Possible to Have Rhinoplasty While Patient is Awake?

Question

The thing holding me back is apprehension about anesthesia. I'm terrified to be intubated, and twilight carries its own risks. I read that certain (but few) docs will use local anestesia w/ valium. Are there any NY/NJ area docs that are comfortable with this? I have decent pain tolerance... Thanks.

Toby Mayer, MD · Answer

All of the senior surgeons use to them mainly awake.  Find one in your area who does them that way. I still do patients this way who don't want to be intubated.

William Portuese, MD · Answer

It is not possible to have a rhinoplasty done while you are awake. Conscious awareness of surgery is something patients simply do not wish to have. Anesthesia today is extremely safe when administered by a board certified physician anesthesiologist in a Medicare certified ambulatory surgery center. Typically patients are not intubated, however, they do get a laryngeal mask airway that prevents any blood from going down the back of the throat. The laryngeal mask airway prevents the aspiration of blood into the lungs and prevents pneumonia.

Darryl J. Blinski, MD · Answer

Yes, it is possible but in today's environment safety is the paramount issue. Totally awake is near impossible, but with local and anesthesiologist administered sedation via IV (like valium IV NOT orally), I think it would be acceptable. Remember do not tell your surgeon of choice how to do the surgery. If that surgeon you have chosen feels better you are sedated, then either follow those plans or keep searching.

	Good Luck from MIAMI Dr. B

Richard W. Fleming, MD (retired) · Answer

Rhinoplasty can be done with the patient awake, but why? I was trained to do this surgery without general anesthesia, but with the physicians and techniques available today, I encourage patients to consider all alterrnatives. Depending on the patient and what needs to be done, I will do the surgery with only local anesthesia..

Oleh Slupchynskyj, MD, FACS (retired) · Answer

Hi,

	Yes it is possible to perform a rhinoplasty with oral sedation. You have to be the right patient for the procedure and be willing to tolerate being somewhat aware of cutting and osteotomy ( breaking of the bone).

	Best,

	Dr.S.

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