Rhinoplasty is a complex operation to reshape the nose and improve breathing if necessary. The nose is a very sensitive area of the face with lots of pain receptors. In addition, the nose is very vascular and can bleed quite a bit. When you are laying down, that blood can run into your throat or airway and can lead to aspiration.
It is for these reasons that I recommend rhinoplasty NOT be done with local anesthesia alone, but with general anesthesia. General anesthesia does require a breathing tube to protect the airway as discussed. Local anesthesia will also be used and is injected after you have been put to sleep to help with pain control and minimize bleeding.
Small minor revisions to the nose can be performed sparingly under local anesthesia.
Dr. Funk is a rhinoplasty expert in Houston, TX.