Reconstruction of an absent ala and lateral wall of the nose can be accomplished in many ways, the way usually being dictated by the degree of lost substance and the condition of the local surrounding tissues.
If the margin of the ala be missing and it be not too large, it may be replaced by a composite free graft taken from the ear. This replaces the surface skin, supplies a pleasing margin and the lining, all in one procedure. It is an excellent, easy way of correcting such a small defect. Should the marginal defect be large, such a free graft will not take. The area being too large to fill by this method, a sliding, or pedicle, flap must be used.
When a larger area is involved, say the entire soft tissue lateral wall, including both the lateral cartilage and the lateral wing of the ala, one then has
HOLMES EM. Reconstruction of Soft Tissue Side of Nose. AMA Arch Otolaryngol. 1955;61(4):397–400. doi:https://doi.org/10.1001/archotol.1955.00720020413004
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