The management of ala ptosis in Oriental rhinoplasty

We use the term ala ptosis to describe a condition in which the nostril sidewall is bulbous with overhanging of the alar margin. This hides the columella from view, especially in profile. The management of ala ptosis in Oriental rhinoplasty is done in two steps, i.e., to reduce the bulbous nostril sidewall by manipulating the alar cartilage and to reduce the alar margin to a gentle, graceful curve by means of selective rim excision after wide undermining of the ala. The definitive alar margin runs more or less parallel to the white roll of the upper lip.