My preferred method for the stenotic nares procedure is to take a very deep wedge.
My first incision is very close to the alar fold, from dorsal to ventral. I visualise the 11 scalpel blade as it enters the vestible caudally. The exact distance it exits caudally is around 1cm, but depends on the size of the dog.
I then direct the blade via this same incision but in the opposite direction (to get to the most dorsal tip again) and then I change the direction to lateral and take a large section of the alar wing. I then close with 4-0 monocryl
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