Anesthesia and least invasive treatment for bulbous tip (Photo)

Since somebody's nose is part of their Airway, invariably, there is bleeding from the nose into the airway. Having general anesthesia delivered through an endotracheal tube may prevent blood and secretions from entering the airway during rhinoplasty surgery. Additionally, I do not think it is possible to get somebody completely comfortable for rhinoplasty surgery with simply local anesthetic. Thank you for your question! Sincerely, Dr Joseph

I would recommend at minimum IV sedation. Local only would be difficult to keep you comfortable mostly due to the harvesting of cartilage from the septum.

Hello! Thank you for your question.
As far as I can understand from your question.
General anesthesia is an extremely safe method, it is not correct to perform a rhinoplasty operation with local anesthesia, general anesthesia will be a very correct method both for the surgeon's vision and safety and for the psychology and safety of the patient.
It would be better face to face consultation.
Best Regards!

Thank you for your photographs. The rate of mortality or complications with generally anesthesia for rhinoplasty is extremely low, approaching zero. General anesthesia also gives you an excellent experience as you have no memory of the procedure. Locally anesthesia could potentially have issues with fluids getting into your airway, requiring uncomfortable suctioning. This is especially true if nasal septal cartilage grafts need to be harvested from your septum for nasal tip support. All surgeons want their patients to have a good experience and be happy with their results. I believe general anesthesia for your rhinoplasty would be the smartest way forward for you. Have a detailed consultation with your plastic surgeon. Best wishes.

Tip plasty can be done under local anesthesia only. The technique can be open or closed. Most patients can handle it well. The important thing is to find a surgeon who is used to doing these under local anesthesia.
Regards
Dr. J

Hello and thank you for your question. Based on your photographs, you are a great candidate for Rhinoplasty. However, your nose appears much more complicated than you likely think. You should not do this under local anesthesia as you will likely end up needing a Revision that setting. You should definitely do under general anesthesia with a board certified anesthesiologist managing your anesthesia, which is a very safe setting for this surgery. With good surgical technique, you could have an outstanding result. 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

Hello,
Thanks for your question.
If you are only looking to change your nasal tip size and shape, then I routinely perform tip rhinoplasty using local anesthesia and have for almost 20 years. It is easily tolerated. Patients experience minimal bleeding. Recovery is quicker and pain control is easier.
If you need septoplasty surgery and/or need the hump removed then I prefer to use general anesthesia.
I hope this answers your question.
Regards,
Dr. Shah

Hello,
Rhinoplasty is one of the most commonly performed procedures and it’s not uncommon for a patient to inquire about local anesthetic options.
While nearly 20 ago the use of local anesthesia was common it is typically performed under general anesthesia now. Advancements in surgical techniques and a better understanding of patient safety have changed the landscape since then. While both general and local anesthesia carry risks, modern advancements have made general anesthesia significantly safer than it was two decades ago.
The idea of performing rhinoplasty under local anesthesia raises several concerns, not just for the patient but for the surgeon as well.
For the patient, being awake during rhinoplasty is a highly unsettling experience. The sensations of pressure, movement, and manipulation of the nasal structures (not to mention noises and smells) can be quite disturbing. Even if pain is not present, the feeling of the procedure happening in real-time can cause extreme anxiety and stress.
This isn't an approach suitable for individuals sensitive to such stimuli, making the experience difficult for the majority of patients. With increased stress, comes increased heart rate which contributes to swelling and the long-term healing of the result.
The patient couldn’t get what they want and the surgeon couldn’t give the final result they truly want to give.
Rhinoplasty involves precise and controlled adjustments to the bone and cartilage. The slightest movement on the patients end could impede the surgeons ability to perform optimally.
One of the lesser-discussed but significant risks associated with local anesthesia is the potential for allergic reactions. Allergic reactions to anesthetics, while rare, are unpredictable. Just because a patient hasn't experienced an allergic reaction during a previous procedure, doesn't mean they are in the clear. An allergic reaction could occur during the second, third, or even fifth exposure to a local anesthetic.
Without an anesthesiologist present or a hospital-grade setup, dealing with these reactions can be life-threatening. Severe allergic reactions to anesthetics or the adrenaline commonly used alongside them can cause anaphylaxis, a condition that requires immediate and intensive medical intervention.
In a clinic setting where local anesthesia is typically administered, there may not be the necessary equipment, medications, or staff to manage such an emergency. This risk alone makes local anesthesia a far less appealing option for rhinoplasty, as patient safety must always come first.
General anesthesia provides the best environment for both the surgeon and the patient, ensuring that the procedure can be performed smoothly and without unnecessary risks. For this reason, most skilled surgeons choose to perform rhinoplasty with general anesthesia, allowing them to deliver the high-quality outcomes. Ultimately, there is no need to take on the risks associated with performing rhinoplasty under local anesthesia.

I suggest focusing on finding the right provider, then let them schedule surgery the way they feel is most appropriate.
There are a lot of consideration why we use different forms of anesthesia.
It’s not only a matter of comfort for the patient.
Local anesthesia an anesthesiologist is probably no safer than having anesthesia with an anesthesiologist.
There’s also something to be said about patients laying still while surgeons do very delicate surgery, which doesn’t always happen when patients are fully awake.
Rhinoplasty surgery is fairly complex and finding someone who can deliver consistent quality outcomes is going to be hard enough.
To put anesthesia demand on top of this is probably just going to limit your provider selection, which is not in your benefit.
I recommend you let the driver do the driving.
Resist the temptation of making your own assessment or prescribing your own treatment plan.
Best,
Mats Hagstrom MD