Related Experiment Video
Updated: May 24, 2026
Surgical Approach to Full Soft Tissue Face Allograft Procurement for Vascularized Composite Allotransplantation
Published on: December 30, 2025
Nasal ala reconstruction with a crus helix composite graft: a stepladder approach
Isaac Zilinsky1, Nimrod Farber, Josef Haik
1Mohs Micrographic Surgery Unit, Chaim Sheba Medical Center, Tel Hashomer, Israel.
Background:
Defects of the nasal ala present a complex reconstructive challenge. Composite grafts comprise all layers required to successfully reconstruct these full thickness deformities making them the ideal reconstructive method, yet they are usually avoided because of unjustified disreputable failure rates.
Objective:
The authors introduce a stepladder approach for alar reconstruction with a crus of helix composite graft according to the severity and complexity of the defect.
Methods:
Data from 25 patients who underwent correction of full thickness alar defects with composite grafts was collected and reviewed.
Results:
There were no complete graft failures in any of the cases. Ten patients (40%) had partial graft necrosis ranging from 5 to 50% (average 18%); two of them (20%) were heavy smokers.
Conclusions:
Composite grafts should be considered for reconstruction of full thickness nasal ala defects, given the correct surgical technique is implemented.
