Issue: Basal Cell Carcinoma
Procedures: Mohs, Bilobed Flap Nose Reconstruction
Description: This patient presented with a destructive basal cell carcinoma skin cancer on her right nasal supratip (image 1). After 3 layers of Mohs surgery, Dr. Swann extracted the tumor completely and examined the margins under the microscope to verify all the roots were removed. Because the roots were quite deep, a simple skin graft would have left the patient with a more obvious surgical scar, so Dr. Swann performed a bilobed transposition flap where he utilized the more flexible skin from the upper nose to delicately fill the defect. This type of repair does involve additional cutting to make the surgical area larger, but ultimately the shape of the nose shows very little distortion as Dr. Swann was able the hide the incision lines very well. The patient was very satisfied with the cosmetic result and had no problems with breathing.
