Correction of asymmetric nostrils (alae) by columella transposition.

A new method for correction of asymmetric alae is presented. Asymmetric alae frequently follow nasal, columellar, and alar reconstruction, and the resulting distortion can pose a reconstructive dilemma. Correction of these deformities can require complex composite grafting or tissue rearrangement procedures. By transposing the columella, we have equalized asymmetric nostrils without introducing new tissue to the region. Although not appropriate to all types of alar discrepancy, this novel method, where applicable, is safe, reliable, and does not produce significant visible scarring or donor site morbidity.