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Much like judging a book by its cover, gauging the complexity of a defect solely on size often does not do it justice. In this case, after removal of a squamous cell carcinoma with Mohs micrographic surgery, this hole appears relatively small yet is in a very important anatomical location, not just for the way that it looks, but because of the way that it allows the nasal aperture to function and move air! I find that delineating all of the anatomy beforehand helps when decision-making time rolls around after tumor removal, and here you can see those decisions and reconstructive technique lead to an excellent outcome with perfectly maintained function that is incredibly inconspicuous.

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