I won't lie, if you're going to be sedated rather than put under with general anesthesia, the nastiest part of the surgery is when (and if) you're getting your bridge filed down. First, they rasp it with what feels like a giant file, and then they take a small hammer and chisel to it. It felt like an immense amount of pressure bearing down on my nose, and even though I was completely numbed, it was the closest thing to actual pain I felt throughout. I remember reaching out for the nurse's hand at this point and grasping it tightly. Luckily, my surgeon is very skilled and this part passed quickly. I remember him asking the nurse for a cortisone injection which he put in my tip to reduce initial swelling as I have quite thick skin. A couple of tiny pricks, no pain. At this point, we were finished, and all that was left was a few sutures and the application of surgical tape and the cast.
This part was quite bothersome because he began pressing down hard and generally touching and "molding" my tender nose. I understand this is necessary to stamp out any swelling, to evaluate the result and to make sure my nose was the proper shape before applying the cast.
Soon after, I was being helped up and led back to my bed. It felt like barely a half hour had passed but it had been an hour and fifteen minutes. They tucked me in and asked me to evaluate my pain scale 1 to 10. I have quite a high tolerance for pain, but I gave them a solid 7 and asked them for some pain meds which they gave me. I wasn't in unbearable pain but there was a lot of pressure and I anticipated it would get worse. About 20 minutes later the pain meds kicked in, and even though I was itching to go home they made me lie down another 20 minutes before letting my mom come and get me. I remember feeling really hot and fanning myself but that subsided by the time I went home.
I slept away the majority of the first day (got home around 2 pm) and the whole night, only waking up to eat some soup and crackers so I could take my antibiotic. I also have an RX for prednisone for swelling but I could only start those the next day since I was given a cortisone injection during the procedure.
I credit this to my surgeon's technique, but also how diligent I was in preparing pre-op. I followed all instructions given to me to the letter (no smoking, alcohol, aspirin/ibuprofen, ate healthy, lots of sleep, etc). I also took 1000 mg of vitamin C in the week leading up to surgery and am continuing to do so throughout recovery (vit c supposedly aids in wound healing but clear this with your doc first). Post op I am drinking plenty of water, icing my eyes/cheeks, resting, sleeping upright, taking my meds on time, etc. Even through the swelling in my nose and the cast I have on, I can already see the beautiful shape my surgeon gave me and I know that he and I were on the exact same page regarding what I wanted.
I also know a big part of why I'm feeling so great is that I did not go under general anesthesia. I really wanted to avoid it if possible and was thrilled when I found out that my surgeon avoids it altogether in his practice. Again, it's not for everyone. It you are extremely squeamish/anxious with needles or medical procedures, you might be better off being put under. At least this way you pass out and wake up what feels like a minute later. There is always a tradeoff though: usually nausea and feeling really out of it accompany general anesthesia. It all comes down to what you are comfortable with.
You should discuss all your options with your surgeon, and speaking of surgeons, make sure you don't settle! Don't look for a bargain because you're just going to pay for it later in quality of recovery/possible revisions.
Overall pain rating: 7/10 the hour immediately following surgery, 0/10 from that point on (I'm not kidding!).
Ease of recovery: 8/10. I docked points because keeping my nose clean and my cast dry is annoying but certainly doable. With rhinoplasty the key word is "patience" and allowing the swelling to go down over time and reveal your final result.
Worth it rating: 10/10. I would do it again. And again.
Don't be shy to message me any question you guys might have, I am a little bored here on the couch while recovering!