Cutaneous malignancies is a growing problem within every otolaryngology practice. The nose is the most common subsite and nasal reconstruction remains a particularly challenging procedure with high standards of aesthetics and normal nasal function. There are numerous nuances that have been borne out after many years of practice and this series will review the evolution of major nasal reconstruction with algorithms and case demonstrations. The goal will be to introduce specific tricks and pearls for reconstructive rhinoplasty that our participants can take home for immediate application. This session will cover different techniques for internal lining restoration, structural grafting in non-anatomic ways, and options for a reliable and aesthetic cover. There will be an emphasis on major subtotal defects requiring complex repairs, demonstrated through several video clips. Learning Objectives: 1.Recognize the need for prompt biopsy. 2. Understand general principles and an algorithm for repair of complex nasal defects. 3. Learn specific nuances for local flaps and the forehead flap that yield the most aesthetic results. Faculty: Catherine Meller, MD(Nothing to disclose), Stephen S. Park, MD(Nothing to disclose).