Post-operative short nose is one of the most difficult problems encountered in plastic surgery. We propose a technique of lining rotation flaps combined with composite chondrocutaneous auricular graft from the triangular fossa to reconstruct the lining defect and improve surgical results. Twenty patients were operated on between 2016 to 2019 for post-operative short nose. Lining rotation flaps were used to supply missing medial mucosal lining with creation of a raw surface at the lateral lining in ten patients (intervention group). A total of 17 composite chondrocutaneous grafts taken from the triangular fossa of the ears were used to resurface the defect. The other ten patients were operated on using conventional techniques (control group). There was complete take of 13/17 composite grafts (76.5%), with 4 partial losses that healed uneventfully. Anthropometric analysis of pre-op and post-op profile photos demonstrated statistically significant decreased nasolabial angle in both groups. The amount of derotation achieved was significantly increased (p<0.05) with our proposed method (Intervention group: 12.3±9.3° vs. Control group: 6.55±4.5°). Donor sites healed uneventfully. The lining rotation flap with triangular fossa composite graft is a safe and effective method for management of the post-operative short nose in Asians.

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