Considering alar batten grafts revision rhinoplasty. Can this be done under local anesthesia?

Batten grafts can definitely be placed under local anesthesia and they should stay in place permanently. 

Batten grafts CAN be done under local Anesthesia.  They do stay in place permanently,  but they can lead to some shadowing, unless they are placed under the lower lateral cartilage to hide their sharp edges; these are actually called alar strut grafts. The risk to revision surgery in the nose is causing increased scar tissue and unexpected deviation of the nose or asymmetries.  Having said that, I would try to convince you to do a more significant anesthesia if you were my patient, because you would be more comfortable.  

Dear fluser12345, Batten grafts may be performed under local anesthesia. However the surgeon typically chooses the anesthesia choice they are most comfortable with. When having a third revision rhinoplasty procedure you must weigh the risks versus rewards to determine candidacy. Best regards, Michael V. Elam, M.D.