ABSTRACT
Reconstruction of full-thickness defects of the nasal alae has always been a challenge.
Local flaps are commonly used but often result in facial scars and bulky alae that
require secondary revisions. The structural similarities between the nasal alae and
auricular helices have allowed the use of free helical composite grafts to repair
small nasal defects of less than 2.0 cm. Recent delineation of vascular territories
of the ear has allowed the use of vascularized helical free flaps in the repair of
large alar defects. Successful reconstruction of a 3.2 cm × 3.0 cm full-thickness
alar defect, with a chondrocutaneous microsurgical free flap from the root of the
auricular helix, is presented. The reconstruction was satisfactory as to contour,
symmetry, and color match over a one year follow-up.
