News & Blog - Clinic for Nose Surgery & Rhinoplasty

by Dr. Stephan Bessler

In our clinic I perform nose surgery in general anesthesia and in local anesthesia. General anesthesia means, that you sleep during your rhinoplasty. Nose surgery in local insensitivity – also known as local anesthesia – means, that you are awake and able to talk to me. With thin cannulas I make your nose pain free, which means, that you feel something, but you have no pain.

You can eat before the operation and if you need to use the restroom, we can interrupt the rhinoplasty for some minutes. Usually, under local anesthesia, the patients don’t need tranquilizers.

The advantages of local anesthesia are:

• That you don’t need general anesthesia (for example if you are afraid of it)
• The costs of your nose surgery are around a third lower
• You have no drowsiness
• You can drive a car directly after your nose surgery.

Operations to change the cartilaginous nose – this is the elastic part of your nose, the one which you can move – and simple changes of the bony pyramid – which is the stable part of your nose – can be operated in local anesthesia.

Big changes of the nose or bony changes of the nasal cavity I perform in general anesthesia.

Every experienced nose surgeon offers rhinoplasty in local anesthesia. It is your choice, which method is crucial.

by Dr. Stephan Bessler

During the initial consultation for nose surgery, patients often ask whether I have to break the nose. I always feel a certain shudder at this question. Indeed, 'breaking the nose' sounds like an act of violence, an accidental surgical result, and pain with bruising around the nose and eyes.

Let me reassure you! Such horror scenarios of nose-breaking date back to the original era of rhinoplasty, which began around the time of the First World War. They belong to the past.

It is the case that I often change the bony part of the nose. However, I don't break the nasal bone, but I cut the bone since a fracture line on the bony nasal pyramid usually does not lie in the perfect place.

For cutting the bone, I use three different instruments:

• The ultrasonic knife, called piezzotome: this instrument is widely used in surgery of the bone. With the ultrasonic knife, I can cut the nasal bone precisely and reduce bleeding.
• The diamond drill or the so-called burr: With 14 thousand revolutions per minute, this device cuts the bone precisely. I can cut the nasal bone finely and accurately and thin it out. Continuous water rinsing is necessary with the piezzotome and the diamond drill for heat dissipation.
• The micro chisel: This 2 mm wide chisel is also very useful when cutting the nasal bone, especially when only a short bone gap is necessary.

These instruments - ultrasonic knife, diamond drill, and micro-chisel - significantly reduce swelling and bleeding and allow high precision in rhinoplasty.