Can Rhinoplasty Be Done Under Local Anesthesia With Sedation?

Q: Dr. Eppley, I am interested in getting a rhinoplasty to straighten and reduce the hump on my nose. My questions concerns that I do not wish to go under general anesthesia and wish to be sedated and under local anesthesia instead. Please also let me know what you think in regards to whether I should also consider reducing the size of the nose overall or nostrils. 

A: Thank you for your inquiry. When it comes to anesthesia options for rhinoplasty surgery, that is highly influenced by the type of rhinoplasty being performed. If nasal osteotomies with hump reduction and/or internal nasal surgery is being done (septoplasty, turbinate reduction), local anesthesia with sedation is a poor and unsafe choice. These types of rhinoplasty induce bleeding down the nose and into the throat and risk aspiration and laryngospasm, two potentially deadly problems. A general anesthetic with an endotracheal tube is the only prudent way to have such a rhinoplasty. If no bone work is being done and no cartilages grafts are needed such as in a tip only rhinoplasty, then local anesthesia with sedation would be safe and tolerable.

I would need to see pictures of your nose (front and side views, non-smiling) to see what type of changes you desire/need by doing some computer imaging.

Dr. Barry Eppley

Indianapolis, Indiana