Conventionally, the alar cartilages
were divided into medial and lateral cartilages;  however, it was not until 1987 where middle crus was described that linked to various aesthetic problems ensuring applicable reconstructions as well.
It is important to have sufficient length in order to properly flatten the newly turned alar cartilage
. It is fixed to the alar cartilage
with 5/0 PDS suture between its middle and distal third.
Excising an ellipse of skin, and subcutaneous tis- sue, in the nasofacial fold, can open the nasal valve by rotating the alar cartilage
The characteristics of Coffin-Lowry syndrome can certainly be within easy reach if someone could connect downward slanting palpebral fissures, a broad nose with thick alar cartilage
and thick lips (don't forget the short stature, large hands, and tapering fingers) with the imagery of melting popsicles on a hot Sunday in the park or some other easily retrieved vision.
On examination, a smooth mucosa covered dark-coloured mass was seen in the left nasal cavity completely blocking whole of the vestibule and displacing the left lateral alar cartilage
On extraoral examination, the patient was noted to have cleft lip left side; columella deviated toward noncleft side; depressed left lateral alar cartilage
The vestibule is surrounded laterally by the lower (alar) cartilage and extends posteriorly to the limen nasi, a ridge of tissue that marks the mucocutaneous junction approximately 2 cm from the vestibule entrance and corresponds to the upper margin of the alar cartilage
. The medial wall of the vestibule is the columella, which is formed by the medial wing of the alar cartilage
and is 4-6mm wide.
Several weeks earlier, she had affixed a magnetic blinking-light earring and a backing magnet to the alar cartilage
on one side.
Primary reconstruction of the oral and nasal mucosa, alar cartilages
, perioral and nasal muscles, and skin was completed successfully.
The unique shape and tightly attached skin to underlying alar cartilages
makes the reconstruction hard to perform.