Piggyback composite ear grafts in nasal ala reconstruction

Two cases of nasal ala reconstruction are presented, documenting the feasibility of sequentially adding one cartilage-containing composite ear graft onto another in piggyback fashion. The junction between the composites is relatively unnoticeable. This technique enables one to fully correct a nasal defect that has been incompletely reconstructed using a single composite graft, thanks to a partial take or to shrinkage that has reduced the graft bulk more than was anticipated. Defects of a size greater than would be amenable to a single composite graft may be repaired by planned serial addition.