Reconstruction of a Large Full-Thickness Nasal Defect

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An 87-year-old man presented with a 4.0- × 3.5-cm basal cell carcinoma of the nose involving the nasal dorsum, nasal tip, and columella. Tumor-free margins were achieved after 5 stages of Mohs micrographic surgery, leaving a 5.0- × 6.0-cm defect that included the nasal dorsum, the nasal tip, the columella, and both nasal sidewalls and alae. In addition, a 2.5- × 2.0-cm portion of the defect including the left ala and tip was full thickness (Figure 1).
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