Use the least amount of infiltrative anesthesia (0.5% Xylocaine with 1:200,000 epinephrine) to prevent distortion of the nasal anatomy.
The tip cartilage can be approached by external approach - Bilateral marginal incisions connected by a transcolumellar incision
- Removal of cephalic margin of the lateral crura
- Suturing together of dome areas
- Trimming of the caudal margin of medial crura
- Insertion of a columellar strut
- Larg excision of the alar to the vestibule around the alar facial junction to correct widely flaring alas. The scar should be kept approximately 1 mm on the alar side of the alar facial crease.
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