Case Study: Skin Cancer on Nose
Nose defects can be challenging to repair.
In this case study, the patient had a Mohs defect located to her nasal tip.
Here was my thought process on how I chose the best repair option for optimal results to help YOU more easily choose the best option for YOUR patients.
Last week, I went over 5 main considerations to be mindful of when choosing the best repair option. (Here is a LINK to it just in case you missed it). Well, here are the 5 things to ask yourself ~
- What anatomic location is the defect located at?
- What size is the defect?
- How much skin laxity does the surrounding tissue have?
- Where would be the best place to recruit skin if I don’t have enough laxity to close the defect?
- If recruitment needed and a flap needs to be performed, what kind of anatomic structures would be affected (Remember, we do not want any distortion or unwanted pulling)?
So considering these 5 things, I decided the best repair option would be a DORSAL NASAL FLAP for this Mohs nasal defect.
In the middle picture, you can see that once incisions were made, and the flap was undermined and lifted, the flap freely rotated into the defect achieving the following results:
- Reconstructed her nasal tip fullness
- Preserved symmetry of her nose
- Preserved patency (no occlusion to nasal cavity)
- Design of flap hid incisions well within her glabella lines, curvature of her nose, and alar creases
In the very right picture, you can see how the patient healed at her one week postoperative visit.
Next time you approach a defect, or need help deciding on what the best repair option for your patient is, remember those 5 considerations to ask yourself.
That should help guide you on picking the best repair option, and your patient will be pleased and happy.
Hope this helps!
All my BEST,
Theresa Talens DNP, FNP-C
P.U.L.S.E. Dermatology & Procedures, Inc.
Where we believe in Precision. Ultimate Care. Leverage. Skills. Excellence.
