ala

Caption: Figure 1: Patient's facial appearance demonstrating cloudy cornea, exophthalmos, underdeveloped ala nasi, maxillary hypoplasia, and micrognathia.

Malar advancement flaps were used in the reconstruction of nine defects with diameters of up to two cm in the sidewall and three defects in ala nasi extending to the sidewalls.

In case of First son, it revealed annular papules, annular plaques with central clearing and raised peripheral edge of different sizes varying from 2mm to 20 mm over dorsum of nose and ala nasi, distributed bilateral symmetrically (Figures 2 and 3).

Plastic Surgical reconstruction of deformed nose: Nasolabial flap was used to reconstruct the lost ala nasi to improve the appearance of the grotesque shape of the nose.

The patient was born with intrauterine growth retardation (birth height and weight under 10 percentile), microcephalia (under 10 percentile), broad nasal root, hypoplastic ala nasi, long philtrum, cleft palate, micrognathia, and low set ears (Figure 1c).