Moderate sized cancers of the upper third of the ear can be widely excised, including cartilage, leaving the posterior skin intact, This avoids a large wedge excision and primary closure which leaves a significant defect. The unsupported soft tissue of the upper ear following excision of the cancer can be reconstructed by rotating into position a composite flap of skin and cartilage from the middle third of the ear. This composite flap supports the superior helix. The tissue defects of the flap donor site and the area superior to the flap inset can be closed with thick split grafts from the post-auricular area.