Roe corrects this deformity by making an incision, either vertically or horizontally, in the mucosa in one or both nares, through which he introduces the blades of a fine curved scissors, with which sufficient redundant tissue is removed to bring the lobule down into the desired contour.
The mucosa should be sutured to facilitate rapid cicatrization. The operation should be overdone to get the desired result.
Not infrequently the extreme convexity of the lower lateral cartilage must be overcome by either removal submucously or by excision of the cartilage itself, employing an elliptical incision in the mucosa for the purpose.
The alæ are kept in position after such ablation by compress dressings or by a suture made transversely through both wings of the nose and the septum, and tied over a quill or cork support placed externally upon the skin at either side of the nose. This is removed about the sixth day.
Sheet lead or a splint of aluminum of proper thickness and covered with gauze may also be used to retain the parts during cicatrization.
ANGULAR EXCISION TO CORRECT LOBULE
When the lobule is unduly broad at its base and is more or less concave above the rim of the alæ, it can be reduced by removing a diamond-shaped piece of tissue at either side of the subseptum.
The bases of the two triangles making up the diamond at its widest area meet at the anterior rim of the nostrils, extending with their apices upward and backward, as shown in [Fig. 480].
If there be a prominence of the cartilaginous structure of the lobule, this may be removed subcutaneously after the two ablations have been made.
