The authors describe a new chondrocutaneous reverse island flap from the ear helix for nose and eyelid reconstruction. Anatomic studies showed that the blood supply of the helix is derived from the superficial temporal system. The presence of vascular communications between the anterior frontal branch of the superficial temporal artery and the supra-orbital and supra-trochlear arterial systems allows this flap to be used in a reverse vascular flow fashion. Three flaps have been successfully used for reconstruction of alar and nose tip defects and in one case for total lower eyelid reconstruction. The donor site is repaired with an advancement and rotation flap from the helical rim giving an acceptable result. In this paper, the authors propose a new pedicle flap for reconstruction of complex nose and eyelid defects.