Full-thickness skin graft (FTSG) is a core reconstructive option for small to moderate nasal defects after oncologic resection. By providing full dermal thickness and adnexal structures, they offer durability, sensory recovery and good aesthetic potential. However traditional FTSGs often struggle with contour and colour match on the nose. The contoured composite graft refines the FTSG technique by emphasising optimal donor site selection, meticulous tissue handling, precise haemostasis, accurate inset and strict postoperative care. Limitations in traditional FTSGs frequently arise from habitual use of preauricular or supraclavicular donor sites and graft thinning, driven by concerns of graft survival. While colour match is usually considered, dermal thickness and sebaceous match, essential for nasal reconstruction, are often overlooked. We advocate for alternative donor sites such as the infraauricular and upper neck region, dog ear grafts, and the glabella, which provide superior match to nasal skin. Graft inset should focus on meticulous dermal opposition, supported with a traditional tie-over dressing and additional contouring aided by jelonet pledgets. We recommend maintaining the tie over for a full three weeks to optimise graft integration. The contoured composite graft offers a more reliable and aesthetically harmonious solution than traditional FTSGs, achieving outcomes that often surpass both standard grafts and local flaps. Techniques and examples demonstrated in this presentation.