Yes, it is possible, but I would not recommend it. You will need to run the UIAlertView routines until you find one that has the correct class, I would assume UIButton and add your UIImageView from above like this:
for (UIView *v in [myAlertView subviews]) {
if ([v isKindOfClass:[UIButton class]]) {
[v addSubview:myUIImageView];
}
}
, , "foobar5", , , , , UIImageView.