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Nasal Reconstruction With Mid-helical Rim Composite Grafts: A Single Surgeon's Experience Based on 65 Cases
Caroline Asirvatham Gjorup1, Anand K Deva1, Gazi Hussain1
1From the Department of Plastic and Reconstructive Surgery, Macquarie University Hospital, Sydney, New South Wales, Australia.
Plastic and Reconstructive Surgery. Global Open
|August 4, 2026
Summary
The mid-helical rim composite graft offers a reliable one-stage solution for nasal alar rim reconstruction. This technique allows for larger graft sizes and successful outcomes in defects up to 20mm.
Area of Science:
- Plastic Surgery
- Otolaryngology
- Dermatologic Surgery
Background:
- Composite grafts are established for nasal alar rim reconstruction.
- The traditional helical root donor site limits graft size and can cause ear distortion.
- The mid-helical rim offers a larger graft and avoids secondary donor site closure.
Purpose of the Study:
- To detail a one-stage technique using the mid-helical rim composite graft for nasal alar rim defects.
- To evaluate the outcomes of this alternative grafting method.
Main Methods:
- Retrospective cohort study of 65 patients.
- Single surgeon's experience with mid-helical rim composite grafts.
- Reconstruction performed following basal cell carcinoma excision under local anesthesia with sedation.
Main Results:
- Successful reconstruction in 65 patients from 2010-2024.
- Median defect size of 14mm (range 9-20mm).
- Graft loss in 4 patients (3 smokers), indicating reliable outcomes.
Conclusions:
- Mid-helical rim composite grafts enable reliable one-stage reconstruction of nasal alar rim defects up to 20mm.
- Optimizing the recipient vascular bed enhances graft take.
- This method provides a viable alternative to traditional techniques.