An 82-year-old native Californian presented with two rapidly growing pink growths on his right and left forehead (left photo, top). Both lesions were biopsied showing basal cell carcinoma skin cancers, and Mohs micrographic surgery was used to successfully treat both skin cancers on the same day (left photo, mid). Because both cancers spread aggressively beneath the skin resulting in larger surgical wounds, facial plastic reconstructive surgery was used to suture both gaps closed together (left photo, bottom). This was done under local anesthesia with the patient comfortable, but alert and awake. 6 weeks after his surgery, both wounds have healed well, scarring is minimized, and his forehead contour preserved.