When the defect is in the posterior margin of the ear, a large bipedicle flap of posterior ear skin is recommended (see Chapter 81). These tissues are thin, well vascularized, pliable, and of the same color as the rest of the ear.

If the defect is in the superior portion of the external ear, a cartilage graft may be required for support. If the defect is in the inferior portion of the ear, there is no need for cartilage because the force of gravity does not alter the shape obtained with a skin flap (1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18).