Reconstruction of defects involving the upper one-third of the auricle.

We describe here a reconstructive technique for the repair of defects involving the upper one-third of the auricle using a combination of several flaps. For a defect of the preauricular surface only, a chondrocutaneous flap from the concha and a postauricular subcutaneous pedicle flap were used. For a full-thickness defect, the reconstruction was made by using the chondrocutaneous flap, the postauricular subcutaneous pedicle flap, and a postauricular skin flap. The final skin defect was collected in the postauricular region and was directly sutured or covered by skin grafting. Seven patients were treated by this procedure. Although the tip of the postauricular skin flap fell into partial necrosis in one patient, all of the other flaps were well healed without vascular stasis. All of the reconstructed auricles had good three-dimensional forms with satisfactory color and texture to match. There was neither constriction of the ear nor deformation owing to scar contracture.