This usually occurs when the nasal bones are separated too far and or the nostrils are more horizontal than vertical. This can occur in any individual, but is commonly seen in certain ethnic groups such as the Afro-American or in the Oriental patient. These are corrected by bringing the nasal bones together and if necessary reduce the nostrils. Occasionally the bridge of the nose will have to be built up as well with either the patient’s own cartilage or an implant.