Rhinoplasty is typically performed under general anesthesia. There are a few reasons for this. The nose is a quite sensitive area and despite utilizing lots of local anesthesia during rhinoplasty, injection of this initially into the nose is uncomfortable if you are awake or even sedated. Not to mention, it is impossible to completely anesthetize the entire nose with local anesthesia. In rhinoplasty, frequently, controlled osteotomies are performed to narrow the nasal bones and most people do not want to be awake when someone is using a mallet and osteotome (chisel like instrument) on the bones of their face.
Lastly, during rhinoplasty, there is bleeding from the nose which will drip into the throat. If you are sedated, that blood could enter the airway and you could aspirate leading to airway complications. With general anesthesia, there is a breathing tube in the airway and guaze in the back of the throat to prevent blood from entering the airway or the stomach (which can cause nausea).
For these reasons, most rhinoplasty is done under general anesthesia.
Dr. Funk is a top rhinoplasty surgeon in Houston, Texas.