The helical rim of the auricule is one of the most common sites of skin cancer to occur. Smaller excisional defects can be closed directly, and larger defects by a helical rim advancement flap, with a variety of modifications.
When a helical rim advancement flap is used to close a larger defect, the auricule becomes considerably smaller in size. Besides the esthetic concern, conchal bowl- or behind-the-auricule- hearing devices may not fit anymore, and acoustics may be impaired if the size of the auricule decreases by more than a third.
The postauricular page flap (retroauricular pedicle flap) is an interpolated staged procedure, using the postauricular scalp to form a bridge onto the missing section of the helicle rim. After 3-4 weeks the transposed flap tip is autonomized so that the pedicle can be dissected, to be wrapped around and shape a neo-helix. This simple and elegant procedure leaves the auricule size and anatomy virtually unchanged.