Is Rhinoplasty under IV sedation a painful procedure?

I have to agree with the first three posts on this subject: I prefer intubation with a heavier degree of sedation for Rhinoplasty.  Although IV sedation is usually preferable for elective facial cosmetic procedures, airway protection in the event of bleeding during Rhinoplasty is paramount.

I personally prefer to perform rhinoplasty using general anesthesia, however some physicians do prefer sedation for their surgeries. It is really a surgeon's preference and having a good anesthesiologist can give sedation that is just about equivalent to general anesthesia. The whole idea with sedation is that they should give you enough medication to make you comfortable (anesthesia) and also medication to make you forget what happened during surgery (amnesia).

There should be no pain under proper IV sedation, however, I would not advise rhinoplasty under IV sedation.  I like to protect the airway with general endotracheal intubation.  There is always the possibility of bleeding in a rhinoplasty, while it almost never happens, there are large vessels that can release a large amount of blood quickly before they are controlled.  this poses no safety risk if the airway is protected, but if it isnt it can lead to aspiration and a host of complications.  I am a big advocate of limiting depth of anaesthesia and using local for many surgeries, but I strongly recommend airway protection with rhinoplasty.   I hope this helps!All the best,Rina A. Maercks M.D.

I perform almost all rhinoplasties under general anesthesia to avoid pain and movement during this delicate surgery.Find a board certified plastic surgeon who performs hundreds
of rhinoplasties and rhinoplasty revisions each year. Then look at the
plastic surgeon's website before and after photo galleries to get a
sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

I prefer to perform rhinoplasty with general anesthesia for the same reasons mentioned most importantly airway protection.  With that said, I have seen many rhinoplasties done under IV sedation and local anesthesia and this can be done comfortably for patients depending on the depth of the anesthesia and the ability of the surgeon to numb your nose with local injections.