesia by a board certified physician anesthesiologist.  An standalone alar -plasty can be performed under local anesthesia.  

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

Tip rhinoplasty

Hello and thank you for your question.  There are some surgeons who do this under local anesthesia I am sure.  I do not.  For the best results in my hands, I prefer general anesthesia with a board-certified doctor anesthesiologist in the room at all times.    Make sure you specifically look at before and after pictures of real patients who have had this surgery performed by your surgeon and not just a computer animation system. The most important aspect is to find a surgeon you are comfortable with. I recommend that you seek consultation with a qualified board-certified plastic surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Richard G. Reish, MD
New York Plastic Surgeon
5.0 out of 5 stars 126 reviews


You could, but you would not be happy and the result might not be as good as if you were asleep. I do the surgery usually under sedation which makes the patients happy, because they feel nothing. Putting in the local is painful without sedation and the anesthesia does add to the cost, but it is worth it. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.2 out of 5 stars 12 reviews

Local only Rhinoplasty

a full tip rhinoplasty under local is difficult and you would probably sacrifice result by not having anesthesia. An alar base reduction is very possible under local, as is an open columella plasty. So the answer is yes and no. Costs will vary based on overall plan. 

Richard W. Westreich, MD
Manhattan Facial Plastic Surgeon
5.0 out of 5 stars 51 reviews

Tip rhino under local?

While it can be done with local, sedation or general is more comfortable.  If you go under straight local and are uncomfortable during the procedure, how would you like your surgeon to proceed.  I am sure he would not want you to be uncomfortable during the procedure.  I have a fully accredited facility and use board certified anesthesiologists in my office. Good luck.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 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.