A Surgical Conundrum: Addressing a Large Nasal Defect Following Mohs Micrographic Surgery.

Area of Science:

• Dermatologic Surgery
• Plastic and Reconstructive Surgery

Background:

• Managing large nasal defects post-Mohs surgery requires balancing structural integrity, aesthetics, and vascular health.
• Primary closure is often impractical for extensive defects, necessitating advanced reconstructive techniques.

Observation:

• An 84-year-old male presented with a large nasal defect involving multiple aesthetic units after Mohs surgery for basal cell carcinoma.
• The defect's size and location complicated primary closure due to skin tension and cosmetic concerns.

Findings:

• The double rhomboid transposition flap was utilized for reconstruction, effectively addressing aesthetic and structural needs.
• This technique facilitated tissue continuity with appropriate texture, color, and thickness, minimizing tension and preserving symmetry.

Implications:

• The double rhomboid flap provides a versatile solution for complex nasal reconstructions following Mohs surgery.
• Tailored reconstructive strategies are crucial for achieving optimal cosmetic and functional outcomes in challenging nasal defects.