Including: nasal tip hypertrophy and alar width and thickness, mostly congenital. The reason of hypertrophy is that the skin is thicker, there are more subcutaneous tissues, and the cartilage scaffold is hypertrophy, which is easy to bulge out.

1. For patients with nasal tip hypertrophy, a V-shaped skin incision can be made along the front edge of the lateral foot and the medial foot of the alar cartilage, and the nasal cartilage can be separated sharply through the incision. Pull the alar cartilage out of the incision as far as possible with a small retractor to cut off the adipose tissue on the cartilage surface. Then, most of the upper and lateral parts of the cartilage are removed, leaving only an L-shaped cartilage at the center and edge.

2. If the alar is too wide or too thick, we can make a skin incision along the front edge of the lateral foot of alar cartilage, and then use small scissors to separate the skin from the alar cartilage below. Pull the alar cartilage out of the incision with a small hook, cut off the soft tissue on the cartilage surface, and then cut off the upper and lateral parts of the cartilage. Then, in the nostril, a diamond-shaped vestibular skin and nasal mucosa were removed at the inner side of the alar base. If the alar is thick, you can cut off the excess adipose tissue with small scissors through the incision.