The retroauricular skin flap is a useful technique to provide skin coverage for full-thickness ear defects resulting from trauma or oncological resection. Defects that involve the posteromedial and retroauricular skin, however, limit the use of this flap. An extended retroauricular flap used to reconstruct a middle-third marginal defect extending anteriorly into the concha and posteriorly onto the retroauricular skin is described. Triangular extensions of retroauricular skin adjacent to the distal aspect of the flap as well as flap elevation posteriorly into the scalp were used to increase flap length. This technique provided acceptable aesthetic results with minimal distortion of ear shape and contour.
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