“Will I be asleep?” is one of the first things people ask before a nose job. For most rhinoplasties the answer is yes, but not always, and the choice has trade-offs.

Key takeaways

  • Rhinoplasty is usually done under general anesthesia, according to the NHS and BAAPS; in a 2026 review of 43 studies, 72% used it.
  • The same review found complication rates were not significantly different between general, sedation and local anesthesia when each was suitably chosen. Nausea and vomiting were reported more often with general anesthesia (12%) than with sedation (7%) or local (4%).
  • Your surgeon and an anesthesiologist decide the type for you, based on your health, the operation and your preferences.
  • A tendency to nausea is worth mentioning to the team; persistent vomiting or being unable to keep fluids down after you go home needs a call to your clinic.

What is general anesthesia and how does it work?

The NHS describes general anesthetic as medicine that makes you unconscious so you do not feel pain, are not aware of what is happening and do not move. It is usually given by injection into a vein and you fall asleep within about a minute. An anesthetist stays with you throughout, monitors your heart rate, blood pressure and oxygen levels, and places a tube in your throat to help you breathe. You wake up in the operating room or a recovery room.

Common side effects include drowsiness, thirst, a sore throat from the tube, shivering and feeling or being sick. The NHS says these usually get better within minutes or hours, and that the effects of the anesthetic can last around 24 hours. Complications are rare but can include allergic reactions, breathing difficulties and a chest infection.

Is general anesthesia necessary for rhinoplasty?

It is the usual choice, not a requirement. The NHS says nose reshaping is usually carried out under general anesthetic, and BAAPS says the operation usually takes about two hours. A 2026 systematic review of 43 studies found general anesthesia was used most often (72%), with local anesthesia plus sedation favored in selected minor or secondary procedures. The review found that complication rates did not differ significantly between general anesthesia, sedation and local anesthesia, and concluded that all three can be used safely when chosen appropriately. The authors also noted there is no unified guideline.

Sedation is a real option for some noses. In a study of 45 patients under conscious sedation, average pain was 3.3 out of 10 and 93% said they would choose it again, including some who had bone cuts. That is a small study from one team, so it does not show that sedation suits everyone. The decision depends on how complex the surgery is, your health and anxiety, and what your surgeon and anesthesiologist recommend.

Anesthesia is not risk-free. BAAPS lists allergic reaction, chest infection, blood clots and, rarely, heart attack or stroke among the risks of anesthetic, and says you will be assessed beforehand. Our guide to preparing for nose surgery and the article on anesthesia factors in surgery explain what the pre-operative assessment covers. Guides on surgery with HIV and surgery during your period look at two specific questions people raise.

Why does nausea happen after anesthesia?

Feeling sick is among the listed effects of general anesthetic. The NHS says staff give medicines for pain or sickness in recovery, and that you may be given medicines before the anesthetic to help you relax, reduce stomach acid or stop you feeling sick. The review above found nausea and vomiting in about 12% of general anesthesia cases compared with 7% under sedation and 4% under local. A retrospective study of 202 rhinoplasty patients found less nausea and vomiting, and faster recovery, with intravenous-only anesthesia than with an inhaled gas, but it was a single-center review, so ask your anesthetist about their approach rather than assuming one method suits you.

Medication choices belong to your anesthetist and surgeon. Tell the team if you have had motion sickness or sickness after previous operations. After you go home, mention vomiting to your clinic: BAAPS notes that straining may increase the chance of bleeding after rhinoplasty. Our aftercare guide and article on nutrition after rhinoplasty cover eating once you are home.

When should you contact your clinic after anesthesia?

The NHS says to get urgent advice if you recently had a general anesthetic and are worried about side effects or they do not get better. In practice, contact your clinic if vomiting keeps going, you cannot keep fluids down, or you notice signs of dehydration, severe pain or fever. Someone responsible should collect you and stay with you for the first day or night, as the NHS and BAAPS both advise.

Questions to ask your surgeon and anesthesiologist

  • Which type of anesthesia do you recommend for my operation, and what are the alternatives?
  • Who will give the anesthesia, and will I meet them before the day?
  • Which of my health conditions, medicines or past reactions to anesthesia should I tell you about?
  • What is the plan for nausea and pain, and how likely am I to need it?
  • When can I leave, who must stay with me, and whom do I call if I feel unwell?

Sources

All pages were opened and checked on 10 October 2026.

  • NHS, General anaesthetic, last reviewed 29 November 2024.
  • NHS, Nose reshaping (rhinoplasty), last reviewed 22 September 2023.
  • British Association of Aesthetic Plastic Surgeons, Rhinoplasty patient information.
  • Barone M et al. Anesthesia Modalities and Nasal Packing in Rhinoplasty: A Systematic Review of Complications, Postoperative Management, and Safety Guidelines. Aesthetic Plastic Surgery, 2026;50(5):1769-1775. PubMed 41249522.
  • Kim JS, Heo SJ. Patient Discomfort After Rhinoplasty With and Without Osteotomy Under Conscious Sedation. Journal of Craniofacial Surgery, 2022;33(8):e788-e791. PubMed 35882239.
  • Sagalow ES et al. Recovery Benefit With Total Intravenous Anesthesia in Patients Receiving Rhinoplasty. Otolaryngology-Head and Neck Surgery, 2023;169(3):489-495. PubMed 36906818.
  • American Society of Plastic Surgeons, Rhinoplasty risks and safety (anesthesia risks listed among rhinoplasty risks).