A revision rhinoplasty and septoplasty is more difficult than a primary rhinoplasty and septoplasty, therefore more details, and a full set of photographs are required to make a decision what can and cannot be accomplished with the procedure. In our practice, we perform all rhinoplasty surgeries under general anesthesia in a licensed and certified outpatient surgery center. General anesthesia is performed by a board-certified physician anesthesiologist for patient safety and comfort. In our practice, we do not recommend performing a rhinoplasty procedure under local anesthesia or twilight sedation, due to the fact that there's an uncontrolled airway, bleeding going down the back of the throat/lungs, and patients will have conscious awareness of the nasal bones being broken which is extremely painful. It's also best to get your anxiety under control to be able to undergo a secondary rhinoplasty and septoplasty procedure
I will use only local anesthesia for very limited rhinoplasty procedures. Both twilight and inhalation anesthesia are used for most rhinoplasty surgery depending on what will be done. Details are necessary to to make recommendations for you.