This 62 year-old woman was referred by her dermatologist for treatment of a basal cell carcinoma on the left nasal ala (wing of the nose). The patient lived in Santa Barbara and was looking forward to her daughter’s wedding in a few months. She originally considered having the surgery performed by a plastic surgeon, but at the recommendation of her doctor, she chose to have Dr. Kaufman perform the Mohs surgery and reconstruction.
The skin cancer was removed in a four-stage Mohs procedure, and the final surgical defect measured 2.1 x 1.1 cm. The defect involved the majority of the nasal ala and extended over the alar rim. It was obvious after removal of the cancer that the ala required structural support to successfully reconstruct the nose. A cartilage graft was taken from the left ear to provide structural support to the external nasal valve and nasal ala and a cheek-to-nose interpolation flap was utilized to reconstruct the nose. This type of flap provided coverage with tissue of similar color, texture and thickness and permitted hiding the donor incision line in a wrinkle on the cheek-lip border. The procedure went very well. The wound healed with excellent cosmetic and functional results. The patient was very happy with the results and was able to attend her daughter’s wedding and have family photographs taken without any concern.