Can a tip rhinoplasty only be an in-office procedure? (Photo)

Question

Is it cheaper if a tip rhinoplasty surgery is performed in an in-office facility instead of an out-patient facility? And can a tip rhinoplasty be done under local anesthesia?

Evan Ransom, MD, FACS · Answer

In short, yes, a tip-only nose surgery can be done with local anesthesia only. However, this still requires a safe, sterile, operating room.  In addition, patients who select surgery with local anesthesia only must understand that a well-executed operation requires the patient to be still and cooperative. It takes a certain type of patient to sit through such a procedure without becoming anxious, etc. Best of luck moving forward!#San Francisco Rhinoplasty

Nima Shemirani, MD · Answer

Dear loserface (don't be too hard on yourself),I understand that rhinoplasties are not cheapAlthough price is a major factor, it should not be the deciding factor on who you choose for rhinoplastyThis will be a permanent change in your face and you want to make sure all the elements of your surgery are as ideal as possibleAll of my rhinoplasties are performed under IV sedation so that you can rest easy and I can concentrate on making you look your bestIn addition, you may need additional refinements in the bones, septum, etc that can be determined at a consultationThe short answer is "yes" you can do it under local, but the better answer is that you are better off with a little sedation and keeping the surgeon busy with making your nose look the best instead of pausing every 30 minutes to readjust you, making sure you are not moving etcBest,Nima Shemirani

Kenneth Hughes, MD · Answer

Tip rhinoplasty can be performed under local, but minimizing pain and patient movement during a delicate procedure is important as well.Kenneth Hughes, MDLos Angeles, CA

Toby Mayer, MD · Answer

Tip plasty for only bulbous tip can be done in the office OR. However, you will need the base of your nose narrowed as well since it is wide and will look wider after the tip is made narrower. See an experienced rhinoplasty surgeon and you will want this done under general or deep sedation with local. You will be more comfortable with general.

Vincent N. Zubowicz, MD · Answer

Pretty much any operation Can be performed under local anesthesia although most of the time this is not suitable. Injection of the nose is exquisitely painful but if the patient can put up with that discomfort the operation could be done with local only.

Robert Singer, MD · Answer

A tip rhinoplasty can be performed under local anesthesia in an office facility, but most surgeons would  feel that a local anesthesia and intravenous sedation or a general anesthesia will make the experience much more comfortable.No matter which type of anesthesia is used, the procedures should be performed in an ambulatory facility that is accredited by one of the national organizations like the American Association for Accreditation of Ambulatory Surgical Facilities (AAAASF) or in a licensed hospital. If sedation or general anesthesia is utilized, the anesthesia should be administered and monitored by an appropriately trained anesthesia provider. I would suggest you find a plastic surgeon certified by the American Board of Plastic Surgery and ideally a member of the American Society for Aesthetic Plastic Surgery (ASAPS) or otolaryngologist that you trust and are comfortable with. You should discuss your concerns with the plastic surgeon and have a consultation to see what is safe and makes the most sense for you.Robert Singer, MD  FACSLa Jolla, California

Kimberly Lee, MD · Answer

Depending on what you are looking to do to the nasal tip, it can potentially be done under local anesthesia in the office under sterile conditions.  Please consult with a board certified specialist who can assist you with achieving the results you seek.  3-dimensional computer imaging can also help you visualize what you may look like afterwards and help you communicate with your surgeon the results you desire.

William Portuese, MD · Answer

It's very difficult to get the entire tip of the nose numbed up with local anesthetic, and yet have the patient comfortable. In our practice, all rhinoplasty surgery is performed under general anesthesia for patient safety and comfort. It's also important to have a controlled airway in place in case there is any bleeding in the nose which can trickle down the back of the throat and into the trachea. All rhinoplasty surgery is performed in an outpatient ambulatory surgery Center setting, not a clinic.

Chase Lay, MD · Answer

rhinoplasty that does not involve altering the nasal bones cannot very often be performed under local anesthesia.  Roughly half of the rhinoplasties that I perform are performed in the surgical suite in my office completely under local anesthesia.  In this situation it is important to understand that IV sedation and other narcotics are not offered.  When narcotics are used to "relax the patient " you still want to do this in a certified surgical center with additional staff if not an anesthesiologist present.  That being said many rhinoplasty cases can be performed under local anesthesia safely and effectively.Best of luckChase Lay,MDDouble board-certified facial plastic surgeon

Michael Elam, MD (retired) · Answer

Dear Loserface, Yes, a tip rhinoplasty can be performed in an in-office facility. Make sure the in office facility is fully accredited and that you are having an anesthesiologist their for your procedure. The photographs are a bit blurry and no profile photographs was shown for evaluation. So with that said,  you may need a rhinoplasty with tip reduction. Most patients need some other modifications besides just their tip so I suggest that you see a rhinoplasty expert for consultation. Digital imaging will be helpful to show you the proposed results and the surgeon may discuss with you at that time the exact surgical plan. Do not base this procedure on what is cheapest! Your nose is the center of your face and helps bring all of your features together and the goal post surgery is to have a natural looking, functioning nose that pulls these features together in harmony. Best regards, Michael V. Elam, M.D.

Can a tip rhinoplasty only be an in-office procedure? (Photo)

Answers (14)

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