How to add curvature to ala? (Photo)

It is very difficult to almost impossible to add the curvature back to the ala. A cartilage graft can be added to get some improvement. It is best to try some saline injection first to see if it improves it and then you could use a filler.
Revision alarplasty is high risk.
Regards
Dr.J

Hello and thank you for your question. Based on your photograph, may benefit from a revision in order to improve the shape of your ala and fix the soft triangle notching. I will usually perform extended Alar contour grafts as part of a revision to fix this issue. With good surgical technique, you could have an outstanding result. I recommend that you seek consultation with a qualified board-certified rhinoplasty surgeon who can evaluate you in person.

Best wishes and good luck.

Richard G. Reish, M.D.
Harvard-trained plastic surgeon