The correct answer is B. Discuss flap staging.

This is a case of a retroauricular (eg, book) flap performed on this patient. The patient is likely unaware of the staging of this flap since it will require pedicle division at 3 weeks to return the ear to normal contours. Because the patient is expressing frustration, it is important to listen and discuss the procedure to aid the Mohs surgeon in improving patient education on this topic.

Aspiration is inappropriate, as the flap appears to be healing well. Dermabrasion is inappropriate at this time, especially considering the need for pedicle division. Education on squamous cell carcinoma could be useful, though given the patient’s frustration and need to discuss Mohs micrographic surgery, this may not be the most appropriate time for this course of action. Referral to plastic surgery is likely inappropriate since the patient should follow up with the original surgeon ideally after understanding the procedure better. Camouflage agents may be considered once the lesion has healed, though this is inappropriate at this time.

References: Cerci FB. Staged retroauricular flap for helical reconstruction after Mohs micrographic surgery. An Bras Dermatol. 2016;91(5 suppl 1):144-147. doi:10.1590/abd1806-4841.20164733