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Arch Aesthetic Plast Surg. 2017 Oct;23(3):149-154. English. Original Article.
Yoon SM , Lee DW , Nam SM , Wee SY , Jeong HG , Choi CY .
Department of Plastic and Reconstructive Surgery, Soonchunhyang Gumi Hospital, Gumi, Korea.
Department of Plastic and Reconstructive Surgery, Soonchunhyang Seoul Hospital, Soonchunhyang University College of Medicine, Seoul, Korea.
Department of Plastic and Reconstructive Surgery, Soonchunhyang Bucheon Hospital, Bucheon, Korea.


Composite grafts have advantages for small nasal defect coverage. However, if the the outer skin defect and the inner skin defect have a different location, conventional composite grafts encounter considerable limitations. Therefore, we devised a 4-limbed graft to overcome this limitation by use of soft tissue transposition.


Over the course of 5 years, this auricular composite graft was used in 10 cases of reconstruction. We harvested skin and cartilage from the helix. The composite graft had 2 limbs of soft tissue to cover the nasal defect and another 2 limbs of cartilage to support nasal framework. The cartilage limbs extended 3 to 5 mm beyond the margin of the skin. The direction of each limb was modified according to defect position.


All 10 composite grafts survived completely. All composite grafts shrank by a small percentage of their bulk. Nonetheless, the nasal framework was maintained to an acceptable extent because of the cartilage limbs.


This technique was capable not only of covering defects in the alar and columellar area, but also of maintaining a satisfactory external appearance, because the 2 limbs of cartilage included in the graft strengthened the nasal framework and provided modest support to the nostril margin. The 2 limbs of soft tissue covered the defect area. Our 4-limbed auricular chondrocutaneous composite graft is reliable option for the reconstruction of alar and columellar defects in a single-stage procedure.

Copyright © 2019. Korean Association of Medical Journal Editors.