<p>Nasal alar reconstruction is complex due to the region’s anatomy and aesthetic importance. This report describes repairing a small, full-thickness alar rim defect in a 36-year-old man using a rotational columellar skin flap with septal cartilage grafting. This single-stage technique achieved good color match, symmetry, and minimal donor-site morbidity. Compared to multi-stage flaps or composite grafts, this method is less invasive and effective for small defects, offering reliable aesthetic and functional results in carefully selected cases.</p><p><i>Level of Evidence V</i> This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors <a href="http://www.springer.com/00266">www.springer.com/00266</a></p>