Basal Cell Carcinoma of the Nose and Nasal Reconstruction

About Dr. Hootan Zandifar

Dr. Hootan Zandifar is board-certified in Otolaryngology and fellowship-trained in Facial Plastics and Reconstructive Surgery. Dr. Zandifar is the director of the Skin Center at the Osborne Head and Neck Institute based at Cedars-Sinai Medical Towers.

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About Dr. Ryan Osborne

Ryan F. Osborne, M.D. is the Director of Head and Neck Surgery at OHNI and is an internationally renowned expert in head and neck oncology. He has developed a special interest for the treatment of parotid gland tumors and focuses on the use of minimally-invasive techniques in the care of patients needing parotid surgery.

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I have a small bump on my nose. My doctor says it is basal cell carcinoma and I should have it removed. What should I expect to happen when I get it removed?

Case study 

A patient in his forties noted a growing bump on the side of his nose. The mass was biopsied and and found to be consistent with basal cell carcinoma. The patient underwent Mohs surgical excision of the mass and was left with a much larger defect than the originally visible cancer. He was referred to Dr. Zandifar for nasal reconstruction. A skin flap (advancement flap) was used to close the defect and 3 months after reconstruction the area is hardly noticeable.

Figure 1: Small lesion on the side of the nose noted.
Figure 1: Small lesion on the side of the nose noted.
Figure 2: The large defect after Mohs excision of the basal cell carcinoma of the nose.
Figure 2: The large defect after Mohs excision of the basal cell carcinoma of the nose.
Figure 3: Defect 3 months after reconstruction by Dr. Zandifar.
Figure 3: Defect 3 months after reconstruction by Dr. Zandifar.

Discussion

Skin cancer is the most common malignancy worldwide and basal cell carcinoma is the most prevalent type of skin cancer. Over eighty percent of skin cancers occur on the head and neck, most frequently on the nose. Although basal cell carcinomas typically do not metastasize (meaning they do not travel to other parts of the body), they can be very destructive locally. The initially visible bump is often only the tip of the iceberg. The lesion can often be present in a larger distribution beneath the surface of the skin.

As such, early treatment is the best approach to basal cell carcinoma. Surgical excision, with any acceptable method, usually has a very high cure rate. The reconstruction is, however, a different story especially for those cancers that involve the functional parts of the face. These parts include the eyelids, mouth, nose, eyebrows, and ears. It is important that these defects be repaired using appropriate techniques that preserve function, while being cosmetically acceptable. For this reason, someone well versed in functional as well as cosmetic aspects of the face should perform the reconstruction.

To learn more about Dr. Hootan Zandifar or basal cell carcinoma, please visit, www.ohniskin.com.