Basic Surgical Techniques

Abstract

Except for bony and septal work, almost all rhinoplasty can be performed under local anesthesia and/or intravenous sedation. Lidocaine containing 1:100,000 epinephrine is injected around the foramen of the infraorbital nerve and infratrochlear nerve (1 mL each) (Fig. 3.1). The remaining agent is then injected into the dorsum and tip area for both local anesthesia and homeostasis. For anesthesia of the septal cartilage, lidocaine containing 1:100,000 epinephrine is injected into the caudal part of the muco-perichondrium.

When you approach bone and septum, general anesthesia with intubation (or laryngeal mask) is recommended.