I have several questions about your service. Can I choose whether to have local or general anesthesia for a nose job? What determines whether it will be a closed or open rhinoplasty? How do you determine which is used?
I would recommend not having local anesthesia for a rhinoplasty. I do perform rhinoplasty under IV (twilight) and general anesthesia, but, I feel that the procedure is too traumatic to be performed under local anesthesia. In terms of which approach I use, open rhinoplasty versus closed rhinoplasty, that is a more difficult question. I tend to perform open rhinoplasty in revision rhinoplasty cases, reconstructive rhinoplasty cases, and in difficult nasal tip surgeries. I use the closed rhinoplasty approach when there is moderate tip work to perform, or hump reduction with nasal bridge narrowing. During your consultation we will discuss whether you are a candidate for an open or closed rhinoplasty. The bottom line is that I will use the rhinoplasty approach that will give you the best surgical outcome as I have found that the difference in healing between a closed and open rhinoplasty is negligible and the real determinant of the length of healing is the complexity of the rhinoplasty.
Posted by Dr. Philip Schoenfeld