Reconstruction of Tip, Columella, and Ala Open image in new window
The patient was a 66-year-old female who was referred to the University of Michigan, Department of Dermatology. The patient noted a crusty growth on her nose for 7 months, and biopsy of this skin lesion showed a basal cell carcinoma. She initially was treated by a private practitioner using Mohs surgery; however, this procedure was discontinued due to persistent involvement of the surgical margins with neoplasm. The patient was healthy but admitted to smoking one-half pack of cigarettes per day and had done so for the past 50 years. Examination of the nose demonstrated a 2.5 × 1.5-cm full thickness defect of the right nasal tip (Fig. 28.1).