A Refined Technique for Management of Nasal Flaring: The Quest for the Holy Grail of Alar Base Modification

"A smile is happiness you'll find right under your nose"- Tom Wilson. This quote holds true just for patients, not for surgeons. The correction of the nose always poses a challenge to the cosmetic surgeon. Deformities of the external and internal nose may be congenital or acquired and may be secondary to soft tissue and/or osseo-cartilaginous abnormalities, leading to aesthetic and/or functional consequences. Alar flare poses a common problem, sometimes alone and sometimes in conjunction with other external deformities. Alar base reduction is generally considered when the interalar distance exceeds the intercanthal distance. It has been well documented that this simple additional procedure brings about a substantial enhancement in the nose. Various techniques have been described and used in the past, each having their benefits and drawbacks, with the modified Weir wedge excision, Aufricht nasal sill excision, and Bernstein V-Y advancement being the common ones. We hereby describe a technique that is simple yet effective in achieving the desired results and at the same time aims at preventing relapse to obtain satisfactory long term results.