Review of the literature revealed congenital deficiencies of the alar cartilages
are very rare.
This is a 61-year-old patient consulted for esthetic concerns regarding bilateral concave alar cartilages
, without any associated breathing issues (Figure 2A-E).
Columellar strut was inserted, and tip sutures with add-on grafts of excised alar cartilage
along with bilateral lateral osteotomies were implemented.
The proper function of the nasal valve is dependent on the integrity of the upper lateral cartilages, the alar cartilages
, the mucosal surface of the nasal valve, the nasal septum, and the intrinsic muscles of the nose.
The objectives include lip segments that are almost in contact at rest, symmetrical lower lateral alar cartilages
, and adequate nasal mucosal lining, which permits postsurgical retention of the projected nasal tip.
The unique shape and tightly attached skin to underlying alar cartilages
makes the reconstruction hard to perform.