title: Iatrogenic Through-and-Through Conchal Defect Secondary to Auricular Cartilage Graft.
abstract: BACKGROUND
  Over the past few years, conchal cartilage has been most often used in rhinoplasty. The donor site complications following conchal cartilage graft harvesting are scar formation, hematoma formation, and delayed wound healing, although hematoma is one of the most important and common complications. A complete conchal defect as a complication of auricular cartilage graft harvesting has not been previously reported in the literature. The authors report an unusual case of an iatrogenic conchal defect resulting from conchal cartilage graft harvesting that was treated using a posterior auricular island flap.
  
  
  METHODS
  A 24-year-old male with a left conchal inflammation and perforation visited our plastic surgery department after receiving augmentation rhinoplasty and tip plasty using a conchal cartilage graft. A tight dressing had been applied to the ear, and postoperative infection was uncontrolled, which resulted in iatrogenic conchal perforation.
  
  
  RESULTS
  A tie-over bolster dressing has been widely used to prevent hematoma following conchal cartilage graft harvesting with an associated donor site complication. However, a tight tie-over dressing and inappropriate postoperative care can cause complete through-and-through conchal defects. The posterior auricular island flap provides an elegant means of reconstructing conchal defects.
  
  
  CONCLUSIONS
  In the described case, aesthetic reconstruction of a conspicuous iatrogenic conchal defect was achieved with minimal scarring using the posterior auricular island flap. To the best of our knowledge, this report is the first to describe reconstruction of an iatrogenic defect in the concha as a complication of auricular cartilage graft harvesting.
  
  
  METHODS
  This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, 20, Geonji-ro, Deokjin-Gu, Jeonju-si, 561-712, Republic of Korea.
authors.forename: Hyung-Suk
authors.initials: HS
authors.lastname: Ro
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, 20, Geonji-ro, Deokjin-Gu, Jeonju-si, 561-712, Republic of Korea. pssroh@jbnu.ac.kr.
authors.forename: Si-Gyun
authors.initials: SG
authors.lastname: Roh
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, 20, Geonji-ro, Deokjin-Gu, Jeonju-si, 561-712, Republic of Korea.
authors.forename: Jin Yong
authors.initials: JY
authors.lastname: Shin
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, 20, Geonji-ro, Deokjin-Gu, Jeonju-si, 561-712, Republic of Korea.
authors.forename: Nae-Ho
authors.initials: NH
authors.lastname: Lee
authors.affiliation: Department of Plastic and Reconstructive Surgery, Chonbuk National University Medical School, 20, Geonji-ro, Deokjin-Gu, Jeonju-si, 561-712, Republic of Korea.
authors.forename: Kyung-Moo
authors.initials: KM
authors.lastname: Yang
mesh_terms: D004425:Ear Cartilage / Q000637:transplantation*; D005500:Follow-Up Studies; D006801:Humans; D007049:Iatrogenic Disease; D007431:Intraoperative Complications / Q000503:physiopathology; D008297:Male; D035583:Rare Diseases; D019651:Plastic Surgery Procedures / Q000379:methods*; D012086:Reoperation / Q000379:methods; D012225:Rhinoplasty / Q000009:adverse effects* / Q000379:methods; D018570:Risk Assessment; D016378:Tissue Transplantation / Q000009:adverse effects; D060053:Transplant Donor Site / Q000473:pathology; D016896:Treatment Outcome; D014420:Turbinates / Q000293:injuries*; D055815:Young Adult
keywords: Concha reconstruction; Conchal defect; Iatrogenic defect; Posterior auricular flap