Before you book a rhinoplasty, ask two plain questions: where will the operation actually happen, and who is watching your breathing while you are sedated? For a nose those answers matter more than for most procedures, because the airway is the very thing being operated on. At Troell Cosmetic Surgery, most rhinoplasties are performed awake in the office on South Fort Apache Road, under local anesthesia with IV sedation, with continuous monitoring and same-day discharge; when general anesthesia is the sounder plan, the case is done at an AAAASF-accredited surgical facility. Dr. Robert J. Troell is ACLS-certified, a Diplomate of the American Board of Sleep Medicine, and has run his own anesthesia comparison studies, so the sedation approach is one he has measured rather than defaulted to. Troell Cosmetic Surgery & Facial Plastic Clinic is a cosmetic and facial plastic surgery practice in Las Vegas. Our guide to where your rhinoplasty happens and who monitors you is on our website — tap Learn More to start there.