Is it possible to define the supra-alar crease under local anesthesia?

Hello and thank you for your question.  The
best advice you can receive is from an in-person consultation.  It would be important to examine you before making specific advice in your case.  Generally, I would prefer general anesthesia for this procedure in order to obtain the best result.   Make sure you specifically look
at before and after pictures of real patients who have had this surgery
performed by your surgeon and evaluate their results.   The most
important aspect is to find a surgeon you are comfortable with. I recommend
that you seek consultation with a qualified board-certified plastic surgeon who
can evaluate you in person.
Best wishes and good luck.
Richard G. Reish, M.D.
Harvard-trained plastic surgeon

Hello,Thanks for your question. Yes, it is possible to define the supra-alar crease under local anesthesia. It can be done using a surgical needle to cut the skin using a single point of access. It will take several months for the crease to appear as the skin will swell and bruise. Once the swelling and bruising go away the crease shows itself.Good luck,Dr. Shah

In my experience it is absolutely possible to do this and it takes about 1 hour to perform in the office under local anesthesia..

Then definition of the upper border of the nostril or the 'supra-alar' crease can be affected by a number of techniques.  Without reviewing your photos and doing a proper nasal exam, it is difficult to advise on the best option to provide the most natural definition for your nose.  The definition of the crease can be influenced by the thickness of the nasal skin, the position,  shape and characteristics of the nostril cartilage and a variety of other factors.  A properly planned and executed rhinoplasty can definitely enhance the alar crease.  Be sure you discus your goals and concerns with an experienced and board certified surgeon who specializes in facial aesthetic surgery.

Defining a supra-alar crease is typically something that will not be treated with injections in a non-surgical rhinoplasty.  However, many issues can be addressed in a rhinoplasty done without anesthesia other than local.  Pictures and a consultation would be required to better define what needs to be done.  Best wishes.