ABSTRACT
INTRODUCTION As our sophistication in skin cancer surgery has markedly improved with the advent of Mohs micrographic surgery, so has the demand for more esthetic reconstructive surgery. Prior to Mohs surgery, it was not uncommon for the surgeon to remove entire cosmetic subunits to assure complete tumor extirpation. This approach usually necessitated a larger or more complex reconstructive surgery. Mohs micrographic surgery has allowed for removal of the entire tumor, with the highest cure rate, while conserving the maximum amount of normal tissue. The tissue-sparing properties of Mohs micrographic surgery has markedly influenced how the surgeon approaches the reconstructive surgery. Not all nasal tip tumors require extensive grafting or forehead flaps to repair entire cosmetic units. Likewise, not all vermilion defects require mucosal advancement repairs. The advent of Mohs micrographic surgery has afforded the reconstructive surgeon to consider the entire spectrum of reconstructive options, with the added assurance of a tumor-free defect.
