Because our surgery center only provides cosmetic surgery, we have refined and created our deep twilight anesthetic technique at Ocean Drive Plastic Surgery. The technique resembles a colonoscopy-type anesthetic rather than a formal surgical anesthetic. Most patients receive rhinoplasty without a formal general anesthetic. Surgery is most often performed without any endotracheal tube placement, and the use of anesthetic gas, paralytics, and high-dose narcotics is minimized.