A reverse flow retroauricular island flap was successfully used for reconstruction of nasal defects as a one stage procedure in three cases. The length of the pedicle allows its transfer to cover defects of the nose. There was no partial or total flap necrosis and scars were inconspicuous. The patients were very satisfied with the result. Although this technique is of a higher level of difficulty than a conventional washio flap, it allows aesthetically favourable nasal reconstruction by a single stage operation in selected cases.