If the alar development is excessive and bulbous, excision of a wedge of ala at the alar-facial junction 1 mm to 2 mm above the alar-facial crease will reduce the overall bulkiness of the alar anatomy (Fig. 3). Some medial repositioning of the alae may be effected with this maneuver. Reduction of the overall length of the alar sidewalls occurs when generous wedges are excised, ideal in the reduction of the alar flare created when correcting the overprojecting tip.

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Figure 3. Excision of a wedge of ala at the alar-facial junction 1 mm to 2 mm above the alar-facial crease will reduce the overall bulkiness of the alar anatomy. Some medial repositioning of the alae may be effected with this maneuver.