title: Can we add auricular composite graft to our rhinoplasty armamentarium?
abstract: BACKGROUND
  The ala of the nose, with its particular texture and characteristics, poses both aesthetically and functionally intriguing challenges and is rather problematic regarding choices for reconstructive methods. Both flaps and grafts have been used to restore natural structure of nasal ala. The present study summarizes a ten-year experience of reconstructive surgery using small composite grafts from non-cartilage bearing tissues, and large composite grafts, containing cartilaginous tissue, with a mean follow-up of 4 years and 8 months.
  
  
  METHODS
  Cumulatively 56 patients were reported. Some of them required surgery due to previous cosmetic rhinoplasty. In 47 of the cases, a small graft from the non-cartilage bearing junction of ear lobule to helical rim sufficed. Nine patients had rather large defects for which grafts were harvested from the helical root. Donor sites were primarily closed and grafts were implanted in place in a single, rapid session.
  
  
  RESULTS
  All small grafts had excellent take. Of 9 large grafts, 5 had excellent take, three had acceptable, and one, in a male smoker, failed to take. During follow-up, no gross deformity or poor scar was detected in either donor or recipient site.
  
  
  CONCLUSIONS
  We have demonstrated that using both large and small auricular composite grafts has favorable long term results for reconstruction of alar rim deformities. However, use of small grafts seems more beneficial and applicability of large grafts requires further studies.
authors.affiliation: Department of Plastic Surgery, Tehran University of Medical Sciences, Tehran, Iran;
authors.forename: Ali
authors.initials: A
authors.lastname: Manafi
authors.affiliation: Sport Medicine Research Center, Tehran University of Medical Sciences, Tehran, Iran;
authors.forename: Amir
authors.initials: A
authors.lastname: Eslami Shahr Babaki
authors.affiliation: Stem Cell Research and Transgenic Technology Research Center, Student Research Committee, Shiraz University of Medical Sciences, Shiraz, Iran.
authors.forename: Golnoush
authors.initials: G
authors.lastname: Mehrabani
authors.affiliation: Medical Student Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran;
authors.forename: Abtine
authors.initials: A
authors.lastname: Shahlaee
authors.affiliation: Medical Student, Shahid Beheshti University, Tehran, Iran.
authors.forename: Amir
authors.initials: A
authors.lastname: Manafi
keywords: Alar rim; Armamentarium; Auricular composite; Graft; Reconstruction; Rhinoplasty