Risks of epinephrine injections to the nose during rhinoplasty

Question

I’m considering rhinoplasty, however I’m concerned about potential risks associated with epinefrine injections. How dangerous are epinephrine injections to the nose during rhinoplasty? Is there a risk of injecting epinephrine to the blood vessel particularly one supplying the eye? What would be consequences to the vision considering epinephrine is a vasoconstrictor?

Richard G. Reish, MD, FACS · Answer

Hello and thank you for your question. Lidocaine with epinephrine is a critical step in performing in Rhinoplasty as it is injected before the surgery begins in order to decrease bleeding during the surgery so your surgeon can visualize the structures better. I have personally performed thousands of rhinoplasties using epinephrine and never once had an issue with vision in the way you describe. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

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

Ronald J. Edelson, MD · Answer

Although I have heard of fat or other  fillers injected causing blindness I have never heard of epinephrine injected around the eye causing it

Eric M. Joseph, MD · Answer

Many times, while we are injecting the nose with lidocaine and epinephrine, our patients will experience a temporary elevation of their heart rates. If somebody has a personal history of heart disease or hypertension, medical clearance may be indicated before pursuing rhinoplasty surgery with general anesthesia. I hope this helps. Sincerely, Dr Joseph

Zoran Potparic, MD · Answer

Epinephrine has been part of local anesthetic compound for over 70-80 years. Its function is to provide vasoconstriction and increase visibility in surgical field. It is so diluted and given in such a limited quantity that it is considered absolutely safe when given in rhinoplasty. Hope this helps. Good luck.

Jeffrey H. Spiegel, MD · Answer

Injecting epinephrine (with anesthetic lidocaine) is a standard part of rhinoplasty.  There is very little concern for a problem. This is standard.  However, if you are worried about these details of surgery, perhaps surgery is not for you.  You will need to trust that your surgeon is safe and uses appropriate measures. This is done by reviewing her/his qualifications.

Risks of epinephrine injections to the nose during rhinoplasty

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Risks of epinephrine injections to the nose during rhinoplasty

Answers (10)

Answer: Risks of epinephrine as a part of local anesthetic

Answer: Risks of epinephrine as a part of local anesthetic

Answer: Routine

Answer: Routine

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Everything you need to know about Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.