Addressing your questions regarding what are the risks of local anesthesia. Some people are allergic to local anesthesia and this is quite rare. Overall it is considered quite safe. Epinephrine has to be used during rhinoplasty to minimize bleeding so the surgeon can visualize what he is doing and sometimes the epinephrine reaction to the patient is overwhelming and they become quite anxious and it becomes difficult to do the surgery unless they have taken something like Valium orally. In my experience, in the vast majority of cases patients do quite well with oral sedation such as Valium and or versed using local anesthesia with epinephrine. Patient selection is crucial and the surgeon and the patient must be on the same page as far as the type of experience they are willing to undergo during surgery. If a patient is really frightened then either intravenous sedation or general anesthesia is preferred. In some cases patients have such a dramatic reaction to epinephrine that general anesthesia and or intravenous sedation is required to minimize the effects of epinephrine.

Sometimes the gases in general anesthesia cause more bleeding therefore. Intravenous sedation is the preferred method or a procedure called total intravenous general anesthesia is preferred.

I think one of the most important issues is your surgeon feeling comfortable during the procedure and you feeling comfortable with your surgeon.

30% of the general population has a fear of general anesthesia. In reality, studies have shown for healthy patients undergoing a planned operation, general anesthesia is about as dangerous as pregnancy in a healthy woman.

When considering all ages and all illnesses and a group of 100,000 persons, the chance of dying is less than 13 deaths per 100,000 persons.

Remember, the majority of these deaths occur in patients over 70 years of age with multiple illnesses. Local anesthesia does have its risks however the general consensus is it is safer than general anesthesia although finding exact statistics on this matter is difficult.

The anesthesia options range from local, to iv sedation to general anesthesia. The choice is larger determined by the pathology identified, the work required, the associated medical condition's the patient may have, and surgeon preferance. My advice would be to chose a surgeon who makes you feel comforable, has before and after pictures, high patient satiification scores and Board Certified in Plastic Surgery or Facial Plastic Surgery. Not by the type of anesthesia they suggest.

Good luck!

The choice of local or general anesthesia for rhinoplasty is determined by a dialogue between the doctor and patient. I do 90 % of nasal surgeries under local so I am biased that way. All well trained rhinoplasty surgeons are able to do good local nerve blocks. If you have trust in your surgeon, this is the safest way to do surgery.

Till about 15 or so years ago most people did rhinoplasties under local anesthesia. Many surgeons can do a very good job under local anaesthesia. It is and art to make the patient feel comfortable while performing all that one plans to perform to achieve the desired result. For the last 15 years I have been performing all my rhinoplasty surgeries except for some minor work, under general anesthesia. I can do more and have the patient safe and very comfortable also.

So please don't worry and ask the surgeons all the questions you need ask days ahead of the surgery. On the day of surgery you deserve to be peaceful, comfortable and confident. It will help your surgeon to do the best for you. .

I personally prefer to do all my rhinoplasties, closed and open, under IV sedation administered by a CRNA or an Anesthesiologist, supplemented with local aneshesia. This outpatient procedure should be performed in a hospital or an accredited surgery facility. This will ensure thorough monitoring during the procedure.

The surgeon you select must be certified by the American Board of Plastic Surgery specifically and have a great deal of experience with Rhinoplasty especially the open kind.

I agree with what many of the other rhinoplasty surgeons have said in that the type of anesthesia used is a matter of surgeon and patient preference. In my busy rhinoplasty practice, I ONLY offer general anesthesia except for minor skin/tip revisions. Unfortunately, there is a prevailing misconception that general anesthesia is somehow unsafe. I can't think of anything further from the truth in properly selected patients with a known qualified anesthesiologist. Presumably, anyone healthy enough to consider elective rhinoplasty should be at exceptionally low risk for general anesthesia. My prerogative is that the surgery is meticulous and precise. Thus, in my hands, rhinoplasty is much better executed when the patient is unconscious, completely comfortable and not anxious. In addition, I prefer to have the throat packed so as not to allow any blood form the nasal cavity to be swallowed or aspirated. When rhinoplasty is done under local anesthesia or local with sedation, the surgeon must be careful to closely monitor the amounts of anesthetic injected as excessive amounts can cause cardiopulmonary and neurologic issues. As with most things surgical, experience trumps most all else.

I prefer to perform rhinoplasty under general anesthesia. I find this surgery to be time consuming and potentially painful.

However, every surgeon exercises techniques with which they have had the most success.

Facial plastic surgery is often performed under oral or IV sedation. I have had colleagues perform various surgeries in this manner. Additionally, facelift surgery is often performed in this manner.

However, rhinoplasty sometimes requires osteotomies, which are broken bones. This can provoke anxiety. There are benefits and risks to every surgical approach. Thus it is important to disccuss these concerns with your doctor.

Good Luck!!

anesthesia choice should be in any circumstance meet 2 criteria

1. make sure the patient is comfortable with that level of anesthesia in order to make sure the surgeon and the patient are comfortable during the procedure.

2. use the least amount of anesthesia possible. ie dont put each patient under general anesthesia just so the surgeon doesnt have to deal with it. now i know some surgeons who do this and im not saying its wrong for them to do it this way because it makes them most comfortable for the patient to be completely asleep but the patient should be given options.

Rhinoplasty varies in complexity from patient to patient. However, in my professional opinion, the safest way to perform an open rhinoplasty would be under general anesthesia. In my experience, this has also always been the most comfortable option for the patient.