The "jigsaw puzzle" advancement flap for reconstruction of a retroauricular surgical defect

Repairing retroauricular defects is quite challenging. Although direct observation of the repaired defect is not possible, choosing the wrong reconstruction might result in serious deformity of the auricle that will be easily noticed. An 89-year-old man presented with a large basal cell carcinoma tumor on his right retroauricular area adjacent to the mastoid-auricle border. The clinical tumor size was 17 × 17 mm. The tumor was excised in one stage, using the Mohs micrographic surgery technique. The final defect size was 20 × 20 mm. The surgical defect was reconstructed by a "jigsaw puzzle"-like flap.