Auricular Composite Graft for the Reconstruction of a Partial Alar Defect: A Case Report

Reconstruction of partial nasal alar defects requires restoration of both aesthetic contour and functional support. For defects with preserved internal lining, local flaps and full-thickness skin grafts are commonly selected; however, local flaps may be challenging depending on the size and location of the defect, and skin grafts may be insufficient when the underlying structural support is compromised. We report a case of an octogenarian man with basal cell carcinoma of the nasal ala who underwent surgical excision followed by reconstruction using an auricular composite graft. The post-excisional defect measured approximately 1.6 cm in diameter and extended to a depth exposing the roots of the nasal hairs. A composite graft consisting of skin and cartilage was harvested from the posterior aspect of the auricle and transplanted to the defect. Although partial epidermal necrosis was observed postoperatively, complete epithelialization was achieved within approximately three weeks, with good graft survival and satisfactory aesthetic and functional outcomes. The donor site also healed without complications. Although auricular composite grafts are typically used for full-thickness alar defects, this case suggests that they may also be a useful option in selected partial defects requiring both skin coverage and structural support. This technique may represent a valuable single-stage reconstructive option that balances functional preservation, aesthetic outcome, and surgical invasiveness.