Reconstruction of the ala of the nose is a very common task for the pl
astic surgeon. Many different techniques are available, but as in all
reconstructive procedures in the face it is important to consider the
combination of function and aesthetics. It is not only important to cl
ose the defect, but how it looks afterwards. According to these criter
ia the various methods were analysed and local flaps were found to be
the most favorable technique due to their identical texture and colour
match to the surrounding tissue. On the nose, the skin of the tip and
the ala is very tight which makes it difficult to use local flaps the
re. However, there is a surplus and looseness of skin in the glabella
region. This skin can be transferred by an axial fronto-nasal flap, pe
dicled on a branch of the angular artery as described by Marchac. With
this flap any point of the nose can be reached. In our opinion, this
flap appears preferable to all others. The new technique of ala recons
truction based on this axial fronto-nasal flap is demonstrated. The sk
in defect is covered by this flap and for the inner lining a mucosal f
lap from the septum can be used which includes a strip of cartilage fo
r stabilisation. In addition the surplus of tissue at the point of rot
ation, which normally has to be resected as a Burow's triangle, can al
so be used for the inner lining.