I agree that nasal tip work is best done in a controlled setting in an operating room. Many procedures can be performed under local anesthesia in the office, but that doesn't mean they should be performed this way. Maximizing surgical outcomes involves precision and controlling the operative experience. Make sure to get several opinions from true rhinoplasty experts.All the Best,Dr. Brian Reagan
Alar base reduction can generally be done in the office under local anesthesia. For tip work, it is generally more comfortable for the patient to have this done under general anesthesia, but it depends on the extent you are looking to have done. 3-dimensional computer imaging can help you visualize what you may look like afterwards and serve as an important communication tool with your surgeon. Please consult with a board certified specialist who can help you achieve the results you seek.