Cosmetically to correct large, thick and flaring ala, Weir method have been frequently used. But
after excessive Weir excision, it causes tightened distal nose, lowered nasal tip, and unnatural shape
of ala. A 32-years-old female patient suffered from the marked tightness of distal nose, lowered
height of nasal tip, and mild dyspnea after Wier excision 1 year ago. She showed unnatural alar base
shape with blunting of alar-facial groove angle up to 110 degree, and it rapidly slanted to the nasal tip.
The incision was made along the previous operative scars at alar base, and release of tension were
done. There was a 7 mm gap in each side of both alar bases. The two wedge shaped composite grafts
from the left helical rim were obtained, and insetted to the alar base gaps. Immediately after
operation, she showed relief of dyspnea and tightness of nasal tip, and improved shape of distal nose.
The 3 months postoperatively , mild hyperpigmentation of the grafted sites were noticed. The overall
results were excellent. To correct the deformed ala and unnatural distal nose shape after excessive
alar reduction using Wier excision, we present a technique of the composite auricular chondrocutaneous
grafts at alar base. (Archives of Aesthetic Plastic Surgery 17: 133, 2011)