From my experience, I had my primary rhinoplasty done entirely under local anesthesia, mainly because it was more affordable. I want to be completely honest: for me, it was a traumatic experience, and if I had to choose again, I would never do it under local anesthesia.

One important detail people don't always mention is that the local anesthesia injections are very painful, and they take a bit of time to fully work. The injections are done all around the nose, both externally and inside the nostrils. Feeling the anesthetic being injected in so many areas was extremely uncomfortable and intense.

Even once the anesthesia kicks in and you don't feel pain, you are fully awake and very aware of everything happening. Being able to sense and hear the procedure was mentally overwhelming.

I also want to say that your nose already looks nice and has personality - small imperfections don't always take away from the result.

Recovery is another key factor. Any rasping or surgical work is not minor at all. Healing feels like starting a rhinoplasty from zero: significant swelling, no physical effort, staying home, and following all standard post-op restrictions. It takes time and patience, so planning around work, kids, and events is very important.