The authors of this study describe a case of nasal alar deformity with a congenital deficiency of cartilage treated with a rotation flap. To choose the reconstruction technique, reference parameters such as the age of the patient, the presence of preexisting scars, and the size of the defect are assessed by focusing on the tissue structure and on the major aesthetic demands of the younger patients. Good aesthetic results, with an acceptable cicatricial outcome and an excellent morphofunctional reconstruction of the ala, were achieved in the treated subject. The postoperative course was also good with no complications.