Repair of a Large Defect Involving the Nose, Cheek, and Upper Cutaneous Lip.

A78-year-old undomiciledCaucasianmanpresented for treatment of a 2.8 · 2.8-cm infiltrative basal cell carcinoma involving the right nose, cheek, and upper cutaneous lip (Figure 1). Because of the size, histologic subtype, and location, the lesion was treated withMohs micrographic surgery. Tumor-free margins were established after 2 stages of Mohs surgery resulting in a 4.0 · 4.0-cm multisubunit defect of the nose, cheek, and upper cutaneous lip.Ofnote, thepatientalsohadahealing 7.0 · 6.5-cmwound on the right frontal scalp afterMohs surgery for another basal cell carcinoma treated 3 weeks prior.Howwouldyou reconstruct thenosedefect (Figure2)?

[1]  J. McGowan,et al.  Two Suturing Techniques for the Prevention and Treatment of Nasal Valve Collapse After Mohs Micrographic Surgery , 2017, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[2]  J. Carucci,et al.  An Inferiorly Based Rotation Flap for Defects Involving the Lower Eyelid and Medial Cheek , 2015, Facial Plastic Surgery.

[3]  D. Ratner,et al.  Modified Flap Design for Symmetric Reconstruction of the Apical Triangle of the Upper Lip , 2012, Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].

[4]  M. Mureau,et al.  Maximizing results in reconstruction of cheek defects. , 2009, Clinics in plastic surgery.

[5]  F. Menick.  Defects of the Nose, Lip, and Cheek: Rebuilding the Composite Defect , 2007, Plastic and reconstructive surgery.