Is iv sedation safer than General anesthesia, and should I see an allergist before I go under? (Photos)

I want to reduce as much risks as possible with my rhinoplasty, I'm 22, I don't smoke or drink and I exercise 4 days a week because I'm a personal trainer, but I've read stories of young healthy people dying under anesthesia

Doctor Answers 7


As a person who investigates plastic surgery misconduct, statewide,  for the NYS Department of Health, Office of Professional Medical Conduct, I have investigated a number of unexpected deaths, over my 14 year tenure.

Just about every fatal anesthesia outcome, in a plastic surgery case, was a case of sedation with failure to properly monitor ventilation and the end tidal CO2.

With an endotracheal tube in place and proper monitoring and proper emergency medications, at the ready, General anesthesia is what I consider safer, in nearly all instances. You do need a properly qualified and experienced anesthesiologist.

The endotracheal tube or laryngeal mask, also prevents blood from being aspirated during rhinoplasty.

Great Neck Plastic Surgeon
5.0 out of 5 stars 6 reviews


Safety depends on the competence of the doctors involved. I have used the same MD anesthesiologist for over 20 years. We have done both general and sedation on thousands of patients safely. We pick the right anesthesia for the individual patient. With competent careing doctor both forms of anesthesia are safe. 

William B. Rosenblatt, MD
New York Plastic Surgeon
4.1 out of 5 stars 11 reviews

IV sedation vs GA

my belief is that most anesthesiologists would say that in a young healthy person like you, general anesthesia would be at least as safe if not safer than heavy sedation. try not to worry and do discuss your reservations with your surgeon.

Bruce K. Barach, MD
Schenectady Plastic Surgeon
4.6 out of 5 stars 13 reviews

Anesthesia and surgery

If you are young healthy individual, you should be ok.  Anesthesia is very safe and the risk is low especially if you are young and healthy.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

General anesthesia is safer

Trying to perform IV sedation for rhinoplasty is very difficult, since you will have conscious awareness of your nasal bones being broken which can be very traumatic and painful. In addition there is no controlled airway which can be very problematic especially when there's blood on down the back of the throat from the rhinoplasty procedure. It's best to undergo a rhinoplasty procedure under general anesthesia by a board-certified physician anesthesiologist for patient safety and comfort.

William Portuese, MD
Seattle Facial Plastic Surgeon
4.7 out of 5 stars 126 reviews

Is iv sedation safer than General anesthesia, and should I see an allergist before I go under?

Rhinoplasty operation is performed under general anesthesia and it takes to perform the procedure nearly 1 hour. You will be advised not to eat 6 hours before the surgery and that is all! You will get a physical examination by your surgeon and anesthetist. After the examination; we will prepare you for the surgery. You will receive a sedation in order to reduce the preoperative anxiety and fell yourself more comfortable.


Hello and thank you for your question. Based on your photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can accomplish this by trimming, suturing, and reshaping the cartilage in your lower nose. Cartilage grafts may also be used to help improve tip refinement. You may also benefit from decreasing the width of your alar base.  Either type of anesthesia is very safe in the right setting.  The most important aspect is to make sure there is a board-certified MD anesthesiologist in the room for your entire case administering anesthesia.   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 67 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.