Basal Cell Carcinoma: Nasal Bridge 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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What is the best reconstruction after Mohs surgery?

Basal cell carcinoma is the most common type of skin cancer afflicting close to a million patients a year. The head and neck region is a particularly common location for diagnosis of basal cell carcinoma. Within this region, the nose is one of the more frequently afflicted locations. This is likely due to the prominence of the nose on the face and its frequent exposure to sunlight.

Various techniques can be utilized by board-certified plastic and facial plastic surgeons to reconstruct the resulting defect of the nose after a Mohs surgeon or a dermatologist has removed a cancerous lesion. These techniques depend on the size and the location of the defect. When the defect involves the bridge of the nose, various minimally invasive reconstructive techniques can be utilized to close the defect with great cosmetic results.

It is important to note that successful reconstruction of facial skin defects requires a skilled and experienced surgeon. Extensive experience in facial plastic surgery as well as familiarity with modern methods and techniques are essential to obtain excellent cosmetic results. Patients have the option to have their Mohh’s facial defect reconstructed with whatever surgeon they would like. In addition, it is not uncommon to have skin cancer removed by a Mohs surgeon and the resulting defect reconstructed by an experienced facial plastic and reconstructive surgeon at a later time. 

Case Study

A 55-year-old male presents with basal cell carcinoma of the bridge of his nose. He undergoes Mohs surgical excision of this skin cancer with clear margins. A large defect is produced along the bridge of the nose and requires reconstruction.

Figure 1: Patient image depicting a defect on the bridge of the nose following Mohs surgery.
Figure 2: Patient image one week after facial reconstruction by Dr. Zandifar.


The patient presented to Dr. Zandifar for this reconstruction. A local advancement flap was utilized to close the defect with excellent cosmetic results. One week after surgery the patient’s scar is minimally visible.