Introduction: Neoplasms of the outer ear are not uncommon given the high incidence of solar exposure in Australia. Reconstruction following resection of conchal fossa and anti-helical rim lesions can sometimes prove to be challenging. Full thickness skin grafts (FTSG) are commonly used. However, colour mismatch, contour defect and additional donor site scarring are all drawbacks of this method. A single-stage postauricular skin-island flap can reliably reconstruct conchal defects without compromising the aforementioned. Aim: Reviewing the use of the trap door flap based on post auricular vessels to reconstruct defects of the concha following nonmelanoma skin cancer excision. Methods: The trap door flap is a random pattern flap based on the post auricular artery. The flap is designed on the mastoid and postauricular surfaces, tailored according to conchal defect. Results: A 67 year old male patient underwent excision of conchal fossa biopsy proven squamous cell carcinoma. The lesion was completely excised and defect reconstructed with trap door flap. There were no post-operative complications and no evidence of locoregional recurrence at 3, 6 and 12 month follow-up. Cosmetic result was beyond satisfactory and nil revision was required. Conclusion: A randomized controlled trial by Dessy1 identified 40 patients who underwent reconstruction of anterior conchal defects with either trap door flap or FTSG. Greater aesthetic outcomes for the trap door flap group in comparison to the FTSG group was of statistical significance. The trap door flap should be considered as favourable choice for reconstruction of anterior auricular conchal defects following neoplasm excision. References: 1. Lynch J, Mahajan AL, Regan P. The trap door flap for reconstructing defects of the concha. The British Association of Plastic Surgeons 2003;56:709-11 2. McInerney NM, Piggott RP, Regan PJ. The trap door flap: a reliable, reproducible method of anterior pinna reconstruction. J Plast Reconstr Aesthet Surg 2013; 66: 1360-64