Dr Nathan Schaefer

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Australia
Brisbane, QLD
Dr Nathan Schaefer

Queensland-trained Plastic and Reconstructive Surgeon specialising in skin cancer excision and reconstruction

04/03/2026

This patient had a BCC removed from beneath her nose. I reconstructed the defect using an A-T flap.

Top row: day of surgery
Bottom row: before and 12 months later

When the lesion sits below the nose but more lateral, I prefer an advancement/rotation-type flap so the scar can sit along the nasolabial fold (swipe right for an example 👉🏻).

📩 I recently wrote a newsletter about the challenges of upper lip reconstruction. Comment LIP and I’ll send it to you. You can also sign up via the link in my bio.

25/02/2026

This patient came to see me after having a skin cancer removed and reconstructed elsewhere. Unfortunately, that reconstruction later broke down, leaving a significant defect in the nose.

I rebuilt the area using a composite graft taken from the ear — including both skin and cartilage — and closed the donor site with a local transposition flap.

The opening photos show before surgery and seven weeks later.

👉🏻 Swipe right to see how it looked on the day of surgery.

If you enjoy surgical breakdowns like this, join my free weekly newsletter Skin School — link in bio.

10/02/2026

This patient had a BCC removed from the right lower eyelid. I reconstructed the defect using bilateral advancement flaps.

An alternative in this area is a laterally-based advancement flap, but this creates a long vertical scar on the lower eyelid (swipe right for an example 👉🏻).

Bilateral advancement flaps keep most of the scarring horizontal, matching the natural skin creases, and replace eyelid skin with eyelid skin for the best cosmetic result. A lateral advancement flap brings thicker cheek skin into the eyelid, so I reserve it for larger defects where bilateral flaps aren’t possible.

Top row: day of surgery
Bottom row: before and 14 months later

For more skin-cancer surgery tips and case breakdowns, join my free weekly newsletter Skin School — link in bio.

22/01/2026

This patient had two basal cell carcinomas.

👉🏻 The lesion next to the nose allowed me to hide the scar along the nasolabial fold.
👉🏻 The lesion near the eye required a full thickness skin graft.

In younger patients, I often use post-auricular skin as the donor site. It’s thin and similar to medial canthus skin. But the colour match is not ideal because it gets less sun exposure.

In older patients, I prefer upper eyelid skin. It’s the best match for colour and thickness, and the donor scar usually becomes very hard to see over time.

Top row: day of surgery
Bottom row: 10 months later

📩 I recently wrote a newsletter on the two most common reasons skin grafts fail. Comment GRAFT and I’ll send it to you. You can also sign up via the link in my bio.

16/01/2026

This young patient had a squamous cell carcinoma on his nasal dorsum.�After excision (shaded area), I reconstructed the defect with a V-Y advancement flap.

Top row: day of surgery
Bottom row: 17 months later

The other option I commonly use here is a bilobed flap. If a pre-existing scar along the nasal sidewall limits V-Y movement, I’ll use a bilobed flap instead.

For more skin-cancer surgery tips and case breakdowns, join my free weekly newsletter Skin School — link in bio.

09/01/2026

This young patient had a large keloid scar on her right ear. This developed after getting her ear pierced. It failed to respond to intralesional steroids. I excised the keloid scar and used a full thickness skin graft to reconstruct the area.

The AFTER photo was taken at fourteen months post-op.

If you want to learn more about skin surgery you can join my free email newsletter - link in bio.

30/12/2025

This patient had a basal cell carcinoma above her left eyebrow. After excision, I reconstructed the defect using bilateral advancement flaps.

Top row - day of surgery.
Bottom row - before and 14 months after surgery.

👉🏻 Swipe right to see how much skin was removed (shaded red).

This area is often reconstructed with an A–T flap, but I usually avoid it because it creates a long vertical forehead scar. The natural anatomy here runs horizontally - the eyebrow, forehead creases, and hairline. Bilateral advancement flaps allow the scars to follow these horizontal lines, where they’re better concealed, especially within existing forehead creases.

15/12/2025

This patient had a large basal cell carcinoma on the tip of her nose. After removing it, I reconstructed the defect with a V-Y advancement flap.

👉🏻 Swipe right to see how much skin was removed (shaded red).

Top row: day of surgery.
Bottom row: 14 months later.

When the defect is this large, it’s tempting to use a full thickness skin graft instead. But a local flap almost always gives a better cosmetic result.

08/12/2025

This patient had a melanoma removed from in front of her right ear. I reconstructed the area using bilateral advancement flaps.

I previously used cervicofacial flaps in this area (swipe right to see an example). They leave a long horizontal scar that extends onto the cheek. Bilateral advancement flaps create a much shorter scar that stays off the cheek, which makes it far less noticeable.

First photos: day of surgery.�Post-op: 12 months later.

If you want to learn more about skin cancer surgery and reconstruction, join my free email newsletter - link in bio.

12/11/2025

This patient had an aggressive BCC on his right ear. To ensure clear margins, I removed both the skin and the underlying cartilage. Reconstruction was done using an Antia-Buch flap.

👉🏻 Swipe right to see the amount of skin removed (shaded red).

Top row: day of surgery.
Bottom row: before and 12 months after.

📩 I recently wrote a newsletter article called My Colour-Coded Roadmap for Ear Reconstruction. Comment NEWSLETTER and I’ll send it to you. You can sign up to the newsletter via the link in my bio.

14/10/2025

This lovely patient had a basal cell carcinoma on her nasal rim removed with Mohs micrographic surgery. It was an aggressive cancer, so a significant portion of her nostril margin had to be removed to get clear margins.

For the reconstruction, I used a full thickness skin graft taken from her forehead. To recreate the natural contour of the nostril rim, the graft was wrapped around itself and secured to the nasal lining. As expected, the blood supply to this area was limited, resulting in a slightly pale graft. She is able to easily conceal this with some makeup.

Traditionally, this type of defect is reconstructed with a two-stage forehead flap. However, in selected cases like this one, a graft can achieve an excellent result while avoiding the morbidity and complexity of a staged procedure. It also reinforces just how versatile and reliable the forehead is as a donor site.

The top photos were taken on the day of surgery. The bottom photos were taken twelve months after surgery.

If you’re interested in learning more about skin cancer surgery and reconstruction techniques, sign up to my free email newsletter - the link is in my bio.

08/10/2025

Presenting my approach to reconstruction of complex nasal ala defects at the Australasian Skin Cancer Congress. I was pretty nervous when I was sitting down because I had split my pants getting out of my car that morning. Thankfully I think I managed to get through it without anyone seeing my junk.

Address

149 Wickham Terrace, Spring Hill
Brisbane, QLD
4000

Website

https://drnathanschaefer.com.au/

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