Sometimes you have to get creative! The fun part about reconstruction is that every tumor and every defect is just a little bit different from anything you’ve ever seen before. You get to rely on your knowledge of anatomy, tissue movement, and a foundation of aesthetics to re-create something that is undetectable in both form and function. Here a large basal cell carcinoma of the lip was treated with Mohs micrographic surgery and reconstructed using an island pedicle flap based on a branch of the facial artery. This was all completed with one stage and one reconstruction.