The nose is the most prominent feature on our faces, so it often will bear the brunt of this exposure. When skin cancers occur on the tip of the nose, removal can result in disfiguring scars. There are, however, ways of shifting tissue from the cheek to the nose that minimize scarring. The most important part of the operation, nevertheless, is to ensure that the entire cancer is removed. The most common skin cancer, a basal cell carcinoma, does not spread through the lymphatic system or via the blood vessels so I can send the removed specimen to the pathologist to microscopically verify that the entire tumor is out. I then pull forward a triangular section of skin that covers the defect resulting from the skin cancer removal. The scars left behind are well hidden in the naso-labial fold. The nose is minimally distorted, if at all.
Many older patients do not realize that they have an option for this kind of reconstruction and just accept wide, white, indented scars from procedures that burn or freeze the cancer and may take weeks or months to heal. I have been doing this operation for over twenty years and even presented a paper on it at an international meeting. Patients have been thrilled with the results and I would be happy to discuss the possibility of revising any such scars or planning an immediate reconstruction for anyone with an untreated skin cancer of the nose.