Alar defects are usually secondary to trauma or nasal tumour excision. Congenital alar defects are rare of which isolated bilateral nasal clefts are extremely sparse. Reconstruction of these bilateral nasal clefts poses additional challenge due to lack of equivalent structural analogue on the opposite side to weigh against. Myriad of strategies are available for management of these clefts ranging from intelligible rotation flaps to more complex grafting procedures. Here we present a case report of bilateral isolated nasal cleft management in a 17-year-old male patient and the hurdles involved in achieving the desired results. It is important for an astute surgeon to provide an aesthetically appealing result on the most dominant structure defining the mid face.
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