Is it possible to correct the nasal tip under local numbing or the twilight anesthesia? What about full Rhinoplasty?

Dear BrownAsh,If you prefer some sort of anesthesia, twilight sedation is great for rhinoplastyYou need to visit a surgeon who works with a special kind of anesthesiologist who performs this type of anesthesiaI think you will want something to keep you relaxed and tip work is usually the most complicated part of the rhinoplastyBest regards,Nima Shemirani

In the past, most surgeons performed rhinoplasty under twilight sedation. Over the past decade, anesthesia and the drugs used have improved to the point where the recovery is no different following general or twilight anesthesia. Most patients prefer not "knowing" or "hearing" anything during surgery, then we elect general anesthesia. The drugs used are the same for general and twilight anesh3esia in an ambulatory setting. Only a "smidge" more is used for general. And in that case we use what is called an LMA. Laryngeal mask anesthesia. This mask protects the airway yet can deliver equal anesthesa to the old intubation inside the trachea.

I do almost all of my noses under sedation. We do not find there is a need for general anesthesia as the drugs and monitoring equipment have improved over the years. You take a nap, know and hear nothing and wake up easily and quickly, this surgery is pain free.

The nose has a significant amount of nerve endings and blood vessels in it, and it is quite sensitive and bleeds easily. For this reason, anytime we perform nasal surgery  we place patients under  a brief general anesthetic by a board-certified physician anesthesiologist for patient safety and comfort. Its important to control the airway to prevent  any blood draining down the back of the throat and into the lungs. Nasal surgery is performed as an outpatient surgical procedure in an  ambulatory surgery center, not in an office setting under local anesthesia. Packing is not required inside the nose.

In general, general anesthesia is not required for rhinoplasty. Re-doing your rhinoplasty is not so simple. So, doing a revision requires as much attention if not more to detail as the first rhinoplasty.  Therefore, I would not recommend local anesthetic only.  If nasal osteotomies are not necessary, then a light twilight anesthesia may be used. It all depends on what you mean by twilight anesthesia. Usually, I perform rhinoplasty with IV sedation administered by an anesthesiologist. The anesthesiologist would lighten or deepen the anesthesia depending on what is needed. If this is acceptable to you, then you should have no problems finding a plastic surgeon with a lot of experience in revision rhinoplasty doing it this way. Good luck. 

Hi,Rhinoplasty performed with sedation is, in my opinion, the preferred method.  The recovery is faster and there seems to be less swelling. However, the success of a sedation rhinoplasty depends on the skill of the person providing the sedation. Not all anaesthesia providers are comfortable with this method.Best,Dr.S.

I'm sorry you had anesthesia problems following your previous rhinoplasty but this is very unusual, almost rare. Tip work can be done with just local anesthesia; use at least "twilight" sleep for the work on your bridge.