This patient sought Mohs surgery for a nostril basal cell carcinoma by a board-certified Mohs surgeon after his dermatologist suggested electrodessication and curettage (ED&C) and his own research indicated that Mohs surgery offers a higher cure rate. He saw two other Mohs surgeons who recommended a full thickness skin graft or a transposition flap to repair the expected defect due to the expected size of the defect following Mohs surgery. He sought Dr. Morganroth for a third opinion. Dr. Morganroth agreed with Mohs surgery for the highest cure rate and recommended a bespoke flap that Dr. Morganroth invented in his first year of practice that provides more consistent and better cosmetic outcome than a full thickness skin graft (a superior skin color and texture match) and a transposition flap (the transposition flap violated the cosmetic unit of the nostril and often blunts the crease that borders the nostril and nasal sidewall). Please see Cases 1, 2 and 4 for other examples of this repair and the history of Dr. Morganroth’s innovative flap for the nostril cosmetic unit.
