title: Rationale and Argument for Subunit Mohs Excision in Nasal Reconstruction.
abstract: BACKGROUND
  Optimal aesthetic results are achieved when nasal defects after Mohs micrographic surgery (MMS) are reconstructed as entire nasal subunits.
  
  
  OBJECTIVE
  To illustrate the importance of reconstructing the nose in entire subunits and explore the possibilities of expanding the principles of subunit reconstruction to the concept of subunit Mohs excision.
  
  
  METHODS
  An 83-year-old man presented for MMS to excise 3 lesions on the nasal ala. The surgeons elected to excise and reconstruct the entire subunit.
  
  
  RESULTS
  Excellent aesthetic and functional results were obtained.
  
  
  CONCLUSIONS
  When a defect greater than 50% of a nasal subunit is encountered during MMS, immediate marginal control excision of the entire subunit can be performed with subsequent reconstruction. This technique ultimately has the potential to deliver a more aesthetically pleasing outcome and should be, at the very least, considered by all Mohs surgeons.
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Zachary R
authors.initials: ZR
authors.lastname: Jergensen
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA.
authors.forename: Ronnie A
authors.initials: RA
authors.lastname: Pezeshk
authors.affiliation: Department of Plastic Surgery, University of Texas Southwestern Medical Center, Dallas, TX, USA james.thornton@utsouthwestern.edu.
authors.forename: James F
authors.initials: JF
authors.lastname: Thornton
mesh_terms: D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000473:pathology / Q000601:surgery*; D006801:Humans; D008297:Male; D015580:Mohs Surgery / Q000379:methods*; D009669:Nose Neoplasms / Q000473:pathology / Q000601:surgery*; D012225:Rhinoplasty / Q000379:methods*; D012878:Skin Neoplasms / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps
keywords: Mohs surgery; cancer; nasal reconstruction; nasal subunits; subunit Mohs excision