Rhinoplasty Under Local Anesthesia?

I regularly perform rhinoplasty under local anesthesia. To help patients we usually will give a mild sedative in pill form. The surgery takes 1 to 1 and a 1/2 hours. There is usually less bruising and no nausea with this technique. I suggest it to patients who think they can do it.

Rhinoplasty can dramatically impact the appearance of the nose.  When this procedure is performed with local anesthesia alone the response varies from patient to patient.  Unfortunately, we frequently see patients who have significant pain and discomfort during the injection process when local anesthesia is used alone.
            For this reason, many surgeons supplement local anesthesia with I.V. sedation or general anesthesia to minimize pain and discomfort during the procedure.  When utilizing this approach the procedure is more comfortable and there’s less break through pain for the patient.

            It’s important to realize that all surgical procedures and anesthesia techniques have risks.  This is true whether local anesthesia, I.V. sedation or general anesthesia are utilized.

            The vast majority of rhinoplasty surgeons prefer general anesthesia when performing this procedure.  They realize that when this approach is utilized patients seem to have a better overall experience.  Exceptions do exist, and for this reason it’s important to thoroughly discuss anesthesia with your surgeon before proceeding.

            If you’re considering rhinoplasty surgery it’s important to consult a board certified plastic surgeon.  This surgeon should be able to formulate a treatment plan that addresses your anatomic findings and achieves your aesthetic goals. 

It appears, based on your stated goals and attached images, that you may require either a general anesthetic (especially if osteotomies are to be considered), or twilight anesthesia- which is basically intravenous sedation.  I recommend to my patients considering this procedure typically a general anesthesia approach. This is primarily for patient comfort and stability.  As well as, better predictability for the surgeon in the performance of the procedure.Best wishes with your upcoming plans.Sergio Pasquale Maggi, MD, FACSAustin Plastic Surgery Center

Rhinoplasty can be performed under local anesthesia without complication. The real issue is whether this is the safest choice for anesthesia and whether your surgeon is compromising your result by minimizing the type of anesthesia. I generally prefer to perform the surgery under general anesthesia as I prefer to meticulously sculpt the nose during rhinoplasty.

Local anesthesia may initially sound like a good idea for Rhinoplasty, but it's not necessarily the safest, nor the easiest circumstance for you or for the surgeon. As other posters have noted, anesthetic techniques are very safe in healthy patients. I routinely use General Anesthesia for Rhinoplasty (usually with LMA).
As far as evaluating for your nose, I would recommend a consultation with a local Rhinoplasty surgeon; your picture is not adequate to give any meaningful advice. New York City has many qualified surgeons who match this description.