This gentleman was referred to us after skin cancer excision for Mohs reconstruction. As you can see, he is missing the entire tip of his nose, and on profile view, there is a significant loss of the length of the nose as a result. Cartilage grafts taken from the ear were used to support the edges of the nostril to prevent displacement of the overlying skin with contraction of the scar as the tissues healed. A paramedian forehead flap was used to reconstruct skin and deeper soft tissues. You’ll note there is a faint vertical scar on the right side of the forehead. While the skin does not match the nasal skin exactly, it is generally the best option with a nose wound of this size there and yielded good overall contour. Our patient, a wood-carving artist, was extremely appreciative of his results. He is shown here roughly 3 months following his first stage procedure.