I had a rhinoplasty 20 years ago (do not know if it was open or closed). Now I have become intolerant of the expansion of my nostrils. Last year I finally got temporary fillers because I am unwilling to have a revision rhinoplasty that involved general anesthesia. I understand correction for alar retraction involves skin grafts and can be done in office under local according to some great before and after photos from a surgeon in CT. Can my nostrils be lowered/refined/fixed without general?