Auricular composite grafts were used to augment both nasal alar size and thickness in 8 patients who had alar hypoplasia. The grafts included large amounts of conchal cartilage and a small amount of elliptically shaped retroauricular skin. The width of the skin harvested was about one-third that of the harvested cartilage. The cartilage was used to augment the thickness and correct the shape of the ala, and the skin that was grafted to the alar groove was used to restore the covering defect. All grafts took perfectly and the aesthetic results were satisfactory except in 1 patient. The grafted skin provided both a good color and texture match for the nose, and the cartilage maintained the alar shape. This procedure is simple to perform and yields good results with minimal donor site deformities.