Is Tip Rhinoplasty Painful? Local Anesthesia

I love my nose shape but I don't like my profile. It's just a little bit long and when I am talking or laughing the tip bends down. I am considering to do the surgery with local anesthesia. Will it be painful? I will need a little shaving of a bone too. I want to know if I will experience any pain? thanks

Doctor Answers 11

Pain with Rhinoplasty

Although rhinoplasty can be done with only local anesthesia, I usually recommend the patient have at least IV sedation. The discomfort of injecting local anesthesia and the sound of repositioning the nasal bones can make patients anxious. Minimal anesthetic techniques with sedation are very safe today. You are concerned just thinking about it. Take a little medicine and have a pleasant experience.

Beverly Hills Facial Plastic Surgeon
4.9 out of 5 stars 38 reviews

Nose a bit long and local anesthesia

Performing a rhinoplasty with local anesthetic is possible, but I would recommend additional IV sedation or twilight sleep. The pain after a rhinoplasty is minimal with a tip adjustment.

I like the patient to have a natural result. Even though you have minor concerns such as a bit long nose and depression of the tip, your plastic surgeon needs to look at facial balance. The size of the nose in relation to the width of the face and position of the chin. On the profile, the chin position is very important if the nose is a bit long and the chin is slightly retruded.

So you may need adjustment of the depressor muscles of the tip, shaving of the bone and cartilage, and evaluation of the chin position. Pain after a rhinoplasty is individual to each patient.

Andrew Turk, MD
Naples Plastic Surgeon
4.8 out of 5 stars 31 reviews

Rhinoplasty under local anesthesia


Although rhinoplasty may be done under an IV sedation, I prefer to use general anesthesia. It is the best option for the patient and they will be more comfortable. In general, pain after surgery is minimal. Most people take Tylenol after surgery. Thank you, and best of luck to you.

Dr. Nassif

Paul S. Nassif, MD
Beverly Hills Facial Plastic Surgeon
4.7 out of 5 stars 47 reviews

A rhinoplasty can just involve re-shaping the tip of the nose

Hi Gvaa - If you're getting the procedure done under local anesthesia I would expect that not a lot of work needs to be done. So, your pain should be well controlled with oral pain medicine. However, if major work is going to be done including bone work, you may want to consider sedation or general anesthesia. Talk with your surgeon to see what exactly is involved and do what makes you feel the most comfortable. Good luck!

Jeffrey E. Schreiber, MD, FACS
Baltimore Plastic Surgeon
5.0 out of 5 stars 201 reviews

Tip Rhinoplasty is not painful

99% NO! But everyone is an individual so rarely you might be one of those patients that has pain. But it occurs very seldom. Best of Luck.

Darryl J. Blinski, MD
Miami Plastic Surgeon
4.6 out of 5 stars 173 reviews

Rhinoplasty under local anesthesia

The concerns you have with your nose will likely require more than just tip work. The dipping of the nose and the fact that you do not like the length will require alteration of cartilage and likely the depressor septi muscles of the nose. Surgery can be difficult and I would strongly suggest IV sedation at a minimum, for this particular rhinoplasty surgery. The money you will spend on anesthesia could be the best money you have spent in years.

Philip S. Schoenfeld, MD, FACS
Chevy Chase Facial Plastic Surgeon
4.7 out of 5 stars 30 reviews

There is minimal pain after Rhinoplasty Surgery.

Your pain after Rhinoplasty Surgery will be minimal. Most of my patients consume only a few narcotic pain reliever tablets, and some require none. Pain after Rhinoplasty is not dependent on the extent of the procedure. Even surgeries with septal, tip, and bony work do not cause a lot of pain. I almost never use nasal packing since it is usually unnecessary, and is a cause of post-surgical discomfort.

I favor general anesthetic for Rhinoplasty Surgery. There are many prominent surgeons that use local anesthetic along with intra-venous sedation. I would not advise Rhinoplasty Surgery with only local anesthetic.

I hope this is helpful for you.

Eric M. Joseph, MD
West Orange Facial Plastic Surgeon
4.9 out of 5 stars 418 reviews

Most rhinoplasties today are done under light general anesthesia.

You are describing a full rhinoplasty. These are usually done under light general anesthesia. The patient is more comfortable with less anxiety. The feel nothing. With local anesthesia patients will feel some pain from the injections and have more anxiety. Having said that, I personally tailor this to the patient and do them both ways.

Toby Mayer, MD
Beverly Hills Facial Plastic Surgeon
4.8 out of 5 stars 34 reviews

Tip-plasty under Local IV Sedation


You can do most anything under local anesthesia. However, I would recommend a little sedation to take the edge off of the procedure. If you have a little Versed prior to injecting the local anesthesia, you will much more comfortable during the injection and the procedure.



Oleh Slupchynskyj, MD, FACS
New York Facial Plastic Surgeon
4.8 out of 5 stars 272 reviews

Nose Job under Local Anesthesia

I agree with Dr. Placik. When you begin to discuss your profile being long and the nasal tip being pulled down, you are wishing nose operations which are More than a Tip Rhinoplasty.

To SHORTEN the nose, the front (CAUDAL) end of the septum would need to be shortened. The shave down the bone and lower the profile, would require bone rasping, reduction of the cartilaginous hump and in-fracturing of the nasal bones. To stop the nose tip from being pulled down with smiling (with a probable transverse upper lip crease), the two tiny muscles, Depressor Septi nasii muscles need to be separated from the septum and removed,

All this cannot be done under strict local anesthesia. Every surgeon has his preference , either IV sedation with local infiltration or general anesthesia. Ask your surgeon what he prefers.

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
4.9 out of 5 stars 108 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.