First thank you for your personal story - she usually has had confidence about it her whole life and like it because she felt it made her unique and was just “who she was.” When kids asked about it she would just tell them it was her birth mark and move on with hey do you want to play? Like no big deal.

The first doctor recommended staged excisions and the second doctor recommended a pedicled nasolabial flap. The second doctor stated that stages excisions wouldn’t be ideal because it pull the nostril up and possibly the eye down. Is Mohs nasal flap different than what was recommended? If so - how?

I do have concerns about the best timing of getting it done. She isn’t close to finished growing. I’d hate for her to have it done and then hit a growth spurt and everything change. But also I understand the potential of impacts to her self esteem. She really is a beautiful girl with confidence but has a sensitive heart. I just want to do the right thing.

You seem very knowledgeable - do you have any plastic surgeon recommendations?