A simple solution for a difficult location: Reconstruction of the cymba concha and helical crus using the pre-auricular skin

Reconstruction of preauricular defects, particularly those involving the cymba concha and helical crus with exposed auricular cartilage, presents a notable challenge due to limited local tissue availability and the cosmetic significance of the auriculofacial junction. The rhomboid (Limberg) flap is a simple and geometrically precise transposition flap that recruits adjacent skin with favorable laxity and allows scars to be placed along relaxed skin tension lines. We present two patients with small preauricular defects involving the helical crus following excision of non-melanoma skin cancers. In both cases, defects extended to the perichondrium with focal cartilage exposure and were reconstructed using a rhomboid flap designed within the adjacent preauricular skin. This case series demonstrates that the rhomboid flap is a reliable, reproducible and aesthetically favorable option for reconstruction of preauricular and helical crus defects, offering an effective balance between simplicity, structural preservation and cosmetic outcome in this anatomically complex region.