Physiology and Brain Wave Monitoring Equipment During Conscious Sedation and NosePlasty Nose Shaping



How do you explain to the prospective patient who is about to undergo a nose shaping noseplasty operation that may last from 2 to 5 hours that they will be in twilight 'sleep' all the time and that they will not experience any pain or discomfort, and when the surgery is finished they will have their new nose and will think that only 10 or 15 minutes has elapsed?


Conscious Sedation*  (Twilight Anaesthesia) and Time Distortion!

That is the wonder of this highly specialised, computer monitored, safe methodology of painless, conscious anaesthetic sedation as used at NosePlasty Clinics for all facial, plastic shaping surgery of the nose. This is a unique technique rendering painless, elegant nose surgery and practiced in only a handful of Clinics worldwide but rapidly spreading to first-world clinics in the UK, Europe, U.S.A. and South Africa.The original conscious sedation method (using topical cocaine solution intranasally and electro-encephalography monitoring of consciousness) was introduced by Drs. Pieter Swanepoel specialist rhinoplasty surgeon and Dr.Rheinach-specialist anaesthetist at the Nose Clinic, South Africa.


  • No in-patient hospitalization !
  • Painless !
  • Less traumatic than having a tattoo !
  • Less bleeding than with a tooth extraction !
  • Safe !
  • Discharge to home within a few hours post surgery!
  • incomparable safety record!


During Conscious Sedation Nothing is left to Chance.

Incomparable sedation anaesthesia- 'conscious sedation' is administered by highly trained specialist anaesthetist with monitored continuous recording of:-

  • electro-encephalography (EEG) *
  • electro-cardiogram (ECG)
  • blood pressure,
  • pulse rate,
  • blood oxygen saturation,
  • computer dose metering of the intra-venous medication. 
  • continuous monitoring by the specialist anaesthetist.

 * EEG shows the anaesthetist and the surgeon the brain wave level of consciousness  of the patient throughout the duration of the surgical procedure.


Because the medication causes time distortion, a two to three hour operation feels to the patient like only 15 minutes have elapsedThe patient, after the completion of the surgery is awake within minutes and as mentally alert within ten minutes as when she/he entered the surgery.


And they walk out of surgery with a new nose !


This is all done as an out-patient procedure-come in the morning and 

go home the same day.


* Conscious sedation has been used safely and successfully over many years on thousands of patients and is used in modern Clinics in Europe, UK and South Africa.


The wave of the future for all elegant rhinoplasty surgery is Conscious Sedation with local aneasthetic nose block! 


At NosePlasty Clinics we do not use general anaesthetic with its attendant risks and high cost of:


High stress,

Post operative painful throat due to throat packing,

Risk of post anaesthetic voice problems due to the laryngeal intubation, 

Possible Nausea and vomiting,

High costs associated with general anaesthetetic gases,

Prolonged consciousness recovery from the gaseous anaesthetic,

Risk of deep vein thrombosis in prolonged surgery,

Risk of malignant hyperthermia.

High costs of the recovery room for post general anaesthetic


(All the above risks from general anaesthesia for a relatively minor invasive, anatomically small, atraumatic, surgical procedure! The majority of rhinoplasties world wide are today still being performed with general anaesthetic!)


Blog by Dr Lexington (USA) Facial Plastic Surgeon-16-01-2013

"I respectfully disagree with my colleagues who state that general anaesthesia is necessary for performing a rhinoplasty. I have now done over 2000 procedures under twilight anaesthesia and strongly prefer it over general. In my opinion there is less bleeding, no discomfort when done by someone with experience and much less post operatvive nausea. There is no risk of Malignant Hyperthermia and obiously no potential risks associated with use of an endotracheal tube."



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Text 11 November  2020 12:47