A 56 year-old-female presented with a large sclerotic (scar-like) basal cell carcinoma skin cancer on her left cheek that had been growing slowly as a firm whitish pink spot for several months (left photo, top). The deeply infiltrating cancer was completely removed in 3 stages using Mohs micrographic surgery (left photo, bottom). Facial plastic reconstructive surgery with a combined skin graft and skin flap was used to repair the large surgical wound the same day as Mohs surgery. Her scars were placed in her nasolabial and lower eyelid folds to hide the scar lines. Just 6 weeks after her procedure, she is healing well and her facial symmetry is preserved from both front and side views (right photos top and bottom).