This patient had a left nasal tip nodular basal cell carcinoma and was referred to Dr. Morganroth by her dermatologist for Mohs surgery to obtain the highest cure rate, minimal sacrifice of normal skin and best possible cosmetic outcome. The resultant skin defect was complicated in that it involved the nostril and nasal tip cosmetic units and extended to the nostril rim. As discussed in earlier case examples, great care must be taken to ensure that the reconstruction outcome is good and does not cause nasal distortion, asymmetry or negatively impact airflow though the nostril. Another consideration is the nasal tip is rounded and care must be taken to design a reconstruction that matches left side shape with the unaffected right nasal tip. Dr. Morganroth utilized a bilobed transposition flap under local anesthesia to allow for trapdooring or thickening of the nasal tip common with this flap technique to provide a round thickening that matched the round shape of the nasal tip on the contralateral side.
