A rhinoplasty, except small touch ups or small dorsal hump reductions almost always performed with anesthesia. Many factors, including patient comfort, patient safety, and the potential for bleeding must be considered when selecting anesthesia for your rhinoplasty.
In my opinion, general anesthesia is superior to intravenous sedation in all respects for rhinoplasty surgery for one main reason-patient safety. With general anesthesia, a small breathing tube is inserted by the anesthesiologist and a balloon on the end of this tube is inflated. If the patient bleeds, the blood will travel down the back of the throat and can enter the stomach and lead to nausea and vomiting- or worse- wind up in the patients lungs and lead to a pneumonia. With intravenous sedation, the patients gag reflex is diminished by the sedative drugs. For these reasons, I prefer general anesthesia as compared to intravenous sedation for rhinoplasty surgery.