Will alarplasty be painful or uncomfortable under local anesthesia? (Photo)

Hello and thank you for your question. Based on your
photograph, you may benefit from a tip refining rhinoplasty. Your surgeon can
accomplish this by trimming, suturing, and reshaping the cartilage in your
lower nose. You may also benefit from reduction of the width of your alar base.  I would recommend general anesthesia for 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 not just a computer animation system. 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

Typically alarplasty alone can be performed under local anesthesia and it is well tolerated. If this is performed in conjunction with a formal rhinoplasty I would recommend more anesthesia depending on your surgeon's preference. 

In our practice, we perform most  alar-plasty procedures under local anesthesia.  this requires one shot of lidocaine below each nostril which is very tolerable. General anesthesia would not be needed.