In Caucasians, the lateral crural complex is large and long, and the tip plasty is not difficult. In
Asians, however, the nasal tissues are insufficient and the nasal tip needs more volume. Therefore,
many operators rely on a graft insertion for augmentation effect. Occasionally, if the tip supporting
framework is weak, nasal tip drooping is observed by the operators in long period of follow-up.
Recently, release and division of tripod structure combined with framework rebuilding has made the
correction of various tripod types of tip complexes possible. The main principle of alar advancement
technique is that three limbs of the tripod should be properly separated. The nasal tip should be
advanced toward upward and forward direction and reinforcement should be done with autologous
graft. In other words, scroll ligament, which connects between the alar cartilage and upper lateral
cartilage, and nasal hinge complex should be divided freely, inducing the pivot motion and gliding of
alar cartilage which leads the V-Y fashioned advancement and projection of alar cartilage. This paper
presents an operation method using auricular cartilage after examining the principle of alar
advancement in patients who have lack of tip projection, based on my cadaver study and clinical
experience. (J Korean Soc Aesthetic Plast Surg 16: 125, 2010)