Recurrent BCC is more difficult to cure than primary disease the results of all published series on the surgical excision of BCC show cure rates following treatment of recurrent disease that are inferior to those for primary lesions. Recurrent lesions generally require wider peripheral surgical margins than primary lesions with or without standard (non-Mohs) frozen section control. Risk factors for recurrence include size, site, histological subtype and surgical margins. The paramedian forehead flap is the workhorse flap for nasal reconstruction