Absolutely. An alarplasty can be performed in the office under local anesthesia. Your issues with high blood pressure should not create any problems with the procedure. Further, as long as you have reasonable expectations for the expected result, an alar procedure alone can provide significant results in the properly-selected patient. When choosing a plastic surgeon to perform this procedure, ensure that they have experience with alar modification. In experienced hands, the procedure is predictable and provides aesthetically pleasing results. In inexperienced hands, alar surgery can create significant problems that can be incredibly challenging to remedy during a revision procedure. I hope this information is helpful.Stephen Weber MD, FACSWeber Facial Plastic Surgery