|
| Fig. 53.2 A, Preoperative basal cell carcinoma of the nasal tip. B, Defect of the nose following Mohs micrographic surgery. Paramedian forehead flap is designed. Note preservation of cartilaginous skeleton. C, Paramedian forehead flap is attached to reconstruct the nose. The forehead defect is closed. The pedicle is divided at 2 weeks. D, Long-term results. |
The precision of Mohs surgery allows for maximum preservation of normal tissue. However, the surgical defect created during Mohs surgery must be repaired in most cases. Some tumors can be allowed to heal in by themselves (second intention healing), but this should be limited to smaller, shallow defects on concave surfaces. The majority of Mohs defects will need to be reconstructed, using elliptical (primary) closures, flaps, or skin grafts (Fig. 53-2). Mohs surgeons, especially those who have completed fellowships, are well trained and experienced in aesthetic reconstruction.
