Rhinoplasty under local anesthesia? It seems like nobody is willing to perform a nose job without general anesthesia, but why?

Question

dear doctors i am looking for somebody who can perform rhinoplasty with local anesthesia, i dont know for what reason but all surgeons i met do rhinoplasties "ONLY UNDER GENERAL", but whats the logic/reason? if open heart surgery, all kind of organ transplants and even brain tumor surgeries nowadays are being performed under local anesthesia then why not nose jobs? i have had several nose jobs in the past but this last time i want to be awake during, (especially if it takes only 1-2 hours), thx

Alejandro Nogueira, MD · Answer

The examples you have used are all carried out under general anesthesia, as well as the rhinoplasties (unless they are minimal tip procedures and never in revisions).A complete primary rhinoplasty or any kind of revision rhinoplasty may end with your death, chronic brain damage or vegetative state if done under local, or otherwise be an incomplete procedure, technically limited and with guaranteed frustration.With that said, in my opinion 1-2 hours is too short time and does not match with a comprehensive or high end revision rhinoplasty procedure; a basic revision takes 4 hours as minimum (1 hours access and debridement, 1 hour harvesting grafts-closing donor sites-tailoring the grafts, 1 hour assembling the new structure and 1 hours accesory maneuvers and closure).

Toby Mayer, MD · Answer

The reason most doctors don't to do rhinoplasty under local anesthesia is patient anxiety and cooperation. I perform rhinoplasty under local anesthesia in patients who are cooperative and have no anxiety about being awake while they hear nasal bones being fractured.

Andrew L. Greensmith, MBChB, FRACS · Answer

Organ transplants, open heart surgery ,and others you mention are virtually never performed with the patient awake. Neurosurgery if a patient is required to move to test movements is the only occasion. In the 1960s and 1970srhinoplasty was sometimes performed with the patient semi awake or sedated but rhinoplasties were simpler and more primitive in what they could do then and often involved only 30 mins of time. Modern rhinoplasty is more complex, exactly and sophisticated and even more complex in your case if it is a revision. The best option is a full general and the safest for you and allows the surgeon to do their best job without you moving.

Rhinoplasty under local anesthesia? It seems like nobody is willing to perform a nose job without general anesthesia, but why?

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Rhinoplasty under local anesthesia? It seems like nobody is willing to perform a nose job without general anesthesia, but why?

Answers (3)

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Everything you need to know about Revision Rhinoplasty

Our mission is to create a world where every investment in modern beauty is Worth It.